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Fitzpatrick T, Yamoah P, Lacuesta G, Sadarangani M, Cook V, Pourshahnazari P, Kalicinsky C, Upton JEM, Cameron SB, Zaborniak K, Kanani A, Lam G, Burton C, Constantinescu C, Pernica JM, Abdurrahman Z, Betschel S, Drolet JP, De Serres G, Quach C, Des Roches A, Chapdelaine H, Salvadori MI, Carignan A, McConnell A, Pham-Huy A, Buchan CA, Cowan J, Hildebrand K, Top KA. Revaccination outcomes among adolescents and adults with suspected hypersensitivity reactions following COVID-19 vaccination: A Canadian immunization research network study. Vaccine 2024; 42:126078. [PMID: 38910092 DOI: 10.1016/j.vaccine.2024.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND COVID-19 vaccination has been associated with anaphylaxis and hypersensitivity reactions. Infectious disease physicians and allergists in the Canadian Special Immunization Clinic (SIC) Network developed guidance for evaluating patients with adverse events following immunization (AEFI) including suspected hypersensitivity. This study evaluated management and adverse event recurrence following subsequent COVID-19 vaccinations. METHODS Individuals aged 12 years and older enrolled at participating SICs before February 28, 2023 who were referred for suspected or diagnosed hypersensitivity reaction following COVID-19 vaccination, or for prevaccination assessment of suspected allergy to a COVID-19 vaccine component were included. De-identified clinical assessments and revaccination data, captured in a centralized database, were analyzed. The Brighton Collaboration case definition (BCCD) for anaphylaxis (2023 version) was applied. RESULTS The analysis included 206 participants from 13 sites: 26 participants referred for pre-vaccination assessment and 180 participants referred for adverse events following COVID-19 vaccination (15/180 [8.3%] with BCCD confirmed anaphylaxis, 84 [46.7%] with immediate hypersensitivity symptoms not meeting BCCD, 33 [18.3%] with other diagnosed hypersensitivity reactions, and 48 [26.7%] participants with a final diagnosis of non-hypersensitivity AEFI). Among participants referred for AEFIs following COVID-19 vaccination, 166/180 (92.2%) were recommended for COVID-19 revaccination after risk assessment, of whom 158/166 (95.2%) were revaccinated (all with a COVID-19 mRNA vaccine). After revaccination, 1/15 (6.7%) participants with prior anaphylaxis, 1/77 (1.3%) with immediate hypersensitivity not meeting criteria for anaphylaxis and 1/24 (4.2%) with other physician diagnosed hypersensitivity developed recurrent AEFI symptoms that met the BCCD for anaphylaxis. All 26 participants referred pre-vaccination, including 9 (34.6%) with history of polyethylene glycol-asparaginase reactions, were vaccinated without occurrence of immediate hypersensitivity symptoms. CONCLUSIONS Most individuals in this national cohort who experienced a hypersensitivity event following COVID-19 vaccination and were referred for specialist review were revaccinated without AEFI recurrence, suggesting that specialist evaluation can facilitate safe revaccination.
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Affiliation(s)
- Tiffany Fitzpatrick
- Canadian Center for Vaccinology, IWK Health and Dalhousie University, Halifax, Nova Scotia, Canada; Public Health Ontario, Toronto, Ontario, Canada
| | - Peter Yamoah
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Gina Lacuesta
- Halifax Allergy and Asthma Associates, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Manish Sadarangani
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Victoria Cook
- Division of Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Persia Pourshahnazari
- Division of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chrystyna Kalicinsky
- Section of Allergy and Clinical Immunology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julia E M Upton
- Division of Immunology and Allergy, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Scott B Cameron
- Division of Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karver Zaborniak
- Section of Allergy and Clinical Immunology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amin Kanani
- Division of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Godfrey Lam
- Vancouver Costal Health and Providence Health, Vancouver, British Columbia, Canada
| | - Catherine Burton
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Cora Constantinescu
- Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Jeffrey M Pernica
- Department of Pediatrics, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Zainab Abdurrahman
- Department of Pediatrics, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Stephen Betschel
- Division of Allergy and Clinical Immunology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jean-Philippe Drolet
- Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, Quebec, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, Quebec, Canada
| | - Caroline Quach
- Division of Infectious Diseases, CHU Sainte Justine, Universite de Montreal, Montreal, Quebec, Canada
| | - Anne Des Roches
- Primary Immunodeficiency Clinic, Institut de recherches cliniques de Montréal, Montreal, Quebec, Canada
| | - Hugo Chapdelaine
- Primary Immunodeficiency Clinic, Institut de recherches cliniques de Montréal, Montreal, Quebec, Canada
| | - Marina I Salvadori
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada; Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Alex Carignan
- Department of Microbiology and Infectious Diseases, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Athena McConnell
- Pediatric Infectious Diseases, Jim Pattison Children's Hospital, Saskatoon, Saskatchewan, Canada
| | - Anne Pham-Huy
- Division of Infectious Diseases, Immunology and Allergy, CHEO, University of Ottawa, Ottawa, Ontario, Canada
| | - C Arianne Buchan
- Division of Infectious Diseases, Department of Medicine, University of Ottawa, and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Juthaporn Cowan
- Division of Infectious Diseases, Department of Medicine, University of Ottawa, and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kyla Hildebrand
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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2
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Teufelberger AR, Dan AR, Irmler L, Wolf P, Kränke B. COVID-19 vaccines: anaphylaxis and anxiety : A case study from an allergy unit. Wien Klin Wochenschr 2024:10.1007/s00508-024-02435-0. [PMID: 39259224 DOI: 10.1007/s00508-024-02435-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 08/14/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) was one crucial element to overcome the coronavirus disease 2019 (COVID-19) pandemic. Even though anaphylaxis to vaccines is rare, 47 patients came to the Allergy Unit at the University Hospital Graz, Austria, reporting immediate anaphylactoid symptoms after administration of COVID-19 vaccines. In addition, 29 patients with known drug-induced anaphylaxis wanted to be tested for a possible sensitization against COVID-19 vaccines or excipients, such as polyethylene glycol (PEG) or polysorbate 80 (PS80) before the first COVID-19 vaccination. Skin prick tests and intradermal tests were performed in all 76 patients, mostly using PEG 2000, and/or PS80. Skin prick tests with COVID-19 vaccines were performed depending on availability. OBJECTIVE Our aim was to characterize this patient cohort in terms of patients' anaphylactoid responses, their willingness to future vaccinations against SARS-Cov‑2, and reasons for their decision. METHODS We developed a questionnaire and analyzed 34 completed copies. RESULTS Of the 47 patients with anaphylactoid reactions to COVID-19 vaccination, most were female (40 female/7 male). The skin tests, even when performed with the respective COVID-19 vaccine, were negative in all but one patient. Most patients who experienced anaphylactoid reactions after a COVID-19 vaccination, did not want another COVID-19 vaccination at the time of answering the questionnaire because of anxiety for another anaphylactoid response at the next shot. Premedication with antihistamines significantly lowered (n = 74 vaccinations) the severity of anaphylactoid responses after COVID-19 vaccinations. CONCLUSION Anxiety about another anaphylactoid episode hinders patients to be vaccinated against SARS-CoV‑2 again. Premedication with antihistamines and collaboration of allergologists with psychologists might lower the risk of an anaphylactic/anaphylactoid response as well anxiety in drug-induced anaphylactic patients.
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Affiliation(s)
- Andrea R Teufelberger
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria.
| | - Andrada-Renata Dan
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - Linda Irmler
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - Birger Kränke
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
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3
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Liebau J, Laatsch BF, Rusnak J, Gunderson K, Finke B, Bargender K, Narkiewicz-Jodko A, Weeks K, Williams MT, Shulgina I, Musier-Forsyth K, Bhattacharyya S, Hati S. Polyethylene Glycol Impacts Conformation and Dynamics of Escherichia coli Prolyl-tRNA Synthetase Via Crowding and Confinement Effects. Biochemistry 2024; 63:1621-1635. [PMID: 38607680 PMCID: PMC11223479 DOI: 10.1021/acs.biochem.3c00719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024]
Abstract
Polyethylene glycol (PEG) is a flexible, nontoxic polymer commonly used in biological and medical research, and it is generally regarded as biologically inert. PEG molecules of variable sizes are also used as crowding agents to mimic intracellular environments. A recent study with PEG crowders revealed decreased catalytic activity of Escherichia coli prolyl-tRNA synthetase (Ec ProRS), where the smaller molecular weight PEGs had the maximum impact. The molecular mechanism of the crowding effects of PEGs is not clearly understood. PEG may impact protein conformation and dynamics, thus its function. In the present study, the effects of PEG molecules of various molecular weights and concentrations on the conformation and dynamics of Ec ProRS were investigated using a combined experimental and computational approach including intrinsic tryptophan fluorescence spectroscopy, atomic force microscopy, and atomistic molecular dynamic simulations. Results of the present study suggest that lower molecular weight PEGs in the dilute regime have modest effects on the conformational dynamics of Ec ProRS but impact the catalytic function primarily via the excluded volume effect; they form large clusters blocking the active site pocket. In contrast, the larger molecular weight PEGs in dilute to semidilute regimes have a significant impact on the protein's conformational dynamics; they wrap on the protein surface through noncovalent interactions. Thus, lower-molecular-weight PEG molecules impact protein dynamics and function via crowding effects, whereas larger PEGs induce confinement effects. These results have implications for the development of inhibitors for protein targets in a crowded cellular environment.
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Affiliation(s)
- Jessica Liebau
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Bethany F. Laatsch
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Joshua Rusnak
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Keegan Gunderson
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Brianna Finke
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Kassandra Bargender
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Alex Narkiewicz-Jodko
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Katelyn Weeks
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Murphi T. Williams
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Irina Shulgina
- Department
of Chemistry and Biochemistry and Center for RNA Biology, The Ohio State University, Columbus, Ohio 43210, United States
| | - Karin Musier-Forsyth
- Department
of Chemistry and Biochemistry and Center for RNA Biology, The Ohio State University, Columbus, Ohio 43210, United States
| | - Sudeep Bhattacharyya
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
| | - Sanchita Hati
- Department
of Chemistry and Biochemistry, University
of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, United States
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4
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Hodel KVS, Fiuza BSD, Conceição RS, Aleluia ACM, Pitanga TN, Fonseca LMDS, Valente CO, Minafra-Rezende CS, Machado BAS. Pharmacovigilance in Vaccines: Importance, Main Aspects, Perspectives, and Challenges-A Narrative Review. Pharmaceuticals (Basel) 2024; 17:807. [PMID: 38931474 PMCID: PMC11206969 DOI: 10.3390/ph17060807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Pharmacovigilance plays a central role in safeguarding public health by continuously monitoring the safety of vaccines, being critical in a climate of vaccine hesitancy, where public trust is paramount. Pharmacovigilance strategies employed to gather information on adverse events following immunization (AEFIs) include pre-registration data, media reports, clinical trials, and societal reporting. Early detection of AEFIs during clinical trials is crucial for thorough safety analysis and preventing serious reactions once vaccines are deployed. This review highlights the importance of societal reporting, encompassing contributions from community members, healthcare workers, and pharmaceutical companies. Technological advancements such as quick response (QR) codes can facilitate prompt AEFI reporting. While vaccines are demonstrably safe, the possibility of adverse events necessitates continuous post-marketing surveillance. However, underreporting remains a challenge, underscoring the critical role of public engagement in pharmacovigilance. This narrative review comprehensively examines and synthesizes key aspects of virus vaccine pharmacovigilance, with special considerations for specific population groups. We explore applicable legislation, the spectrum of AEFIs associated with major vaccines, and the unique challenges and perspectives surrounding pharmacovigilance in this domain.
