Polythylene glycol severe allergy and SARS-CoV-2 vaccines

Detalhes bibliográficos
Autor(a) principal: Gaspar, A
Data de Publicação: 2023
Outros Autores: Moura, A L, Cruz, C, Borrego, L M
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/150347
Resumo: Background. Polyethylene glycol (PEG) is being used for first time as an excipient for mRNA anti-SARS-CoV-2 vaccines containing-PEG2000, highlighting it as a potential cause of anaphylaxis. Objective. To assess the usefulness of skin tests using PEG1500 extract in patients with suspected allergy to SARS-CoV-2 vaccines. Methods. We evaluated 126 patients with moderate-high risk of allergy to SARS-CoV-2 vaccines referred to our department from March-December 2021. Skin tests were performed with PEG1500 extract (Roxall), using a stepwise approach, with readings at 30 minutes: prick tests with 0.1%, 1% and 10% concentrations; if negative, intradermal tests with 0.0001%, 0.001% and 0.01% concentrations. The same protocol was applied to 5 healthy controls. Results. Six patients had positive immediate intradermal tests with PEG1500, all with severe PEG allergy: one with a near-fatal anaphylaxis after glucocorticoid injection containing-PEG3350 and five with systemic allergic reactions after mRNA vaccines containing-PEG2000 (Pfizer-BioNTech or Moderna). One patient developed anaphylaxis during intradermal test. These six patients were negative to polysorbate 80. The remaining 120 patients had negative tests to PEG1500; seven had positive tests to polysorbate 80. All controls had negative tests. Conclusions. To our knowledge this is the first study describing the allergy work-up testing with PEG1500 commercial extract in the scope of SARS-CoV-2 vaccination. The algorithm designed for skin tests revealed to be a useful tool. Severe PEG allergy was diagnosed in 5% of patients, contraindicating PEG-containing vaccines. PEG allergy was excluded in one hundred patients that afterwards took SARS-CoV-2 vaccines containing-PEG2000. Investigation should be conducted in specialized drug allergy centres.
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spelling Polythylene glycol severe allergy and SARS-CoV-2 vaccinesusefulness of testing with PEG 1500 extractAnaphylaxisCOVID-19vaccinedrug allergyPEG allergyskin testingSDG 3 - Good Health and Well-beingBackground. Polyethylene glycol (PEG) is being used for first time as an excipient for mRNA anti-SARS-CoV-2 vaccines containing-PEG2000, highlighting it as a potential cause of anaphylaxis. Objective. To assess the usefulness of skin tests using PEG1500 extract in patients with suspected allergy to SARS-CoV-2 vaccines. Methods. We evaluated 126 patients with moderate-high risk of allergy to SARS-CoV-2 vaccines referred to our department from March-December 2021. Skin tests were performed with PEG1500 extract (Roxall), using a stepwise approach, with readings at 30 minutes: prick tests with 0.1%, 1% and 10% concentrations; if negative, intradermal tests with 0.0001%, 0.001% and 0.01% concentrations. The same protocol was applied to 5 healthy controls. Results. Six patients had positive immediate intradermal tests with PEG1500, all with severe PEG allergy: one with a near-fatal anaphylaxis after glucocorticoid injection containing-PEG3350 and five with systemic allergic reactions after mRNA vaccines containing-PEG2000 (Pfizer-BioNTech or Moderna). One patient developed anaphylaxis during intradermal test. These six patients were negative to polysorbate 80. The remaining 120 patients had negative tests to PEG1500; seven had positive tests to polysorbate 80. All controls had negative tests. Conclusions. To our knowledge this is the first study describing the allergy work-up testing with PEG1500 commercial extract in the scope of SARS-CoV-2 vaccination. The algorithm designed for skin tests revealed to be a useful tool. Severe PEG allergy was diagnosed in 5% of patients, contraindicating PEG-containing vaccines. PEG allergy was excluded in one hundred patients that afterwards took SARS-CoV-2 vaccines containing-PEG2000. Investigation should be conducted in specialized drug allergy centres.