Polythylene glycol severe allergy and SARS-CoV-2 vaccines: usefulness of testing with PEG 1500 extract.
Eur Ann Allergy Clin Immunol
; 2022 Dec 02.
Article
in English
| MEDLINE | ID: covidwho-2156034
ABSTRACT
Summary:
Background. Polyethylene glycol (PEG) is being used for first time as an excipient for mRNA anti-SARS-CoV-2 vaccines containing-PEG2000, highlighting it as a potential cause of anaphylaxis. Objective. To assess the usefulness of skin tests using PEG1500 extract in patients with suspected allergy to SARS-CoV-2 vaccines. Methods. We evaluated 126 patients with moderate-high risk of allergy to SARS-CoV-2 vaccines referred to our department from March-December 2021. Skin tests were performed with PEG1500 extract (Roxall), using a stepwise approach, with readings at 30 minutes prick tests with 0.1%, 1% and 10% concentrations; if negative, intradermal tests with 0.0001%, 0.001% and 0.01% concentrations. The same protocol was applied to 5 healthy controls. Results. Six patients had positive immediate intradermal tests with PEG1500, all with severe PEG allergy one with a near-fatal anaphylaxis after glucocorticoid injection containing-PEG3350 and five with systemic allergic reactions after mRNA vaccines containing-PEG2000 (Pfizer-BioNTech or Moderna). One patient developed anaphylaxis during intradermal test. These six patients were negative to polysorbate 80. The remaining 120 patients had negative tests to PEG1500; seven had positive tests to polysorbate 80. All controls had negative tests. Conclusions. To our knowledge this is the first study describing the allergy work-up testing with PEG1500 commercial extract in the scope of SARS-CoV-2 vaccination. The algorithm designed for skin tests revealed to be a useful tool. Severe PEG allergy was diagnosed in 5% of patients, contraindicating PEG-containing vaccines. PEG allergy was excluded in one hundred patients that afterwards took SARS-CoV-2 vaccines containing-PEG2000. Investigation should be conducted in specialized drug allergy centres.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Prognostic study
Topics:
Vaccines
Language:
English
Journal subject:
Allergy and Immunology
Year:
2022
Document Type:
Article
Affiliation country:
EurAnnACI.1764-1489.275
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