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Affiliation(s)
- Katharine Valéria Saraiva Hodel
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Bahia State, Brazil
| | - Bianca Sampaio Dotto Fiuza
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Bahia State, Brazil
| | - Rodrigo Souza Conceição
- Department of Medicine, College of Pharmacy, Federal University of Bahia, Salvador 40170-115, Bahia State, Brazil
| | - Augusto Cezar Magalhães Aleluia
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Bahia State, Brazil
- Department of Natural Sciences, Southwestern Bahia State University (UESB), Campus Vitória da Conquista, Vitória da Conquista 45031-300, Bahia State, Brazil
| | - Thassila Nogueira Pitanga
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Bahia State, Brazil
- Laboratory for Research in Genetics and Translational Hematology, Gonçalo Moniz Institute, FIOCRUZ-BA, Salvador 40296-710, Bahia State, Brazil
| | - Larissa Moraes dos Santos Fonseca
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Bahia State, Brazil
| | - Camila Oliveira Valente
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Bahia State, Brazil
| | | | - Bruna Aparecida Souza Machado
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Bahia State, Brazil
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5
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Teh HL, Keowmani T, Tang MM. Risk Factors Associated with Cutaneous Reactions Following COVID-19 Vaccine Immunisation: A Registry-Based Case-Control Study. Malays J Med Sci 2024; 31:133-148. [PMID: 38984235 PMCID: PMC11229573 DOI: 10.21315/mjms2024.31.3.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/24/2023] [Indexed: 07/11/2024] Open
Abstract
Background In Malaysia, following extensive COVID-19 vaccination, Hospital Kuala Lumpur reported an increase in cutaneous reactions post-immunisation. To understand this, a case-control study was initiated to identify potential risk factors. Methods This registry-based, unmatched case-control study encompasses all adverse event following immunisation (AEFI) reports associated with COVID-19 vaccines, received by the Department of Pharmacy at Hospital Kuala Lumpur through the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) AEFI reporting forms. Twenty-four potential risk factors were evaluated, including demographic information, medical history, food allergies, COVID-19 vaccination history and prior SARS-CoV-2 infection, were evaluated using MADRAC AEFI reporting forms. Odds ratio (OR) with 95% confidence interval (CI) were estimated using univariable and multivariable logistic regression. Results Cutaneous reactions were more frequent in middle-aged females, especially after the first COVID-19 vaccine dose. These reactions, primarily mild and generalised, included pruritus and urticaria. Notably, 52% were delayed reactions (more than 4 h post-vaccination). Factors associated with increased risk of cutaneous reaction following COVID-19 immunisation included history of seafood and shellfish allergy (adjusted odds ratio [adjOR]: 2.11; 95% CI: 1.12, 3.96; P = 0.020), history of vaccine allergy (adjOR: 4.07; 95% CI: 1.44, 11.54; P = 0.008), past dermatological diseases (adjOR: 5.48; 95% CI: 2.03, 14.78; P = 0.001), and past medication allergy (adjOR: 2.12; 95% CI: 1.36, 3.31; P = 0.001). Conclusion Self-reported histories of allergies to vaccines, foods or medications were found to increase the likelihood of cutaneous reactions following COVID-19 vaccination. These reactions, which were predominantly mild, did not hinder the administration of the second vaccine dose. The majority of reactions occurred after the first dose, manifesting as generalised pruritus and urticaria. They were effectively managed with oral antihistamines and low-dose corticosteroids, thereby avoiding the need for hospitalisation.
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Affiliation(s)
- Hwei Lin Teh
- Pharmacy Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Thamron Keowmani
- Pharmacy Department, Hospital Wanita dan Kanak-Kanak, Sabah, Malaysia
| | - Min Moon Tang
- Department of Dermatology, Sarawak General Hospital, Sarawak, Malaysia
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Hori T, Shimizu T, Ando H, Okada N, Yamagami H, Yasui S, Hosoki M, Tojima A, Otoda T, Yuasa T, Aihara KI, Takishita M, Yoshida S, Abe M, Ishida T, Nakamura S. Humoral immune response against SARS-CoV-2 and polyethylene glycol elicited by anti-SARS-CoV-2 mRNA vaccine, and effect of pre-existing anti-polyethylene glycol antibody in patients with hematological and autoimmune diseases. Heliyon 2024; 10:e31489. [PMID: 38813140 PMCID: PMC11133887 DOI: 10.1016/j.heliyon.2024.e31489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 05/31/2024] Open
Abstract
Background The effects of vaccination are modified by hematological and autoimmune diseases and/or treatment. Anti-SARS-CoV-2 mRNA vaccine contains polyethylene glycol (PEG), it is largely unknown whether PEG influences the effects of vaccination or induces a humoral response. This study examined whether anti-PEG antibodies before vaccination (pre-existing) influenced the acquisition of SARS-CoV-2 antibodies and evaluated the relationship between the development of anti-SARS-CoV-2 antibodies and anti-PEG antibodies after SARS-CoV-2 vaccination in hematological and autoimmune diseases. Methods Anti-SARS-CoV-2 antibody IgG, anti-PEG IgG, and IgM titers were evaluated in patients with hematological and autoimmune diseases after the second dose of BNT162B2. Anti-PEG IgG and IgM titers were also measured before vaccination to examine changes after vaccination and the relationship with vaccine efficacy. Results In patients with hematological (n = 182) and autoimmune diseases (n = 96), anti-SARS-CoV-2 and anti-PEG antibody titers were evaluated after a median of 33 days from 2nd vaccination. The median anti-SARS-CoV-2 antibody titers were 1901 AU/mL and 3832 AU/mL in patients with hematological and autoimmune disease, respectively. Multiple regression analysis showed that age and days from 2nd vaccination were negatively associated with anti-SARS-CoV-2 antibody titers. Anti-CD20 antibody treatment was negatively correlated with anti-SARS-CoV-2 antibody titers in hematological disease, and C-reactive protein (CRP) was positively correlated with anti-SARS-CoV-2 antibody titers in autoimmune disease. Baseline anti-PEG antibody titers were significantly higher in patients with autoimmune disease but were not correlated with anti-SARS-CoV-2 antibody titers. Patients with increased anti-PEG IgG acquired higher anti-SARS-CoV-2 antibody titers in patients with autoimmune disease. Conclusions Anti-SARS-CoV-2 antibody acquisition was suboptimal in patients with hematological disease, but both anti-SARS-CoV-2 antibody and anti-PEG IgG were acquired in patients with autoimmune disease, reflecting robust humoral immune response. Pre-existing anti-PEG antibody titers did not affect anti-SARS-CoV-2 antibody acquisition.
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Affiliation(s)
- Taiki Hori
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
| | - Taro Shimizu
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hidenori Ando
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Naoto Okada
- Pharmacy Department, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Hiroki Yamagami
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Saya Yasui
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
| | - Minae Hosoki
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
| | - Akihiro Tojima
- Department of Rheumatology, Anan Medical Center, Tokushima, Japan
| | - Toshiki Otoda
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomoyuki Yuasa
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Ken-ichi Aihara
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Makoto Takishita
- Department of Internal Medicine, Anan Medical Center, Tokushima, Japan
| | - Sumiko Yoshida
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Department of Clinical Research, National Hospital Organization Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Masahiro Abe
- Department of Hematology, Kawashima Hospital, Tokushima, Japan
| | - Tatsuhiro Ishida
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shingen Nakamura
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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7
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Maruyama S, Takahashi T, Kobayashi D, Hayase Y, Sugiyama Y. Interstitial Lung Disease With Respiratory Failure After COVID-19 mRNA Vaccination. Cureus 2024; 16:e58491. [PMID: 38765336 PMCID: PMC11101300 DOI: 10.7759/cureus.58491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
A septuagenarian woman developed dyspnea on the day following a fifth vaccination. Just before vaccination, a chest X-ray showed no abnormalities, but after the fifth vaccination, bilateral diffuse ground-glass opacities were detected. Bronchoalveolar lavage revealed a lymphocyte predominance and transbronchial lung biopsy revealed growth of the alveolar epithelium, along with organized polypoid granulation tissues in the alveolar ducts and bronchioles. Despite the administration of corticosteroids, imaging revealed persistent fibrosis, and she required long-term oxygen therapy. Although recent reports indicated that corticosteroids are effective for drug-induced interstitial lung disease related to COVID-19 mRNA vaccination, this case presented a somewhat different clinical manifestation.
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Affiliation(s)
- Soichi Maruyama
- Department of Respiratory Medicine, Nerima Hikarigaoka Hospital, Tokyo, JPN
| | - Taro Takahashi
- Department of Respiratory Medicine, Nerima Hikarigaoka Hospital, Tokyo, JPN
| | | | - Yoneko Hayase
- Department of Pathology, Nerima Hikarigaoka Hospital, Tokyo, JPN
| | - Yukihiko Sugiyama
- Department of Respiratory Medicine, Nerima Hikarigaoka Hospital, Tokyo, JPN
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8
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Gulas E, Bant A, Kruszewski J, Betiuk B, Niedoszytko M, Chciałowski A. The usability of testing skin reaction applying skin prick tests with Comirnaty (Pfizer, USA) vaccine in detecting the risk of developing post-vaccination immediate hypersensitivity response (anaphylaxis) after administration of this vaccine. Postepy Dermatol Alergol 2023; 40:655-660. [PMID: 38028424 PMCID: PMC10646719 DOI: 10.5114/ada.2023.131860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/18/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction COVID-19 vaccines became a relevant element of prevention during COVID-19 pandemic. It is worth highlighting the importance of severe allergic post-vaccination reactions. Aim To evaluate the usability of skin reaction tests using skin prick tests with Comirnaty (Pfizer, USA) vaccine in risk detection of the post-vaccine immediate hypersensitivity reaction (anaphylaxis) after administration of this vaccine [PvIHR(A)]. Material and methods The analysis embraces 102 people, 85 women and 17 men with a history of immediate hypersensitivity (anaphylaxis) [IHR(A)]. Detailed medical history was collected and skin prick tests were made among participants. The positive and negative test results were illustrated in Figure 1. Results As it stands in Table 1, considering all participants of the study, a positive result of the skin prick tests was obtained only in 2 cases, a negative result in 99 and 1 result was questionable. The two positive results were found in participants from a group with a previous PvIHR(A) in their past medical history and they decided not to get vaccinated. The one questionable result was of a person that had PvIHR(A) after administration of the first dose of Comirnaty vaccine (Pfizer, USA). This person decided to get vaccinated again and there was no PvIHR(A) observed. Conclusions COVID-19 vaccination involves a low risk of anaphylaxis. Purposefulness of providing the skin prick tests using the mRNA vaccine is questionable, due to their low sensitivity and low specificity.
