Your browser doesn't support javascript.
Utility and futility of skin testing to address concerns surrounding messenger RNA coronavirus disease 2019 vaccine reactions.
Pitlick, Mitchell M; Sitek, Andrea N; D'Netto, Michael E; Dages, Kelley N; Chiarella, Sergio E; Gonzalez-Estrada, Alexei; Joshi, Avni Y; Park, Miguel A.
  • Pitlick MM; Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: Pitlick.mitchell@mayo.edu.
  • Sitek AN; Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota.
  • D'Netto ME; Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota.
  • Dages KN; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
  • Chiarella SE; Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota.
  • Gonzalez-Estrada A; Division of Pulmonary, Allergy, and Sleep Medicine, Mayo Clinic, Jacksonville, Florida.
  • Joshi AY; Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota.
  • Park MA; Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota.
Ann Allergy Asthma Immunol ; 128(2): 153-160, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1597012
ABSTRACT

BACKGROUND:

The mechanism of coronavirus disease 2019 (COVID-19) vaccine hypersensitivity reactions is unknown. COVID-19 vaccine excipient skin testing has been used in evaluation of these reactions, but its utility in predicting subsequent COVID-19 vaccine tolerance is also unknown.

OBJECTIVE:

To evaluate the utility of COVID-19 vaccine and vaccine excipient skin testing in both patients with an allergic reaction to their first messenger RNA COVID-19 vaccine dose and patients with a history of polyethylene glycol allergy who have not yet received a COVID-19 vaccine dose.

METHODS:

In this multicenter, retrospective review, COVID-19 vaccine and vaccine excipient skin testing was performed in patients referred to 1 of 3 large tertiary academic institutions. Patient medical records were reviewed after skin testing to determine subsequent COVID-19 vaccine tolerance.

RESULTS:

A total of 129 patients underwent skin testing, in whom 12 patients (9.3%) had positive results. There were 101 patients who received a COVID-19 vaccine after the skin testing, which was tolerated in 90 patients (89.1%) with no allergic symptoms, including 5 of 6 patients with positive skin testing results who received a COVID-19 vaccine after the skin testing. The remaining 11 patients experienced minor allergic symptoms after COVID-19 vaccination, none of whom required treatment beyond antihistamines.

CONCLUSION:

The low positivity rate of COVID-19 vaccine excipient skin testing and high rate of subsequent COVID-19 vaccine tolerance suggest a low utility of this method in evaluation of COVID-19 vaccine hypersensitivity reactions. Focus should shift to the use of existing vaccine allergy practice parameters, with consideration of graded dosing when necessary. On the basis of these results, strict avoidance of subsequent COVID-19 vaccination should be discouraged.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Skin Tests / COVID-19 Vaccines / COVID-19 / Hypersensitivity Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Ann Allergy Asthma Immunol Journal subject: Allergy and Immunology Year: 2022 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Skin Tests / COVID-19 Vaccines / COVID-19 / Hypersensitivity Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Ann Allergy Asthma Immunol Journal subject: Allergy and Immunology Year: 2022 Document Type: Article