ABSTRACT
Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets.Copyright © 2023
ABSTRACT
Introduction: Polyethylene glycol (PEG) is one of the ingredients in the Pfizer/BioNTech COVID 19 vaccine (mRNA vaccine) and has been known to cause hypersensitivity [1-3]. Polysorbate is an ingredient in the Johnson vaccine (adenovirus vaccine) which may crossreact with PEG. Objective(s): We report a case of cross-reactivity between Pfizer/ BioNTech and Johnsson vaccines. Method(s): This observation was notified in the pharmacovigilance center of Sfax, Tunisia (faculty of medicine of Sfax). The study of drug imputability was carried out according to the WHO method. Result(s): We report the case of a 32-year-old Tunisian woman with a history of atopy and intolerance to non-steroidal anti-inflammatory drugs (NSAIDs) but no history of SARS-CoV-2 infection. On August 15, 2021 (at 08:30), she developed sweating, vomiting and dizziness immediately after receiving the initial dose of Johnson COVID-19 vaccine. Her blood pressure became lower (less than 90/60 mmHg). She had to stay at the vaccination centre for one hour, and the clinical signs improved spontaneously after one hour. In the evening of the same day, the patient presented a febrile maculopapular eruption in the abdomen, trunk, and face. The rash resolved spontaneously over a week. The patient was referred to the pharmacovigilance center of Sfax (Tunisia). The messenger RNA vaccine was advocated for the second vaccine. On December 2021, she was received the second dose of the Pfizer/BioNTech COVID 19 vaccine (mRNA vaccine). Six hours later, she experienced a pruritic maculopapular rash on the abdomen, trunk, neck, and face. These clinical signs improved spontaneously after two days. the diagnosis of cross-allergy between these two vaccines was retained for this patient Conclusion(s): To our knowledge, this is the first cross-allergy between mRNA and adenovirus COVID-19 vaccines notified in Tunisian population. Healthcare professionals should be aware that hypersensitivity can occur with COVID-19 vaccines containing macrogols/ PEGs and those containing polysorbates. Its recognition may be challenging and often require skin testing. Per CDC guidance, consultation with an allergist-pharmacologist should be considered to help determine if the patient can safely receive vaccination [4].
ABSTRACT
Introduction: Several post-vaccination adverse events (AEFI) have been reported after anti-COVID 19 vaccine SPIKEVAX administration. By the way, we can mention cutaneous manifestations (1). Objective(s): We report 2 cases of women who presented ecchymotic skin plaques after vaccination with SPIKEVAX notified in the Regional Pharmacovigilance Service of Sfax. Method(s): The assessment of the causal link was made according to the method of the World Health Organization. Result(s): Two women, with no previous medical history, presented ecchymotic skin patches after SPIKEVAX-(Moderna) vaccination. Platelet and D-dimer levels were normal in both cases. But an immunological assessment was not requested. The first woman was 33 years old. She presented 2 days after the first dose of the vaccine generalized ecchymotic plaques which measured 7 cm of diameter and was located on the right flank. These plaques persisted for one month before disappearing. The second woman was 26 years old, she presented 20 days after the second dose of the vaccine, 3 ecchymotic plaques on one thigh followed. Two days later, another plaque was appeared on the other thigh. These lesions were associated with myalgias in the lower limbs and headaches and disappears after 2 months. A probable causal link was established in these patients. Conclusion(s): The ecchymotic plaques in our patients may suggest vascular involvement particularly a vasculitis. Few cases have been reported with anti-COVID 19 vaccination (1).
ABSTRACT
Introduction: Polyethylene glycol (PEG) is one of the ingredients in the Pfizer/BioNTech COVID 19 vaccine (mRNA vaccine) and has been known to cause hypersensitivity [1-3]. Polysorbate is an ingredient in the Johnson vaccine (adenovirus vaccine) which may crossreact with PEG. Objective: We report a case of cross-reactivity between Pfizer/ BioNTech and Johnsson vaccines. Methods: This observation was notified in the pharmacovigilance center of Sfax, Tunisia (faculty of medicine of Sfax). The study of drug imputability was carried out according to the WHO method. Results: We report the case of a 32-year-old Tunisian woman with a history of atopy and intolerance to non-steroidal anti-inflammatory drugs (NSAIDs) but no history of SARS-CoV-2 infection. On August 15, 2021 (at 08:30), she developed sweating, vomiting and dizziness immediately after receiving the initial dose of Johnson COVID-19 vaccine. Her blood pressure became lower (less than 90/60 mmHg). She had to stay at the vaccination centre for one hour, and the clinical signs improved spontaneously after one hour. In the evening of the same day, the patient presented a febrile maculopapular eruption in the abdomen, trunk, and face. The rash resolved spontaneously over a week. The patient was referred to the pharma-covigilance center of Sfax (Tunisia). The messenger RNA vaccine was advocated for the second vaccine. On December 2021, she was received the second dose of the Pfizer/BioNTech COVID 19 vaccine (mRNA vaccine). Six hours later, she experienced a pruritic maculopapular rash on the abdomen, trunk, neck, and face. These clinical signs improved spontaneously after two days. the diagnosis of cross-allergy between these two vaccines was retained for this patient Conclusion: To our knowledge, this is the first cross-allergy between mRNA and adenovirus COVID-19 vaccines notified in Tunisian population. Healthcare professionals should be aware that hypersen-sitivity can occur with COVID-19 vaccines containing macrogols/ PEGs and those containing polysorbates. Its recognition may be challenging and often require skin testing. Per CDC guidance, con-sultation with an allergist-pharmacologist should be considered to help determine if the patient can safely receive vaccination [4].
ABSTRACT
Introduction: Several post-vaccination adverse events (AEFI) have been reported after anti-COVID 19 vaccine SPIKEVAX® administration. By the way, we can mention cutaneous manifestations (1). Objective: We report 2 cases of women who presented ecchymotic skin plaques after vaccination with SPIKEVAX® notified in the Regional Pharmacovigilance Service of Sfax. Methods: The assessment of the causal link was made according to the method of the World Health Organization. Results: Two women, with no previous medical history, presented ecchymotic skin patches after SPIKEVAX®(Moderna) vaccination. Platelet and D-dimer levels were normal in both cases. But an immunological assessment was not requested. The first woman was 33 years old. She presented 2 days after the first dose of the vaccine generalized ecchymotic plaques which measured 7 cm of diameter and was located on the right flank. These plaques persisted for one month before disappearing. The second woman was 26 years old, she presented 20 days after the second dose of the vaccine, 3 ecchymotic plaques on one thigh followed. Two days later, another plaque was appeared on the other thigh. These lesions were associated with myalgias in the lower limbs and headaches and disappears after 2 months. A probable causal link was established in these patients. Conclusion: The ecchymotic plaques in our patients may suggest vascular involvement particularly a vasculitis. Few cases have been reported with anti-COVID 19 vaccination (1).