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COVID vaccination can be performed in patients with a history of allergic reactions to the vaccines or their components: experience from a specialist clinic in South Australia.
Tunbridge, Matthew; Perkins, Griffith; Lee, Maverick; Salehi, Tania; Ryoo, Dongjae; Kette, Frank; Smith, William; Gold, Michael; Le, Thanh-Thao Adriana; Yuson, Chino; Hissaria, Pravin.
  • Tunbridge M; Immunology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  • Perkins G; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
  • Lee M; University of Adelaide, Adelaide, South Australia, Australia.
  • Salehi T; SA Pathology, Adelaide, South Australia, Australia.
  • Ryoo D; Immunology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  • Kette F; Immunology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  • Smith W; University of Adelaide, Adelaide, South Australia, Australia.
  • Gold M; Immunology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  • Le TA; Immunology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  • Yuson C; Immunology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  • Hissaria P; Women's and Children's Hospital, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Intern Med J ; 52(11): 1884-1890, 2022 11.
Article in English | MEDLINE | ID: covidwho-1978479
ABSTRACT

BACKGROUND:

The development of vaccines against SARS-CoV2 has been a key public health response to the COVID-19 pandemic. However, since their introduction, there have been reports of anaphylactic reactions to vaccines in individuals with history of allergic reactions to other vaccines, excipients or to COVID vaccines.

AIM:

A dedicated adult COVID vaccine allergy clinic with a standardised allergy testing protocol was set up to investigate safety and suitability of available COVID vaccines in Australia.

METHODS:

Patients referred to a state-wide COVID-19 vaccine allergy clinic between March and August 2021 with a history of allergy underwent skin-prick testing and intradermal testing to both available vaccine formulations (BNT162b2 and ChAdOx1-S), excipients (polyethylene glycol and polysorbate 80), excipient-containing medications and controls. Basophil activation testing was conducted in few subjects with convincing history of immediate type reactions.

RESULTS:

Fifty-three patients underwent testing for possible excipient allergy (n = 19), previous non-COVID vaccine reaction (n = 13) or previous reaction to dose 1 of COVID-19 vaccine (n = 21). Patients were predominantly female (n = 43, 81%), aged 18-83 (median 54) years. Forty-four patients tested negative and 42 of these received at least their first dose of a COVID-19 vaccine. Nine patients tested positive to excipients or excipient-containing medication only (n = 3), or vaccines (n = 6). Five patients were positive to just BNT162b2, 3/5 have been vaccinated with ChAdOx1-S. One who was skin test positive to both vaccines, but negative BAT to ChAdOx1-S was successfully vaccinated with ChAdOx1-S.

CONCLUSION:

Even in a high-risk population, most patients can be vaccinated with available COVID-19 vaccines. This paper reports local experiences using a combined allergy testing protocol with skin testing and BAT during the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 / Anaphylaxis Type of study: Observational study / Prognostic study / Qualitative research Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Oceania Language: English Journal: Intern Med J Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: Imj.15888

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 / Anaphylaxis Type of study: Observational study / Prognostic study / Qualitative research Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Oceania Language: English Journal: Intern Med J Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: Imj.15888