ABSTRACT
Introduction: The health context with COVID-19 pandemic has led to fast development of many vaccines against the SarS-Cov-2 virus. Four of them are currently available in France and contain polyethylene glycol (PEG) or polysorbate 80 as excipients, already described as causing anaphylaxis. French recommendations have been suggested by allergology authorities and proposed a course of action in the event of a suspected allergy to these vaccines. Thus, allergies to excipients were the only contraindication to COVID-19 vaccination. Our main objective was to determine the impact of these allergology vaccine recommendations on the management of these patients. Our secondary objective was to determine prevalence of true allergies to these vaccines. Materials and methods: We conducted a unicentric descriptive retrospective study with all patients over 18 years of age referred for an allergological opinion before or after an injection of one of the anti-COVID-19 vaccines. Nineteen patients were classified into different interest groups, based on french recommendations. Results: The vast majority of patients did not require a pre-vaccination allergological assessment. Indeed, only 25 patients received skin tests prior to vaccination. The rest of patients were able to be vaccinated without allergological assessment. Patients not vaccinated due to allergy to excipients represent less than 1% of the population (n = 3/320). Conclusion: French recommendations made it possible to vaccinate the vast majority of patients included in our study. Allergy to PEG, polysorbate or their derivatives, the only contraindication to anti-COVID vaccination, according to the recommendations of February 2021, remains rare. Today, several authors propose tolerance inductions allowing the vaccination of patients allergic to PEGs or their derivatives with good tolerance.
ABSTRACT
Déclaration de liens d’intérêts: Les auteurs n’ont pas précisé leurs éventuels liens d’intérêts.
ABSTRACT
Background: Atopic Dermatitis (AD) can result in intolerable symptoms, psychological hardships, and stigmatization that affect patient quality of life. Allergic comorbidities may be overlooked by both healthcare providers and patients;emphasizing the importance of allergist referral. The Atopic Dermatitis Quality of Care (ADQoC) Initiative seeks to demonstrate the global imperative for quality AD care, by identifying primary challenges and reporting good practice intervention solutions. The COVID-19 pandemic highlights the positive impact of eHealth in the delivery of care, including allergy care, as a potential good practice intervention for AD. Method: A literature review was conducted to establish a foundation of challenges to AD care. In-depth site visits, performed at thirty-two select international centers, documented challenges to, and examples of, leading AD care. Results: eHealth is a reported good practice intervention to the challenges in AD care including allergy complications. eHealth, along with mHealth and teleHealth, provide opportunities to improve the quality and efficiency of AD care. eHealth provides greater access to care, specifically to patients who otherwise may not be able to access it due to obstacles such as travel distance or financial difficulties. eHealth also benefits dermatologists, allergists, and other AD care providers who can collaborate more easily due to the readily available resources within eHealth platforms. TeleHealth and information sharing through eHealth allows patients to benefit from care afforded by centers that incorporate multi-disciplinary care teams and patient education. Some centers use local databases and patient registries to restructure patient assessment and improve care delivery. Smartphone applications such as Zalf (UMC, Utrecht) and Virtual Nurse (McGill UHC) are designed to improve assessment, care delivery, AD outcomes, and education. Mobile imaging can also improve AD assessment and speed treatment. Conclusion: eHealth, mHealth, and teleHealth may be good practice interventions that improve AD assessment, better manage allergic complications, and provide better outcomes. The efficiency and convenience of eHealth delivers quicker service, reduces patient burden and simultaneously lessens time demands of healthcare providers. Such systems may be particularly useful during social distancing and additional demands on health care providers during COVID-19.