Allergy and COVID Vaccines

We have been experiencing more allergic reactions to vaccines during the recent pandemic. Severe allergic reactions to vaccines are rare and difficult to predict. It might be defined as an idiosyncratic reaction caused by an immunologic mechanism. Regarding the World Allergy Organization (WAO) recommendation, immunologic reactions to drugs are categorized based upon the timing of the appearance of symptoms. This system defines two general types of reactions: immediate and delayed. Recently COVID vaccines are broadly applied worldwide. The CDC has provided the following differentiation: (1) contraindication: persons with a known (diagnosed) allergy to PEG, polysorbate, or another component of a COVID-19 vaccine or who have experienced a severe allergic reaction (e.g., anaphylaxis) after a previous COVID-19 vaccine dose have a contraindication to vaccination;(2) precaution: persons with an immediate allergic reaction to other (non-COVID-19) vaccines or injectable therapies OR a non-severe immediate allergic reaction (onset < 4 hours) after a previous dose of COVID-19 vaccine fall into this category. May proceed with COVID-19 vaccine: (1) persons with a history of food, pet, insect, venom, environmental, oral medication (including the oral equivalent of an injectable medication) or latex allergies;or (2) a family history of allergies. Other reactions like vaccineinduced immune thrombotic thrombocytopenia (VITT) or thrombosis-thrombocytopenia syndrome (TTS) have been reported with adenoviral vector covid-19 vaccines. Myocarditis/pericarditis and Guillain-Barre Syndrome are also reported with COVID vaccines. Results of safety monitoring from VAERS and V-safe after one month of vaccinations show that over 90% of reactions were nonserious. Anaphylaxis rates (4.5 per million doses) remain in the range of other vaccines. The female gender may be a risk factor for adverse reactions and anaphylaxis. To sum up, COVID vaccines are very safe, and severe allergic reactions are exceedingly rare.

COVID-19 and Influenza: Differences, Similarities, and Coinfection

Context: COVID-19 and influenza coinfection may increase mortality and morbidity during the COVID-19 pandemic. Recognizing the differences and similarities between COVID-19 and influenza helps us diagnose and treat these 2 diseases. Accordingly, we aimed to compare virologic, clinical, paraclinical, and radiological features and prophylactic and therapeutic management of SARS-CoV-2 and influenza infections. We also provided an algorithmic approach to the diagnosis and treatment of SARS-CoV-2 and influenza coinfection in children. Evidence Acquisition: Electronic databases, including Cochrane Collaboration, PubMed, Google Scholar, and EMBASE, were searched for the articles published in English language using the following keywords: “influenza virus,” “SARS-CoV-2 virus,” “COVID-19,” “comparison,” “coinfection,” “management,” “treatment,” “antiviral therapy,” “vaccines,” “children,” and “adults.” Boolean op-erations (AND and OR) were used to refine the search. No date limitation was applied. Results: SARS-CoV-2 and influenza are both RNA viruses with different receptors. The reproductive rate of SARS-CoV-2 is higher than influenza. Patients with SARS-CoV-2 infection, particularly adults, have higher rates of anosmia/ageusia. Organ involvement occurs more frequently in COVID-19 cases, and multisystem inflammatory syndrome in children (MIS-C) occurs especially in children. Disease severity, excessive immune response, and mortality are higher in SARS-CoV-2. Radiological peripheral lesions and ground-glass appearance are characteristic of COVID-19 infection. It is important to rule out influenza and SARS-CoV-2 infection in patients with respiratory problems during the pandemic. Timely prescription of currently available antiviral drugs is essential. Conclusions: Treatment of patients suspected of having a coinfection is determined by the patient’s condition and polymerase chain reaction (PCR) evaluation.