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Affiliation(s)
- Ewelina Gulas
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
| | - Andrzej Bant
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
| | - Jerzy Kruszewski
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
| | - Barbara Betiuk
- Vaccination Clinic of Military Instytute of Medicine, National Research Institute, Warsaw, Poland
| | - Marek Niedoszytko
- Allergology Department, Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Chciałowski
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
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9
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Ribak Y, Rubin L, Talmon A, Dranitzki Z, Shamriz O, Hershkowitz I, Tal Y, Hershko AY. Administration of BNT162b2 mRNA COVID-19 vaccine to subjects with various allergic backgrounds. Front Immunol 2023; 14:1172896. [PMID: 37654487 PMCID: PMC10465362 DOI: 10.3389/fimmu.2023.1172896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
Background The mRNA-based COVID-19 vaccine was introduced to the general public in December 2020. Shortly thereafter, safety concerns were raised due to the reporting of allergic reactions. Allergy-related disorders were suspected to be significant risk factors and the excipient polyethylene glycol was suggested to be a robust allergen. Methods This is a retrospective study analysis. Subjects with putative risk factors for severe allergic reactions to the Pfizer-BioNTech BNT162b2 vaccine were referred for vaccination under observation at the Unit of Allergy and Clinical Immunology. Data was collected for each subject, including demographic details, medical history and previous reactions to any allergen. When appropriate, skin tests were done prior to vaccination. Results A total of 346 subjects received 623 vaccine doses under observation. The study included patients with various allergy-related disorders (n=290) and those with allergy to a previous COVID-19 vaccine dose (n=56). Both groups showed female predominance (78% and 88%, p=NS). Patients without reactions to previous doses reported more drug allergy (80% vs. 39%, p<0.001) and previous anaphylaxis (64% vs. 14%, p<0.001). There was no difference in sensitivity to other allergens, including polyethylene glycol. Under observation, mild allergic reactions were noted in 13 individuals characterized by female gender (100%), a history of anaphylaxis (69%) and drug allergy (62%). In 7 subjects, allergy was treated with antihistamines while others recovered spontaneously. Conclusion Our study demonstrates that vaccination under specialist-supervision is a powerful tool for reducing over-diagnosis of systemic reactions and for rapid and reliable collection of vaccine safety data.
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10
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Ossato A, Tessari R, Trabucchi C, Zuppini T, Realdon N, Marchesini F. Comparison of medium-term adverse reactions induced by the first and second dose of mRNA BNT162b2 (Comirnaty, Pfizer-BioNTech) vaccine: a post-marketing Italian study conducted between 1 January and 28 February 2021. Eur J Hosp Pharm 2023; 30:e15. [PMID: 34315774 PMCID: PMC8318724 DOI: 10.1136/ejhpharm-2021-002933] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES On 21 December 2020 the European Commission granted conditional marketing authorisation in the European Union for the anti-COVID-19 mRNA vaccine Bnt162b2 (Comirnaty, Pfizer/BioNTech). The main endpoint of this epidemiological, observational, prospective and monocentric study was to identify the number, types, and severity of adverse events following immunisation that occurred in subjects who had been previously infected with COVID-19, and in those who had not, after vaccination with Comirnaty, and to compare the two groups of subjects looking at events that occurred within a month after the first and the second dose. METHODS Data were gathered by a questionnaire. The results included the responses of all healthcare workers (2030) of the IRCCS Sacro Cuore Don Calabria Hospital (Italy) vaccinated between 1st January and 28th February 2021. Adverse effects of the vaccine were reported after the first and the second doses. RESULTS There was a statistically significant increase (p<0.001, χ2=35.60) in participants who experienced some side-effects after receiving the first dose of the vaccine and who had previously been infected with the coronavirus, compared with participants who had not previously been infected. 46.76% (136) of the participants who had previously been infected experienced some side-effects after the first dose of vaccine, and 63.23% (184) experienced some side-effects after the second dose, compared with 29.15% (507) after the first dose and 70.79% (1231) after the second dose in those who had not been previously infected. The number of participants who experienced side-effects after the second dose and had previously been infected was significantly lower compared with participants who had not previously been infected (p=0.0094, χ2=6.743). CONCLUSIONS Most of the side-effects identified in this trial were also reported by the manufacturer and the US Food and Drug Administration. Active surveillance should always continue to constantly check the vaccine's risk/benefit ratio over time.
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Affiliation(s)
- Andrea Ossato
- Pharmaceutical & Pharmacological Sciences Department, University of Padua, Padova, Italy
| | - Roberto Tessari
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Carlotta Trabucchi
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Teresa Zuppini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Nicola Realdon
- Pharmaceutical & Pharmacological Sciences Department, University of Padua, Padova, Italy
| | - Francesca Marchesini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
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11
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Brice Y, Morgan L, Kirmani M, Kirmani M, Udeh MC. COVID-19 Vaccine Evolution and Beyond. Neurosci Insights 2023; 18:26331055231180543. [PMID: 37351483 PMCID: PMC10280118 DOI: 10.1177/26331055231180543] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
In December 2019, a new severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) was first reported in China. It would quickly spread and emerge as a COVID-19 pandemic. The illness caused by SARS CoV-2 would fall on a clinical spectrum ranging from asymptomatic, mild to severe respiratory symptoms, ARDS, and death. This led to significant morbidity and mortality further impacting at-risk populations with severe complications. Thus, a concerted worldwide effort to meet the challenges of diagnosing, treating, and preventing COVID-19 led to rapid advances in medicine. Some mitigating methods of masking, social distancing, and frequent handwashing, helped to slow the spread of SARS-CoV-2. Effective therapeutics consisting of antivirals and monoclonal antibodies, plus their use for prophylaxis, contributed to the management of COVID-19. The vaccines from various platforms (mRNA, viral vectors, protein base, and inactivated) contributed to decreased incidence, severity, and overall decreased hospitalizations and mortality. This article aims to review the novel mRNA vaccines (Moderna + Pfizer/BioNTech), viral vector (Janssen& Johnson), and protein base (Novavax), their side effects, and their use as boosters.
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Affiliation(s)
- Yardley Brice
- Yale-Lawrence Memorial Hospital, New London, CT, USA
| | | | - Maaida Kirmani
- Department of Neurosciences and Experimental Therapeutics, Texas A & M University, College Station, TX, USA
| | - Maha Kirmani
- Department of Neurosciences and Experimental Therapeutics, Texas A & M University, College Station, TX, USA
| | - Mercy C Udeh
- Texas A & M University, College Station, TX, USA
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12
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Laatsch BF, Brandt M, Finke B, Fossum CJ, Wackett MJ, Lowater HR, Narkiewicz-Jodko A, Le CN, Yang T, Glogowski EM, Bailey-Hartsel SC, Bhattacharyya S, Hati S. Polyethylene Glycol 20k. Does It Fluoresce? ACS OMEGA 2023; 8:14208-14218. [PMID: 37180871 PMCID: PMC10168656 DOI: 10.1021/acsomega.3c01124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 03/22/2023] [Indexed: 05/16/2023]
Abstract
Polyethylene glycol (PEG) is a polyether compound commonly used in biological research and medicine because it is biologically inert. This simple polymer exists in variable chain lengths (and molecular weights). As they are devoid of any contiguous π-system, PEGs are expected to lack fluorescence properties. However, recent studies suggested the occurrence of fluorescence properties in non-traditional fluorophores like PEGs. Herein, a thorough investigation has been conducted to explore if PEG 20k fluoresces. Results of this combined experimental and computational study suggested that although PEG 20k could exhibit "through-space" delocalization of lone pairs of electrons in aggregates/clusters, formed via intermolecular and intramolecular interactions, the actual contributor of fluorescence between 300 and 400 nm is the stabilizer molecule, i.e., 3-tert-butyl-4-hydroxyanisole present in the commercially available PEG 20k. Therefore, the reported fluorescence properties of PEG should be taken with a grain of salt, warranting further investigation.
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Affiliation(s)
- Bethany F. Laatsch
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Michael Brandt
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Brianna Finke
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Carl J. Fossum
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Miles J. Wackett
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Harrison R. Lowater
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Alex Narkiewicz-Jodko
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Christine N. Le
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Thao Yang
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Elizabeth M. Glogowski
- Department of Materials Science and Biomedical Engineering, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin, 54701, United States
| | - Scott C. Bailey-Hartsel
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Sudeep Bhattacharyya
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
| | - Sanchita Hati
- Department of Chemistry and Biochemistry, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54701, United States
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13
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Sabato B, Augusto PSDA, Lima Gonçalves Pereira R, Coutinho Batista Esteves F, Caligiorne SM, Rodrigues Dias Assis B, Apolo Correia Marcelino S, Pires do Espírito Santo L, Dias Dos Reis K, Da Silva Neto L, Goulart G, de Fátima Â, Pierezan F, Toshio Fujiwara R, Castro M, Garcia F. Safety and immunogenicity of the anti-cocaine vaccine UFMG-VAC-V4N2 in a non-human primate model. Vaccine 2023; 41:2127-2136. [PMID: 36822966 DOI: 10.1016/j.vaccine.2023.02.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
A promising strategy for cocaine addiction treatment is the anti-drug vaccine. These vaccines induce the production of anticocaine antibodies, capable of linking to cocaine, and decrease the passage of cocaine throughout the blood-brain barrier, decreasing drug activity in the brain. Our research group developed a new vaccine candidate, the UFMG-V4N2, to treat cocaine use disorders (CUD) using an innovative carrier based on calixarenes. This study assessed the safety and immunogenicity of the anti-cocaine vaccine UFMG-VAC-V4N2 in a non-human primate toxicity study using single and multiple vaccine doses. The UFMG-VAC-V4N2 yielded only mild effects in the injection site and did not influence the general health, feeding behavior, or hematological, renal, hepatic, or metabolic parameters in the vaccinated marmosets. The anti-cocaine vaccine UFMG-VAC-V4N2 presented a favorable safety profile and induced the expected immune response in a non-human primate model of Callithrix penicillata. This preclinical UFMG-VAC-V4N2 study responds to the criteria required by international regulatory agencies contributing to future anticocaine clinical trials of this anti-cocaine vaccine.
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Affiliation(s)
- Brian Sabato
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Pós-graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil.
| | - Paulo Sérgio de Almeida Augusto
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil.
| | - Raissa Lima Gonçalves Pereira
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil.
| | - Felipe Coutinho Batista Esteves
- Laboratório de Imunologia e Genômica de Parasitos, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil
| | - Sordaini M Caligiorne
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | - Bruna Rodrigues Dias Assis
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Pharmaceutics, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | | | - Larissa Pires do Espírito Santo
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Pós-graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil.
| | - Karine Dias Dos Reis
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leonardo Da Silva Neto
- Grupo de Estudos em Química Orgânica e Biológica (GEQOB), Departamento de Química, Universidade Federal de Minas Gerias (UFMG), Belo Horizonte, MG, Brazil
| | - Gisele Goulart
- Department of Pharmaceutics, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | - Ângelo de Fátima
- Grupo de Estudos em Química Orgânica e Biológica (GEQOB), Departamento de Química, Universidade Federal de Minas Gerias (UFMG), Belo Horizonte, MG, Brazil.
| | - Felipe Pierezan
- Escola de Veterinária, Universidade Federal de Minas Gerias (UFMG), Belo Horizonte, MG, Brazil.
| | - Ricardo Toshio Fujiwara
- Laboratório de Imunologia e Genômica de Parasitos, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil.
| | - Maila Castro
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Pós-graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil.
| | - Frederico Garcia
- Center of research on Health Vulnerability (Núcleo de Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Pós-graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil; Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - MG, Brazil.
