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: 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].