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Comprehensive Health Research Centre (CHRC) - pólo NMSRUNGaspar, AMoura, A LCruz, CBorrego, L M2023-03-10T22:52:38Z2023-112023-11-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttp://hdl.handle.net/10362/150347eng1764-1489PURE: 54674623https://doi.org/10.23822/EurAnnACI.1764-1489.275info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:32:18Zoai:run.unl.pt:10362/150347Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:54:03.762454Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Polythylene glycol severe allergy and SARS-CoV-2 vaccines
usefulness of testing with PEG 1500 extract
title Polythylene glycol severe allergy and SARS-CoV-2 vaccines
spellingShingle Polythylene glycol severe allergy and SARS-CoV-2 vaccines
Gaspar, A
Anaphylaxis
COVID-19
vaccine
drug allergy
PEG allergy
skin testing
SDG 3 - Good Health and Well-being
title_short Polythylene glycol severe allergy and SARS-CoV-2 vaccines
title_full Polythylene glycol severe allergy and SARS-CoV-2 vaccines
title_fullStr Polythylene glycol severe allergy and SARS-CoV-2 vaccines
title_full_unstemmed Polythylene glycol severe allergy and SARS-CoV-2 vaccines
title_sort Polythylene glycol severe allergy and SARS-CoV-2 vaccines
author Gaspar, A
author_facet Gaspar, A
Moura, A L
Cruz, C
Borrego, L M
author_role author
author2 Moura, A L
Cruz, C
Borrego, L M
author2_role author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
Comprehensive Health Research Centre (CHRC) - pólo NMS
RUN
dc.contributor.author.fl_str_mv Gaspar, A
Moura, A L
Cruz, C
Borrego, L M
dc.subject.por.fl_str_mv Anaphylaxis
COVID-19
vaccine
drug allergy
PEG allergy
skin testing
SDG 3 - Good Health and Well-being
topic Anaphylaxis
COVID-19
vaccine
drug allergy
PEG allergy
skin testing
SDG 3 - Good Health and Well-being
description Background. Polyethylene glycol (PEG) is being used for first time as an excipient for mRNA anti-SARS-CoV-2 vaccines containing-PEG2000, highlighting it as a potential cause of anaphylaxis. Objective. To assess the usefulness of skin tests using PEG1500 extract in patients with suspected allergy to SARS-CoV-2 vaccines. Methods. We evaluated 126 patients with moderate-high risk of allergy to SARS-CoV-2 vaccines referred to our department from March-December 2021. Skin tests were performed with PEG1500 extract (Roxall), using a stepwise approach, with readings at 30 minutes: prick tests with 0.1%, 1% and 10% concentrations; if negative, intradermal tests with 0.0001%, 0.001% and 0.01% concentrations. The same protocol was applied to 5 healthy controls. Results. Six patients had positive immediate intradermal tests with PEG1500, all with severe PEG allergy: one with a near-fatal anaphylaxis after glucocorticoid injection containing-PEG3350 and five with systemic allergic reactions after mRNA vaccines containing-PEG2000 (Pfizer-BioNTech or Moderna). One patient developed anaphylaxis during intradermal test. These six patients were negative to polysorbate 80. The remaining 120 patients had negative tests to PEG1500; seven had positive tests to polysorbate 80. All controls had negative tests. Conclusions. To our knowledge this is the first study describing the allergy work-up testing with PEG1500 commercial extract in the scope of SARS-CoV-2 vaccination. The algorithm designed for skin tests revealed to be a useful tool. Severe PEG allergy was diagnosed in 5% of patients, contraindicating PEG-containing vaccines. PEG allergy was excluded in one hundred patients that afterwards took SARS-CoV-2 vaccines containing-PEG2000. Investigation should be conducted in specialized drug allergy centres.
publishDate 2023
dc.date.none.fl_str_mv 2023-03-10T22:52:38Z
2023-11
2023-11-01T00:00:00Z
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url http://hdl.handle.net/10362/150347
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1764-1489
PURE: 54674623
https://doi.org/10.23822/EurAnnACI.1764-1489.275
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