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14
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Pawankar R, Thong BY, Recto MT, Wang JY, Abdul Latiff AH, Leung TF, Li PH, Lobo RCM, Lucas M, Oh JW, Kamchaisatian W, Nagao M, Rengganis I, Udwadia ZF, Dhar R, Munkhbayarlakh S, Narantsetseg L, Pham DL, Zhang Y, Zhang L. COVID-19 in the Asia Pacific: Impact on climate change, allergic diseases and One Health. Asia Pac Allergy 2023; 13:44-49. [PMID: 37389098 PMCID: PMC10166246 DOI: 10.5415/apallergy.0000000000000021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 07/01/2023] Open
Abstract
Climate change and environmental factors such as air pollution and loss of biodiversity are known to have a major impact not only on allergic diseases but also on many noncommunicable diseases. Coronavirus disease 2019 (COVID-19) resulted in many environmental changes during the different phases of the pandemic. The use of face masks, enhanced hand hygiene with hand rubs and sanitizers, use of personal protective equipment (gowns and gloves), and safe-distancing measures, reduced the overall incidence of respiratory infections and other communicable diseases. Lockdowns and border closures resulted in a significant reduction in vehicular traffic and hence environmental air pollution. Paradoxically, the use of personal protective equipment and disposables contributed to an increase in environmental waste disposal and new problems such as occupational dermatoses, especially among healthcare workers. Environmental changes and climate change over time may impact the exposome, genome, and microbiome, with the potential for short- and long-term effects on the incidence and prevalence of the allergic disease. The constant use and access to mobile digital devices and technology disrupt work-life harmony and mental well-being. The complex interactions between the environment, genetics, immune, and neuroendocrine systems may have short- and long-term impact on the risk and development of allergic and immunologic diseases in the future.
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Affiliation(s)
- Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Bernard Y Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
| | - Marysia T Recto
- Division of Allergy and Immunology, Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Jiu-Yao Wang
- Allergy, Immunology, and Microbiome (A.I.M.) Research Centre, China Medical University Children’s Hospital, Taichung, Taiwan
| | | | - Ting-Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong
| | - Philip H Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Rommel Crisenio M Lobo
- Philippine Children’s Medical Center Hospital of Infant Jesus Medical Center, Fe Del Mundo Medical Center, Manila, Philippines
| | - Michela Lucas
- Department of Clinical Immunology, Sir Charles Gairdner Hospital, Perth Children’s Hospital, Pathwest; Medical School, University of Western Australia, Perth, WA, Australia
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Wasu Kamchaisatian
- Pediatric Allergy and Immunology, Samitivej Children’s Hospital, Bangkok, Thailand
| | - Mizuho Nagao
- Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Iris Rengganis
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Zarir F Udwadia
- P.D. Hinduja National Hospital and Medical Research Centre and the Breach Candy Hospital, Mumbai, India
| | - Raja Dhar
- CMRI Hospital, Kolkata, West Bengal, India
| | - Sonomjamts Munkhbayarlakh
- Department of Pulmonology and Allergology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Logii Narantsetseg
- Department of Biochemistry, School of Biomedicine, National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Duy L Pham
- Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Yuan Zhang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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15
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Beccia F, Regazzi L, Marziali E, Beccia V, Pascucci D, Mores N, Vetrugno G, Laurenti P. BNT162b2 COVID-19 Vaccine Safety among Healthcare Workers of a Tertiary Hospital in Italy. Vaccines (Basel) 2023; 11:vaccines11020477. [PMID: 36851354 PMCID: PMC9964542 DOI: 10.3390/vaccines11020477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Millions of people have died because of the COVID-19 pandemic. The vaccination campaign helped tackle the pandemic and saved millions of lives. In a retrospective pharmacovigilance study, we explored the safety of the BNT162b2 (Comirnaty) vaccine among healthcare workers (HCWs) in a large Italian teaching hospital, and 2428 Adverse Events Reports (AERs) filed by HCWs after the administration of the first dose of vaccine were collected and analyzed, reporting the results quantitively and comparing them to the vaccine Summary of Product Characteristics (SPC). Spearman's correlation coefficients were computed to investigate the correlation among reported adverse effects, and recurrent clusters of symptoms were investigated through the Principal Component Analysis (PCA) and k-means Cluster Analysis. The BNT162b2 vaccine's safety profile was favorable, with predominant reports of early onset, mild, non-serious and short-term resolved symptoms. We observed higher than the expected frequency for various non-serious undesirable effects, especially among those listed and classified as less common in the SPC. Furthermore, we identified three clusters of adverse effects that were frequently reported together, defined by the presence/absence of fatigue, malaise, localized pain, chills, pyrexia, insomnia, nausea and injection site pain. Post-marketing pharmacovigilance activities, together with targeted public health interventions, can be valuable tools to promote vaccination and improve the control of the spread of the pandemic, especially in sensitive settings and populations such as hospitals and healthcare professionals.
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Affiliation(s)
- Flavia Beccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Regazzi
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Eleonora Marziali
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Viria Beccia
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Domenico Pascucci
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Nadia Mores
- Department of Pharmacology, Faculty of Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe Vetrugno
- Risk Management Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Patrizia Laurenti
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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16
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Kara A, Coskun A, Temel F, Özelci P, Topal S, Ates İ. Self-Reported Allergic Adverse Events Following Inactivated SARS-CoV-2 Vaccine (TURKOVAC™) among General and High-Risk Population. Vaccines (Basel) 2023; 11:vaccines11020437. [PMID: 36851314 PMCID: PMC9958953 DOI: 10.3390/vaccines11020437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
TURKOVAC™ is a whole-virion inactivated COVID-19 vaccine which was developed and granted emergency use and conditional marketing authorization in December 2021 in Türkiye. The objective of this study is to assess the distribution and the severity of allergic adverse events following the administration of the vaccine as the primary or the booster dose in 15 provinces in Türkiye. In this cohort study, between February and May 2022, in the selected 15 provinces having an adequate number of health care personnel in the community health centers to conduct the study, 32,300 people having the first, the second, or the booster dose of the vaccine were invited to the survey. A total of 29,584 people voluntarily agreed to participate to the survey and were given a structured questionnaire after a minimum of 10 days following the vaccination. In our study, only 0.5% of the participants (142 persons) reported to experience any allergic reaction, and 12 of them (8.5%) reported to be given medical treatment in a health center. Male predominance (55.6%) was observed among participants reported to experience any allergic reaction. No hospitalization was recorded. Of the participants, 4.4% (1315 people) reported to have a history of allergy. The most reported allergens were drugs. Among the participants without a known history of allergy (n = 28,269), 0.4% of them (110 people) reported to experience an allergic reaction following the vaccination, and 5.4% of the allergic reactions (six people) were reported to be treated in a health center. The percentage of the participants given any medical treatment among the participants without a known history of allergy is 0.02%. No immediate or anaphylactic reaction was reported. Among the participants with a known history of allergy (n = 1315), 32 people (2.4% of them) reported to experience an allergic reaction following the vaccination, and 18.7% of the allergic reactions (six people) were reported to be prescribed a medical treatment. The percentage of the participants given any medical treatment among the participants with a known history of allergy is 0.4%. A known history of allergy increased the risk of having an allergic experience by approximately six times following vaccination. As a whole-virion inactivated SARS-CoV-2 vaccine, the TURKOVAC™ vaccine, with a low allergic reaction-related adverse event profile, can be an alternative to other COVID-19 vaccines.
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Affiliation(s)
- Ateş Kara
- Department of Pediatrics, Pediatric Infectious Disease Unit, Hacettepe University Faculty of Medicine, Health Institutes of Türkiye, Türkiye Vaccine Institute, Ankara 06100, Türkiye
- Correspondence:
| | - Aslihan Coskun
- Health Institutes of Türkiye, Türkiye Vaccine Institute, Ankara 06260, Türkiye
| | - Fehminaz Temel
- Türkiye Ministry of Health, General Directorate of Public Health, Department of Communicable Diseases and Early Warning, Field Epidemiology Unit, Ankara 06430, Türkiye
| | - Pervin Özelci
- Health Institutes of Türkiye, Türkiye Vaccine Institute, Ankara 06260, Türkiye
| | - Selmur Topal
- Türkiye Ministry of Health, General Directorate of Public Health, Department of Communicable Diseases and Early Warning, Field Epidemiology Unit, Ankara 06430, Türkiye
| | - İhsan Ates
- University of Health Science, Ankara City Hospital, Department of Internal Medicine, Ankara 06610, Türkiye
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Zhang HP, Sun YL, Wang YF, Yazici D, Azkur D, Ogulur I, Azkur AK, Yang ZW, Chen XX, Zhang AZ, Hu JQ, Liu GH, Akdis M, Akdis CA, Gao YD. Recent developments in the immunopathology of COVID-19. Allergy 2023; 78:369-388. [PMID: 36420736 PMCID: PMC10108124 DOI: 10.1111/all.15593] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/01/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022]
Abstract
There has been an important change in the clinical characteristics and immune profile of Coronavirus disease 2019 (COVID-19) patients during the pandemic thanks to the extensive vaccination programs. Here, we highlight recent studies on COVID-19, from the clinical and immunological characteristics to the protective and risk factors for severity and mortality of COVID-19. The efficacy of the COVID-19 vaccines and potential allergic reactions after administration are also discussed. The occurrence of new variants of concerns such as Omicron BA.2, BA.4, and BA.5 and the global administration of COVID-19 vaccines have changed the clinical scenario of COVID-19. Multisystem inflammatory syndrome in children (MIS-C) may cause severe and heterogeneous disease but with a lower mortality rate. Perturbations in immunity of T cells, B cells, and mast cells, as well as autoantibodies and metabolic reprogramming may contribute to the long-term symptoms of COVID-19. There is conflicting evidence about whether atopic diseases, such as allergic asthma and rhinitis, are associated with a lower susceptibility and better outcomes of COVID-19. At the beginning of pandemic, the European Academy of Allergy and Clinical Immunology (EAACI) developed guidelines that provided timely information for the management of allergic diseases and preventive measures to reduce transmission in the allergic clinics. The global distribution of COVID-19 vaccines and emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with reduced pathogenic potential dramatically decreased the morbidity, severity, and mortality of COVID-19. Nevertheless, breakthrough infection remains a challenge for disease control. Hypersensitivity reactions (HSR) to COVID-19 vaccines are low compared to other vaccines, and these were addressed in EAACI statements that provided indications for the management of allergic reactions, including anaphylaxis to COVID-19 vaccines. We have gained a depth knowledge and experience in the over 2 years since the start of the pandemic, and yet a full eradication of SARS-CoV-2 is not on the horizon. Novel strategies are warranted to prevent severe disease in high-risk groups, the development of MIS-C and long COVID-19.
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Affiliation(s)
- Huan-Ping Zhang
- Department of Allergology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Yuan-Li Sun
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan-Fen Wang
- Department of Pediatrics, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Duygu Yazici
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Dilek Azkur
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Ismail Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Ahmet Kursat Azkur
- Department of Virology, Faculty of Veterinary Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Zhao-Wei Yang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiao-Xue Chen
- Department of Allergology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Ai-Zhi Zhang
- Intensive Care Unit, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jia-Qian Hu
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Guang-Hui Liu
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
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18
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Klosko RC, Lynch SE, Cabral DL, Nagaraju K, Johnston YA, Steinberg JD, McCall KL. Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022. Vaccines (Basel) 2023; 11:vaccines11020276. [PMID: 36851154 PMCID: PMC9962937 DOI: 10.3390/vaccines11020276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the Vaccine Adverse Event Reporting System (VAERS) database from 2017 to 2022 and identified cases involving anaphylaxis with an onset within one day of vaccine administration. The primary outcome was the combined prevalence of death or disability for each setting while the secondary outcome was the prevalence of hospitalization. Adjusted (age, sex, prior history of allergy, vaccine type) odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated using logistic regression analysis. A total of 2041 cases of anaphylaxis comprised the primary study cohort with representation in the sample from all 50 US states and the District of Columbia. The mean age was 43.3 ± 17.5 years, and most cases involved women (79.9%). Cases of anaphylaxis were reported after receiving a coronavirus vaccine (85.2%), influenza vaccine (5.9%), tetanus vaccine (2.2%), zoster vaccine (1.6%), measles vaccine (0.7%), and other vaccine (4.5%). Outcomes associated with reports of vaccine anaphylaxis included 35 cases of death and disability and 219 hospitalizations. Compared with all other settings, the aOR of death and disability when anaphylaxis occurred was 1.92 (95% CI, 0.86-4.54) in a medical provider's office, 0.85 (95% CI, 0.26-2.43) in a pharmacy and 1.01 (95% CI, 0.15-3.94) in a public health clinic. Compared with all other settings, the aOR of hospitalization when anaphylaxis occurred was 1.02 (95% CI, 0.71-1.47) in a medical provider's office, 1.06 (95% CI, 0.72-1.54) in a pharmacy, and 1.12 (95% CI, 0.61-1.93) in a public health clinic. An analysis of a national database across six years revealed no significant differences in the odds of death/disability and odds of hospitalization associated with post-vaccination anaphylaxis in the medical office, pharmacy, and public health clinic compared with all other settings. This study expands our understanding of the safety of immunization services and reinforces that all settings must be prepared to respond to such an emergency.
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Affiliation(s)
- Rachel C. Klosko
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Sarah E. Lynch
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Danielle L. Cabral
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Kanneboyina Nagaraju
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Yvonne A. Johnston
- Master of Public Health Program, Decker College of Nursing and Health Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Joshua D. Steinberg
- United Health Services Family Medicine Residency and Upstate Medical University College of Medicine Clinical Campus, Johnson City, NY 13790, USA
| | - Kenneth L. McCall
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
- Correspondence: ; Tel.: +607-777-5853
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19
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Skin Testing and Basophil Activation Testing Is Useful for Assessing Immediate Reactions to Polyethylene Glycol-Containing Vaccines. Vaccines (Basel) 2023; 11:vaccines11020252. [PMID: 36851130 PMCID: PMC9968132 DOI: 10.3390/vaccines11020252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The mechanism of immediate reactions to drugs or vaccines containing polyethylene glycol (PEG) and PEG derivatives is not fully elucidated. It is considered in many instances to be IgE-mediated. Diagnosis and management of PEG allergy is topical, as BNT162b and mRNA-1273 contain PEG (2[PEG-2000]-N), and ChAdOx1-S and NVX-CoV2373 contain polysorbate 80. mRNA vaccines contain PEG 2000, which encapsulates the mRNA to impair its degradation. This PEG MW is specific to mRNA vaccines and is not used in other drugs and vaccines. PEG 2000 allergy is not well studied, as higher PEG molecular weights are implicated in most of the PEG allergy published in the literature. METHODS We performed a literature review on PEG allergy and sought to evaluate the safety and effectiveness of our protocol for assessment of PEG 2000 and polysorbate 80 reactions in an outpatient clinic setting. All patients referred to our drug allergy service between 1 July 2021 and 31 December 2021 with suspected immediate allergy to PEG or its derivatives were eligible for the study. Skin testing (ST) and basophil activation testing (BAT) were performed for all patients to multiple PEG molecular weights (MWs). RESULTS We reviewed twenty patients during the study period. Five patients were allergic. Fifteen patients had a masquerade of allergy and were enrolled as control patients. PEG 2000, polysorbate 80, BNT162b, and ChAdOx1-S had excellent performance characteristics on skin testing. BAT showed high specificity for all vaccines and PEG MWs. DISCUSSION In our small study, we found ST and BAT to add useful information, particularly for PEG 2000 allergy. Further study of our protocol in larger patient cohorts will provide more information on its performance characteristics and usefulness.
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Estrada-García CD, Macías-Robles AP, Cortés-Grimaldo RM, Carvajal-Alonso HL, Barreto-Alcalá M, Ramírez-Nepomuceno A, Esparza-Amaya D, Coronado-Hernández KG, Barrios-Díaz B, Campos-Téllez HH. [Allergy to Pfizer-BioNTech® vaccine demonstrated by skin testing]. REVISTA ALERGIA MÉXICO 2023; 69:89-92. [PMID: 36928249 DOI: 10.29262/ram.v69i2.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/30/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The Pfizer-BioNTech® BNT162b2 vaccine, provides 95% effectiveness from the second dose onwards. The reported rate of anaphylaxis to COVID-19 vaccines is 4.7 cases/million doses administered. CASE REPORT 30-year-old female, health professional, history of allergic rhinitis, asthma, reaction to eye cosmetics and adhesive tape: erythema, edema, and local pruritus. Immediately after application of the first dose of Pfizer-BioNTech vaccine, she presented grade III anaphylaxis. The patient was stratified, phenotyped and skin tests with PEG 3350 were positive. A recommendation was issued not to reapply vaccine containing polyethylene glycol and alternatives were offered. CONCLUSIONS An adequate risk stratification should be performed before applying mRNA-based COVID-19 vaccines for the first time in at-risk groups. In case of anaphylaxis at the first dose, phenotyping and further study with PEG skin tests should be performed and vaccination alternatives should be offered.
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Affiliation(s)
| | - Ana Paola Macías-Robles
- Médico adscrito y profesora titular de la sub-especialidad en Alergia e Inmunología Clínica Pediátrica
| | | | | | - Marlen Barreto-Alcalá
- Residente de segundo año de Alergia e Inmunología. Servicio de Alergia e Inmunología Clínica Pediátrica, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco
| | - Adriana Ramírez-Nepomuceno
- Residente de segundo año de Alergia e Inmunología. Servicio de Alergia e Inmunología Clínica Pediátrica, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco
| | - David Esparza-Amaya
- Residente de segundo año de Alergia e Inmunología. Servicio de Alergia e Inmunología Clínica Pediátrica, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco
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21
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Marks PW. COVID-19 vaccines: the start of a new era in regulation? Expert Rev Vaccines 2023; 22:213-215. [PMID: 36803214 DOI: 10.1080/14760584.2023.2182294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Peter W Marks
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
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22
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Karaaslan BG, Burtecene N, Mustu U, Ocak S, Kasapcopur O, Kıykım A, Cokugras H. Evaluation of pediatric patients with suspected polyethylene glycol and polysorbate allergy before mRNA SARS-CoV2 vaccination. Allergol Immunopathol (Madr) 2023; 51:174-180. [PMID: 37169575 DOI: 10.15586/aei.v51i3.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/29/2023] [Indexed: 05/13/2023]
Abstract
mRNA vaccines, particularly, have been associated with an increased risk of allergic reactions and rarely anaphylaxis. Although rare, vaccine reactions can cause significant anxiety and fear in the population, leading to indecision and vaccine refusal. This study aimed to retrospectively evaluate the role of polyethylene glycol (PEG) sensitivity in vaccination decision-making in pediatric patients at high risk of allergy or with suspected allergic reactions to the first dose of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccine. Seventeen enrolled patients were found to have decreased readiness to receive the Coronavirus Disease 2019 (COVID-19) vaccine after developing hypersensitivity to multiple and/or injectable drugs. Skin testing was performed. A basophil activation test with PEG-2000 and 4000 was performed on three patients who were ineligible for skin prick tests. Nine patients with negative tests received the vaccine without complications. One patient had urticarial angioedema despite negative tests. Three patients with positive tests did not agree to desensitization with the mRNA vaccine, and one of them was vaccinated with the inactivated COVID-19 vaccine. Four patients recurred despite negative tests. The general recommendation for patients describing severe reactions to drugs, foods, and allergens, such as toxins that do not contain the adjuvants of the SARS-CoV-2 vaccines, is to be routinely vaccinated with safety precautions. Excipients such as PEG and polysorbate-80 used in COVID-19 vaccines could be potential allergens, but this hypothesis is unclear. The predictive values of these adjuvants for skin testing and in vitro testing are controversial. Further research is needed on the hypersensitivity reactions of adjuvants, the predictive values of skin tests, and etiopathogenesis.
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Affiliation(s)
- Betul Gemici Karaaslan
- Department of Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nihan Burtecene
- Department of Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ulviye Mustu
- Department of Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Suheyla Ocak
- Department of Pediatric Hematology and Oncology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozgur Kasapcopur
- Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayca Kıykım
- Department of Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Haluk Cokugras
- Department of Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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23
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Koesnoe S, Maria S, Widhani A, Hasibuan AS, Karjadi TH, Khoirunnisa D, Yusuf M, Sumariyono S, Liastuti LD, Djauzi S, Rengganis I, Yunihastuti E. COVID-19 vaccine provocation test outcome in high-risk allergic patients: A retrospective study from a tertiary hospital in Indonesia. World Allergy Organ J 2023; 16:100734. [PMID: 36530537 PMCID: PMC9744675 DOI: 10.1016/j.waojou.2022.100734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/30/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
Background High COVID-19 vaccine coverage is essential. Patients who are considered high risk for hypersensitivity reactions and have had an allergic reaction to the COVID-19 vaccine are usually referred to an allergist for assessment of vaccination. Administration of a vaccine graded challenge (also known as a provocation test) is an option that can be considered in this population. This primary objective of this study is to describe the outcome of the COVID-19 vaccine provocation test and to understand the predicting factors associated with hypersensitivity reaction after the provocation test as the secondary objective. Methods Adult patients with a history of hypersensitivity reaction to the first COVID-19 vaccine and high-allergic patients who underwent COVID-19 vaccine provocation test up until May 2022 were included. A protocol using skin prick test (SPT), intradermal test (IDT), followed by graded challenge was developed for the determined vaccine used. Results A total of 232 patients were included in the analysis. Twenty-eight had hypersensitivity to their first COVID-19 vaccine dose and 204 were high risk for allergic reaction. Hypersensitivity reactions occurred in 20 patients (8.6%, 95% CI: 5-12.2%), consisting of 4 reactions after SPT, 9 after IDT, 7 during or after titrated challenge. Half of the reactions were mild; however, 3 patients developed severe reactions. Patients with history of anaphylaxis were more likely to experience hypersensitivity reaction after provocation test (aRR = 2.79, 95% CI: 1.05-7.42). Conclusion Provocation test in COVID-19 vaccination has a high success rate in patients with a history of hypersensitivity to the first COVID-19 vaccine and in high allergic patients. History of anaphylaxis is associated with hypersensitivity reaction after a COVID-19 vaccine provocation test.
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Key Words
- ACAAI, The American College of Allergy, Asthma, and Immunology
- ADR, adverse drug reaction
- AE, adverse events
- Allergy
- Anaphylaxis
- BMI, body mass index
- CDC, The Center for Disease Control and Prevention
- CI, confidence interval
- COVID-19
- COVID-19, coronavirus disease
- IDT, intradermal test
- Provocation test
- SD, standard deviation
- SJS, Stevens-Johnson syndrome
- SPT, skin prick test
- TEN, toxic epidermal necrolysis
- Vaccination
- aRR, adjusted risk ratio
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Affiliation(s)
- Sukamto Koesnoe
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia,Corresponding author. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Suzy Maria
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Alvina Widhani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Anshari S. Hasibuan
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Teguh H. Karjadi
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dhiya Khoirunnisa
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Muhammad Yusuf
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | | | - Samsuridjal Djauzi
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Iris Rengganis
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Evy Yunihastuti
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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24
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Suzuki H, Adler A, Huang T, Kuramochi A, Ohba Y, Sato Y, Nakamura N, Manivel VA, Ekdahl KN, Nilsson B, Ishihara K, Teramura Y. Impact of spontaneous liposome modification with phospholipid polymer-lipid conjugates on protein interactions. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2022; 23:845-857. [PMID: 36518982 PMCID: PMC9744213 DOI: 10.1080/14686996.2022.2146466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
Liposome surface coating has been studied to avoid the immunological responses caused by the complement system, and alternative materials to poly(ethylene glycol) (PEG) have been explored recently since the production of anti-PEG IgM antibodies has been found in humans. We previously reported a liposome coating with poly(2-methacryloyloxyethyl phosphorylcholine) (poly(MPC))-conjugated lipids (PMPC-lipids) and demonstrated its protective effect on blood protein interactions. Here, we attempted to modify the liposome surface by exogenously adding PMPC-lipids, which were spontaneously incorporated into the outer membrane via hydrophobic interactions. The polymerization degree of the PMPC segment was regulated from 10 to 100. The incorporated ratio of PMPC-lipid increased with a decrease in the degree of PMPC polymerization. Due to surface modification with PMPC-lipids, increase in the length of the PMPC-chain increased the size of the liposomes. The modified liposomes were kept stable for 14 d in terms of their size, polydispersity, and surface properties, where approximately 70% of PMPC-lipids were incorporated into the liposome surface. We demonstrated that liposome surface modification with PMPC-lipids can inhibit protein adsorption when exposed to serum, regardless of the degree of polymerization of PMPC. In addition, the PMPC-lipid modified surface was not recognized by the anti-PEG IgM antibody, whereas PEG-lipid was recognized by the antibody. Thus, we successfully fabricated an inert liposome surface via spontaneous modification with PMPC-lipids, where only the outer bilayer surface was modified. This technique can be available for full loading of water-soluble active pharmaceutical ingredient inside the modified liposome.
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Affiliation(s)
- Haruna Suzuki
- Department of Systems Engineering and Science, Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Anna Adler
- Department of Immunology, Genetics and Pathology (IGP), Uppsala University, Uppsala, Sweden
| | - Tianwei Huang
- Department of Bioengineering, School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Akiko Kuramochi
- Cellular and Molecular Biotechnology Research Institute (CMB), National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Yoshiro Ohba
- Cellular and Molecular Biotechnology Research Institute (CMB), National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Yuya Sato
- Department of Bioengineering, School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Naoko Nakamura
- Department of Bioscience and Engineering, College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Vivek Anand Manivel
- Department of Immunology, Genetics and Pathology (IGP), Uppsala University, Uppsala, Sweden
| | - Kristina N Ekdahl
- Department of Immunology, Genetics and Pathology (IGP), Uppsala University, Uppsala, Sweden
- Linnaeus Center of Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
| | - Bo Nilsson
- Department of Immunology, Genetics and Pathology (IGP), Uppsala University, Uppsala, Sweden
| | - Kazuhiko Ishihara
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Yuji Teramura
- Department of Immunology, Genetics and Pathology (IGP), Uppsala University, Uppsala, Sweden
- Cellular and Molecular Biotechnology Research Institute (CMB), National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
- Master’s/Doctoral Program in Life Science Innovation (T-LSI), University of Tsukuba, Ibaraki, Japan
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25
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Himed S, Gray A, Awethe Z, Libson K, Kaffenberger BH, Korman AM, Trinidad JCL. SARS-CoV-2 Infection and Vaccination Cutaneous Manifestations for the Inpatient Dermatologist. CURRENT DERMATOLOGY REPORTS 2022; 11:252-262. [PMID: 36274753 PMCID: PMC9579541 DOI: 10.1007/s13671-022-00374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review The overall purpose of this review was to characterize and summarize cutaneous eruptions associated with coronavirus disease 2019 (COVID-19) as well as COVID-19 vaccination. Recent Findings Cutaneous eruptions associated with COVID-19 infection have a reported frequency of 1-20%. Increased COVID-19 disease severity has been associated with morbilliform exanthems, urticaria, retiform purpura, and livedo racemosa. Papulovesicular eruptions were associated with a milder COVID-19 disease course. A range of dermatoses have also been reported with COVID-19 vaccination but have rarely prevented subsequent vaccination. Summary Dermatologists should be aware of the associations between COVID-19 disease severity and cutaneous eruptions. Livedo racemosa and retiform purpura are particularly associated with increased disease severity and death. In the setting of COVID-19 vaccination, cutaneous eruptions can largely be managed symptomatically and very rarely do these reactions prevent subsequent vaccination.
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Affiliation(s)
- Sonia Himed
- College of Medicine, University of Cincinnati, Cincinnati, OH USA
| | - Ashley Gray
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Zaynah Awethe
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Karissa Libson
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Benjamin H. Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Abraham M. Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - John C. L. Trinidad
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
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Munblit D, Greenhawt M, Brough HA, Pushkareva A, Karimova D, Demidova A, Warner JO, Kalayci O, Sediva A, Untersmayr E, Rodriguez Del Rio P, Vazquez-Ortiz M, Arasi S, Alvaro-Lozano M, Tsabouri S, Galli E, Beken B, Eigenmann PA. Allergic diseases and immunodeficiencies in children, lessons learnt from COVID-19 pandemic by 2022: A statement from the EAACI-section on pediatrics. Pediatr Allergy Immunol 2022; 33:e13851. [PMID: 36282136 PMCID: PMC9538373 DOI: 10.1111/pai.13851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Abstract
By the April 12, 2022, the COVID-19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short- and long-term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health-care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID-19 or dying from infection. Allergic diseases are not associated with a higher COVID-19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high-standard care. Although children faced a multitude of pandemic-related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.
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Affiliation(s)
- Daniel Munblit
- Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Matthew Greenhawt
- Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Helen A Brough
- Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital, London, UK
- Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Anna Pushkareva
- European Academy of Allergy and Clinical Immunology (EAACI), Zurich, Switzerland
| | - Diana Karimova
- European Academy of Allergy and Clinical Immunology (EAACI), Zurich, Switzerland
| | - Anastasia Demidova
- European Academy of Allergy and Clinical Immunology (EAACI), Zurich, Switzerland
| | - John O Warner
- Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Omer Kalayci
- Pediatric Allergy and Asthma, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Anna Sediva
- Department of Immunology, 2nd Medical Faculty, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Marta Vazquez-Ortiz
- Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Stefania Arasi
- Translational Research in Pediatric Specialities Area, Division of Allergy, IRCCS, Bambino Gesù Children's Hospital, Rome, Italy
| | - Montserrat Alvaro-Lozano
- Allergology and Clinical Immunology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Sophia Tsabouri
- Child Health Department, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elena Galli
- Pediatric Allergology Unit, Department of Pediatric Medicine, S.Pietro Hospital Fatebenefratelli, Rome, Italy
| | - Burcin Beken
- Department of Pediatric Allergy and Immunology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Philippe A Eigenmann
- Pediatric Allergy Unit, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
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Filon FL, Lazzarato I, Patriarca E, Iavernig T, Peratoner A, Perri G, Ponis G, Rocco G, Cegolon L. Allergic Reactions to COVID-19 Vaccination in High-Risk Allergic Patients: The Experience of Trieste University Hospital (North-Eastern Italy). Vaccines (Basel) 2022; 10:vaccines10101616. [PMID: 36298481 PMCID: PMC9607499 DOI: 10.3390/vaccines10101616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/12/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Allergic patients may develop reactions following COVID-19 vaccination more frequently than non-allergic individuals. The aim of our study was to assess the risk of reactions in high-risk allergic patients vaccinated for COVID-19 at the University Health Agency Giuliano-Isontina (ASUGI) of Trieste (northeastern Italy). Methods. Patients were considered at high risk for allergic reactions in case of: prior anaphylactic reaction to any drug/vaccine; multiple drug allergy; intolerance to polyethylene glycol (PEG) or polysorbate 80 (PS80) containing drugs; and mast cell disorders. High-risk allergic patients were immunized in hospital by a dedicated allergy team supported by resuscitation staff. Patients were interviewed over the phone one month after vaccination to complete a structured questionnaire investigating signs and symptoms developed after immunization. Results. From March 2021 to February 2022, 269 patients with a history of severe allergic reactions were assessed, of whom 208 (77.3%) eventually received COVID-19 vaccination, 50 (18.6%) refused to be immunized, 10 (3.7%) were deferred for medical reasons and one was declared exempted due to testing positive for PS80. Mild reactions (urticaria, angioedema, rhinitis, erythema) to COVID-19 vaccines were reported by 30.3% of patients, 8.7% within 4 h and 21.6% > 4 h after immunization. No anaphylactic events were observed. Although they were 80 times (3.8%) more prevalent than in COVID-19 vaccinees from the general population (0.047%), vaccine allergic reactions in high-risk patients were mainly mild and late, more likely affecting women (OR = 3.05; 95% CI 1.22−7.65). Conclusions. High-risk allergic patients with urticaria and angioedema may experience mild flare-ups of mast cell activation-like symptoms following COVID-19 vaccination, supporting antihistamine premedication before vaccination and to be continued for one week afterwards.
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Affiliation(s)
- Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Unit of Occupational Medicine, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Ilaria Lazzarato
- Unit of Occupational Medicine, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Emilia Patriarca
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Correspondence: (E.P.); or (L.C.)
| | - Thomas Iavernig
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Alberto Peratoner
- Accident & Emergency, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Giuseppe Perri
- Directorate Office, Cattinara Hospital, University Health Agency Giuliano-Isontina (ASUGI), 34149 Trieste, Italy
| | - Giuliano Ponis
- Hospital Pharmacy, Giuliano Area, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
| | - Giulio Rocco
- Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
| | - Luca Cegolon
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
- Correspondence: (E.P.); or (L.C.)
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28
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Chavda VP, Chen Y, Dave J, Chen ZS, Chauhan SC, Yallapu MM, Uversky VN, Bezbaruah R, Patel S, Apostolopoulos V. COVID-19 and vaccination: myths vs science. Expert Rev Vaccines 2022; 21:1603-1620. [PMID: 35980281 DOI: 10.1080/14760584.2022.2114900] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Several vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed since the inception of the coronavirus disease 2019 (COVID-19) in December 2019, at unprecedented speed. However, these rapidly developed vaccines raised many questions related to the efficacy and safety of vaccines in different communities across the globe. Various hypotheses regarding COVID-19 and its vaccines were generated, and many of them have also been answered with scientific evidence. Still, there are many myths/misinformation related to COVID-19 and its vaccines, which create hesitancy for COVID-19 vaccination, and must be addressed critically to achieve success in the battle against the pandemic. AREA COVERED The development of anti-SARS-CoV-2 vaccines against COVID-19, their safety and efficacy, and myths/misinformation relating to COVID-19 and vaccines are presented. EXPERT OPINION In this pandemic we have seen a global collaborative effort of researchers, governments, and industry, supported by billions of dollars in funding, have allowed the development of vaccines far more quickly than in the past. Vaccines go through rigorous testing, analysis, and evaluations in clinical settings prior to their approval, even if they are approved for emergency use. Despite the myths, vaccination represents an important strategy to get back to normality.
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Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L.M. College of Pharmacy, Ahmedabad
| | - Yangmin Chen
- Peter J. Tobin College of Business, St. John's University, Queens, NY 11439, USA
| | - Jayant Dave
- Department of Pharmaceutical Quality Assurance, L.M. College of Pharmacy, Ahmedabad
| | - Zhe-Sheng Chen
- College of Pharmacy and Health Sciences, St. John's University, Queens, NY 11439, USA
| | - Subhash C Chauhan
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA.,South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA
| | - Murali M Yallapu
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA.,South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA
| | - Vladimir N Uversky
- Department of Molecular Medicine and Byrd Alzheimer's Research Institure, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Rajashri Bezbaruah
- Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh -786004, Assam, India
| | - Sandip Patel
- Department of Pharmacology, L.M. College of Pharmacy, Ahmedabad
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Immunology and Translational Research Group, Victoria University, Melbourne, VIC, 3030, Australia.,Immunology Program, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, VIC, 3021, Australia
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29
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Anaphylaxis to SARS-CoV-2 Vaccines in the Setting of a Nationwide Passive Epidemiological Surveillance Program. J Clin Immunol 2022; 42:1593-1599. [PMID: 35976470 PMCID: PMC9382604 DOI: 10.1007/s10875-022-01350-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/12/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Information on anaphylaxis among recipients of vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains scarce. OBJECTIVE To identify the observed incidence of anaphylaxis in recipients of different anti-SARS-CoV-2 vaccines. METHODS A nationwide observational study among recipients of 61,414,803 doses of seven different anti-SARS-CoV-2 vaccines, describing the incidence and characteristics of adult patients (age ≥ 18 years) who developed anaphylaxis as an adverse event following immunization (AEFI) against SARS-CoV-2 vaccines between December 24, 2020, and October 15, 2021, in Mexico. RESULTS Sixty-six patients developed anaphylaxis as an AEFI, for an overall observed incidence of 1.07 cases per 1,000,000 (95% CI 0.84-1.37) administered doses. Eighty-six percent of the patients were female, consistent with previous reports of AEFI to COVID-19 vaccines. mRNA-based vaccine recipients had the highest frequency of anaphylaxis, followed by adenovirus-vectored vaccines and inactivated virus recipients, with an observed incidence of 2.5, 0.7, and 0.2 cases per 1,000,000 doses administered, respectively. Only 46% of the patients received correct treatment with epinephrine as the first-line treatment through the appropriate route and dose. We detected one case of anaphylactic reaction-related death occurring 5 min following immunization with ChAdOx1 nCov-19 for a mortality rate of 1.5% among those who developed this AEFI. CONCLUSIONS In our population, anaphylactic reactions were infrequent. Our study provides further evidence supporting the security of these newly developed vaccines.
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30
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Adverse Events following Immunization with COVID-19 Vaccines: A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2911333. [PMID: 36017393 PMCID: PMC9398801 DOI: 10.1155/2022/2911333] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/08/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022]
Abstract
Numerous COVID-19 vaccines are being administered to people around the world. Adverse events following immunization (AEFI) with COVID-19 vaccines have been reported by health care workers as well as surveillance bodies. A wealth of information on the efficacy and safety of vaccines exists in the literature, and the knowledge in this sector is growing exponentially. A narrative literature review was conducted on sources accessed from PubMed, Google Scholar, and Cochrane Review from March 2021 to July 2021. This review is aimed at describing AEFI associated with currently available COVID-19 vaccines, with an emphasis on narrating probable AEFI, and at assisting in a better understanding of the COVID-19 vaccines.
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31
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Cha B, Kwon KS, Lee HL, Kim CW. Successful mRNA COVID-19 Vaccination and Colonoscopy After Oral Desensitization in a Patient With Polyethylene Glycol Allergy. J Korean Med Sci 2022; 37:e251. [PMID: 35971765 PMCID: PMC9424693 DOI: 10.3346/jkms.2022.37.e251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/10/2022] [Indexed: 12/01/2022] Open
Abstract
Anaphylaxis to polyethylene glycol (PEG) is rare and mainly occurs with the use of laxatives containing PEG. Recently, an increasing number of PEG allergies have been reported, particularly those related to coronavirus disease 2019 (COVID-19) vaccines. mRNA COVID-19 vaccines, such as the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines, contain PEG2000 as an excipient and are contraindicated when allergy to a vaccine component exist. We report a 55-year-old woman's history as a case of successful mRNA COVID-19 vaccination and colonoscopy after oral desensitization to PEG in a patient with PEG allergy who required both COVID-19 vaccination and colon evaluation. Allergy to PEG was diagnosed based on clinical history, skin test results, and basophil histamine release testing. Oral desensitization effectively suppressed histamine release from basophils in response to PEG stimulation, suggesting that oral desensitization using PEG-based laxatives may be an effective treatment option for patients with allergy to the substance.
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Affiliation(s)
- Boram Cha
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Kye Sook Kwon
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hong Lyeol Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Cheol-Woo Kim
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
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32
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Pawankar R, Thong BYH, Tiongco-Recto M, Wang JY, Latiff AHA, Leung TF, Li PH, Lobo RCM, Lucas M, Oh JW, Kamchaisatian W, Nagao M, Rengganis I, Udwadia ZF, Dhar R, Munkhbayarlakh S, Narantsetseg L, Pham DL, Zhang Y, Zhang L. Asia Pacific perspectives on the second year of the COVID-19 pandemic: A follow-up survey. Clin Exp Allergy 2022; 52:965-973. [PMID: 35906963 PMCID: PMC9353384 DOI: 10.1111/cea.14191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/08/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
Background The Coronavirus disease 2019 (COVID‐19) pandemic is currently in its third year. This follow‐up survey was commissioned by the Asia Pacific Association of Allergy Asthma and Clinical Immunology (APAAACI) Task Force on COVID‐19 to compare and contrast changes in the epidemiology, clinical profile, therapeutics and public health measures of the pandemic in the Asia Pacific region. Methods A questionnaire‐based survey comprising 32 questions was electronically sent out to all 15 member countries of APAAACI using Survey Monkey® from 1 December 2021 to 28 February 2022. Results Seventeen responses were received from 14/15 (93.4%) member countries and 3 individual members. Mild‐to‐moderate COVID‐19 predominated over severe infection, largely contributed by COVID‐19 vaccination programmes in the region. The incidence of vaccine adverse reactions in particular anaphylaxis from messenger ribonucleic acid (mRNA) vaccines was no longer as high as initially anticipated, although perimyocarditis remains a concern in younger males. Novel therapeutics for mild‐to‐moderate disease including neutralizing antibodies casirivimab/imdevimab (REGEN‐COV®) and sotrovimab (Xevudy®), anti‐virals Paxlovid® (nirmatrelvir and ritonavir) and Molnupiravir pre‐exposure prophylaxis for high‐risk persons with Tixagevimab and Cilgavimab (Evusheld) are now also available to complement established therapeutics (e.g., remdesivir, dexamethasone and baricitinib) for severe disease. In the transition to endemicity, public health measures are also evolving away from containment/elimination strategies. Conclusions With access to internationally recommended standards of care including public health preventive measures, therapeutics and vaccines among most APAAACI member countries, much progress has been made over the 2‐year period in minimizing the morbidity and mortality from COVID‐19 disease.
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Affiliation(s)
- Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Marysia Tiongco-Recto
- Division of Allergy and Immunology, Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Jiu-Yao Wang
- Allergy, Immunology, and Microbiome (A.I.M.) Research Centre, China Medical University Children's Hospital, Taichung, Taiwan
| | | | - Ting Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Philip Hei Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Rommel Crisenio M Lobo
- Philippine Childrens Medical Center Hospital of Infant Jesus Medical Center, Fe del Mundo Medical Center, Quezon City, Philippines
| | - Michela Lucas
- Department of Clinical Immunology, Sir Charles Gairdner Hospital, Perth Children's Hospital, Perth, WA, Australia.,Medical School, University of Western Australia, Perth, WA, Australia
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, South Korea
| | - Wasu Kamchaisatian
- Pediatric Allergy and Immunology, Samitivej Children's Hospital, Bangkok, Thailand
| | - Mizuho Nagao
- National Hospital Organization Mie National Hospital, Institute for Clinical Research, Tsu, Japan
| | - Iris Rengganis
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Cipto Mangunkusumo General Hopsital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Zarir F Udwadia
- P.D. Hinduja National Hospital and Medical Research Centre, Breach Candy Hospital, in Mumbai, Mumbai, India
| | | | - Sonomjamts Munkhbayarlakh
- Department of Pulmonology and Allergology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Logii Narantsetseg
- Department of Biochemistry, School of Biomedicine, National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Duy Le Pham
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Yuan Zhang
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
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33
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Barbaud A, Garvey LH, Arcolaci A, Brockow K, Mori F, Mayorga C, Bonadonna P, Atanaskovic‐Markovic M, Moral L, Zanoni G, Pagani M, Soria A, Jošt M, Caubet J, Carmo A, Mona A, Alvarez‐Perea A, Bavbek S, Benedetta B, Bilo M, Blanca‐López N, Bogas HG, Buonomo A, Calogiuri G, Carli G, Cernadas J, Cortellini G, Celik G, Demir S, Doña I, Dursun AB, Eberlein B, Faria E, Fernandes B, Garcez T, Garcia‐Nunez I, Gawlik R, Gelincik A, Gomes E, Gooi JHC, Grosber M, Gülen T, Hacard F, Hoarau C, Janson C, Johnston SL, Joerg L, Kepil Özdemir S, Klimek L, Košnik M, Kowalski ML, Kuyucu S, Kvedariene V, Laguna JJ, Lombardo C, Marinho S, Merk H, Meucci E, Morisset M, Munoz‐Cano R, Murzilli F, Nakonechna A, Popescu F, Porebski G, Radice A, Regateiro FS, Röckmann H, Romano A, Sargur R, Sastre J, Scherer Hofmeier K, Sedláčková L, Sobotkova M, Terreehorst I, Treudler R, Walusiak‐Skorupa J, Wedi B, Wöhrl S, Zidarn M, Zuberbier T, Agache I, Torres MJ. Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper. Allergy 2022; 77:2292-2312. [PMID: 35112371 DOI: 10.1111/all.15241] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/17/2021] [Accepted: 01/03/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anaphylaxis, which is rare, has been reported after COVID-19 vaccination, but its management is not standardized. METHOD Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre-vaccination screening and management of allergic reactions to COVID-19 vaccines, and literature was analysed. RESULTS No death due to anaphylaxis to COVID-19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1-anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2-anaphylaxis to oral/topical PEG containing products; 3-recurrent anaphylaxis of unknown cause; 4-suspected or confirmed allergy to any mRNA vaccine; and 5-confirmed allergy to PEG or derivatives. We recommend a prick-to-prick skin test with the left-over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable. CONCLUSIONS These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID-19 vaccines and enable more people with history of allergy to be vaccinated.
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Affiliation(s)
- Annick Barbaud
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Epidémiologie et de Santé PubliqueAP‐HP.Sorbonne Université, Hôpital TenonDépartement de dermatologie et allergologie Paris France
| | - Lene Heise Garvey
- Allergy ClinicCopenhagen University Hospital at Gentofte Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Denmark
| | - Alessandra Arcolaci
- Immunology UnitUniversity Hospital of VeronaPoliclinico G.B. Rossi Verona Italy
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein Faculty of Medicine Technical University of Munich Munich Germany
| | - Francesca Mori
- Allergy Unit Department of Pediatrics Meyer Children’s University Hospital
| | - Cristobalina Mayorga
- Allergy Clinical Unit Hospital Regional Universitario de Málaga‐Instituto de Investigación Biomédica de Málaga‐IBIMA ARADyAL, Málaga Spain
| | | | | | - Luis Moral
- Moral Luis. Pediatric Allergy and Respiratory Unit Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL) Alicante Spain
| | - Giovanna Zanoni
- Giovanna Zanoni, Immunology Unit, Policlinico G.B. Rossi, Azienda Ospedaliera Universitaria Integrata Verona Italy
| | - Mauro Pagani
- Medicine Department Medicine Ward Mantova HospitalASST di Mantova Italy
| | - Angèle Soria
- Sorbonne UniversitéINSERM 1135 Cimi‐ParisHôpital TenonAssistance Publique‐Hôpitaux de ParisDepartement de dermatologie et d'allergologie Paris France
| | - Maja Jošt
- University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
| | - Jean‐Christoph Caubet
- Department of Women‐Children‐Teenagers University Hospital of Geneva Geneva Switzerland
| | - Abreu Carmo
- Allergy and Clinical Immunology Unit Centro Hospitalar de Trás‐os‐Montes e Alto DouroVila Real and Allergy and Clinical Immunology UnitCentro Hospitalar do Baixo Vouga Aveiro Portugal
| | - Al‐Ahmad Mona
- Microbiology Department Faculty of MedicineKuwait University Kuwait
| | | | - Sevim Bavbek
- School of Medicine Department of Pulmonary Diseases Division of Allergy FAAAIAnkara University Ankara Turkey
| | - Biagioni Benedetta
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease IRCCS Azienda Ospedaliero‐Universitaria di Bologna Italy
| | - M.Beatrice Bilo
- Department of Clinical and Molecular Sciences Università Politecnica delle Marche Ancona Italy
- Allergy Unit ‐ Department of Internal Medicine University Hospital Ospedali Riuniti di Ancona Italy
| | | | - Herrera Gádor Bogas
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA, and Allergy UnitHospital Regional Universitario de Málaga‐HRUM Málaga Spain
| | - Alessandro Buonomo
- Allergy Unit ‐ Fondazione Policlinico Gemelli IRCCS ‐ Largo Gemelli Rome Italy
| | | | - Giulia Carli
- SOS Allergologia e ImmunologiaAzienda USL Toscana CentroOspedale S. Stefano Prato Italy
| | - Josefina Cernadas
- Allergy and Clinical Immunology Department Centro Hospitalar Universitário de S. JoãoPorto and Allergy UnitHospital Lusíadas Porto Portugal
| | - Gabriele Cortellini
- Allergy Unit Departments of Internal Medicine Azienda Sanitaria della RomagnaRimini, Hospital Rimini Italy
| | - Gülfem Celik
- Department of Chest Diseases Division of Immunology and allergy Ankara University School of Medicine cebeci Hospital Ankara Turkey
| | - Semra Demir
- Istanbul UniversityIstanbul Faculty of MedicineInternal MedicineImmunology and Allergic Diseases Istanbul Turkey
| | - Inmaculada Doña
- Allergy Research Group Allergy UnitHospital Regional Universitario de MálagaInstituto de Investigación Biomédica de Málaga‐IBIMAPlaza del Hospital Civil s/n Málaga Spain
| | | | - Bernadette Eberlein
- Faculty of Medicine Department of Dermatology and Allergy Biederstein Technical University of Munich Munich Germany
| | - Emilia Faria
- Allergy and Clinical Immunology Unit Centro Hospitalar E Universitário de Coimbra Coimbra Portugal
| | | | - Tomaz Garcez
- Immunology Department Manchester University NHS Foundation Trust Manchester UK
| | | | - Radoslaw Gawlik
- Department of Internal Diseases, Allergology and Clinical Immunology Medical University of Silesia Katowice Poland
| | - Asli Gelincik
- Istanbul UniversityIstanbul Faculty of Medicine, Internal Medicine, Immunology and Allergic Diseases Istanbul Turkey
| | - Eva Gomes
- Allergy Department Centro Hospitalar Universitário do Porto Porto Portugal
| | - Jimmy H. C. Gooi
- Department of Clinical Immunology King’s College Hospital London UK
| | - Martine Grosber
- Department of Dermatology Universitair ZiekenhuisVrije Universiteit Brussel Brussel Belgium
| | - Theo Gülen
- Department of Respiratory Medicine and Allergy Department of Medicine Karolinska University Hospital HuddingeKarolinska Institutet Stockholm Sweden
| | - Florence Hacard
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Pierre‐Bénite France
| | - Cyrille Hoarau
- Service transversal d'allergologie et immunologie clinique CHR de Tours Tours France
| | | | | | - Lukas Joerg
- Division of Allergology and Clinical Immunology Department of Pneumology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| | - Seçil Kepil Özdemir
- Department of Chest Diseases Division of Allergy and Immunology Chest Diseases and Surgery Training and Research Hospital Izmir Turkey
| | - Ludger Klimek
- Center for Rhinology and Allergology Wiesbaden Germany
| | | | - Marek L. Kowalski
- Department of Immunology and Allergy Medical University of Lodz Poland
| | - Semanur Kuyucu
- Faculty of Medicine Dpt of Pediatric Allergy and Immunology Mersin University Mersin Turkey
| | - Violeta Kvedariene
- Institute of Biomedical Sciences Department of Pathology Faculty of Medicine Vilnius UniversityInstitute of Clinical Medicine, Clinic of Chest diseases, Immunology and Allergology, Faculty of Medicine Vilnius Lithuania
| | - Jose Julio Laguna
- Allergy Unit, Allergo‐Anaesthesia Unit Faculty of Medicine Hospital Central de la Cruz RojaAlfonso X El Sabio University Madrid Spain
| | | | - Susana Marinho
- Allergy Centre Wythenshawe HospitalManchester University NHS Foundation Trust and University of Manchester Manchester UK
| | | | - Elisa Meucci
- SOS Allergologia ed Immunologia clinicaAzienda USL Toscana CentroOspedale San Giovanni di Dio Firenze Italy
| | | | | | | | - Alla Nakonechna
- Allergy and Clinical Immunology Department University of LiverpoolRoyal Preston HospitalLancashire Teaching HospitalsNHS Foundation Trust UK
| | - Florin‐Dan Popescu
- Department of Allergology Carol Davila University of Medicine and PharmacyNicolae Malaxa Clinical Hospital Bucharest Romania
| | - Grzegorz Porebski
- Department of Clinical and Environmental Allergology Jagiellonian University Medical College Krakow Poland
| | - Anna Radice
- SOS Allergologia ed Immunologia clinicaAzienda USL Toscana CentroOspedale San Giovanni di Dio Firenze Italy
| | - Frederico S. Regateiro
- Allergy and Clinical Immunology Unit Centro Hospitalar E Universitário de Coimbra Coimbra Portugal
- Institute of Immunology Faculty of Medicine University of Coimbra Coimbra Portugal
- ICBR ‐ Coimbra Institute for Clinical and Biomedical ResearchCIBBFaculty of MedicineUniversity of Coimbra Coimbra Portugal
| | - Heike Röckmann
- Department of Dermatology University Medical Centre Utrecht‐Heidelberglaan 100 Utrecht The Netherlands
| | | | - Ravishankar Sargur
- Clinical Immunology and Allergy Unit Northern General HospitalSheffield Teaching Hospitals NHS Foundation Trust Sheffield UK
| | - Joaquin Sastre
- Allergy Department Fundación Jiménez DiazUniversidad Autonoma de MadridCIBERESInstituto de Salud Carlos III Spain
| | | | | | - Marta Sobotkova
- Department of Immunology Motol University Hospital and 2nd Faculty of Medicine Charles University Prague Czech Republic
| | | | - Regina Treudler
- Department of Dermatology, Venerology and Allergology Universitätsmedizin Leipzig Leipzig Germany
| | - Jolanta Walusiak‐Skorupa
- Department of Occupational Diseases and Environmental Health Walusiak‐Skorupa JolantaNofer Institute of Occupational Medicine Lodz Poland
| | - Bettina Wedi
- Department of Dermatology & Allergy OE6600Comprehensive Allergy CenterHannover Medical School Hannover Germany
| | | | - Mihael Zidarn
- University Clinic of Respiratory and Allergic Diseases GolnikGolnik, and Internal Medicine, Faculty of MedicineUniversity of Ljubljana Ljubljana Slovenia
| | - Torsten Zuberbier
- Charité ‐ Universitätsmedizin BerlinKlinik für Dermatologie Berlin Germany
| | - Ioana Agache
- Faculty of Medicine Transylvania University Brasov Romania
| | - Maria J. Torres
- Allergy Unit Regional University Hospital of MalagaIBIMA‐UMA‐ARADyAL Malaga Spain
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Paul P, Janjua E, AlSubaie M, Ramadorai V, Mushannen B, Vattoth AL, Khan W, Bshesh K, Nauman A, Mohammed I, Bouhali I, Khalid M, Zakaria D. Anaphylaxis and Related Events Post-COVID-19 Vaccination: A Systematic Review. J Clin Pharmacol 2022; 62:1335-1349. [PMID: 35794852 PMCID: PMC9349886 DOI: 10.1002/jcph.2120] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19), induced by the SARS CoV-2 virus, is responsible for a global pandemic following widespread transmission and death. Several vaccines have been developed to counter this public health crisis using both novel and conventional methods. Following approval based on promising efficacy and safety data, the AstraZeneca, Janssen, Moderna, Pfizer/BioNTech, and SinoVac vaccines have been administered globally among different populations with various reported side effects. Reports of life-threatening anaphylaxis following administration were of particular concern for both healthcare providers and the public. A systematic literature search using PubMed, Embase, Scopus, Web of Science, Science Direct, MedRxiv, and Lens.org databases identified relevant studies reporting anaphylaxis following vaccine administration. This systematic review includes 41 studies reporting anaphylaxis out of 19908 studies that were retrieved for screening. A total of 7942 cases, including 43 deaths, were reported across 14 countries. Most cases occurred following the administration of the first dose. Importantly, the benefits of vaccination far outweigh the risks of anaphylaxis. Subsequently, as populations continue to get vaccinated, it is important for healthcare providers to be able to recognize individuals at risk of developing anaphylaxis. Furthermore, they must be familiar with both the clinical hallmarks and treatment of anaphylactic reactions to minimize long term sequalae and prevent death in vaccinated individuals. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Pradipta Paul
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Emmad Janjua
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Mai AlSubaie
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Vinutha Ramadorai
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Beshr Mushannen
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | | | - Wafa Khan
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Khalifa Bshesh
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Areej Nauman
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Ibrahim Mohammed
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar.,Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA
| | - Imane Bouhali
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Mohammed Khalid
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Dalia Zakaria
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
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Luxi N, Giovanazzi A, Arcolaci A, Bonadonna P, Crivellaro MA, Cutroneo PM, Ferrajolo C, Furci F, Guidolin L, Moretti U, Olivieri E, Petrelli G, Zanoni G, Senna G, Trifirò G. Allergic Reactions to COVID-19 Vaccines: Risk Factors, Frequency, Mechanisms and Management. BioDrugs 2022; 36:443-458. [PMID: 35696066 PMCID: PMC9190452 DOI: 10.1007/s40259-022-00536-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/01/2022]
Abstract
Conventional vaccines have been widely studied, along with their risk of causing allergic reactions. These generally consist of mild local reactions and only rarely severe anaphylaxis. Although all the current COVID-19 vaccines marketed in Europe have been shown to be safe overall in the general population, early post-marketing evidence has shown that mRNA-based vaccines using novel platforms (i.e., lipid nanoparticles) were associated with an increased risk of severe allergic reactions as compared to conventional vaccines. In this paper we performed an updated literature review on frequency, risk factors, and underlying mechanisms of COVID-19 vaccine-related allergies by searching MEDLINE and Google Scholar databases. We also conducted a qualitative search on VigiBase and EudraVigilance databases to identify reports of "Hypersensitivity" and "Anaphylactic reaction" potentially related to COVID-19 vaccines (Comirnaty, Spikevax, Vaxzevria and COVID-19 Janssen Vaccine), and in EudraVigilance to estimate the reporting rates of "Anaphylactic reaction" and "Anaphylactic shock" after COVID-19 vaccination in the European population. We also summarized the scientific societies' and regulatory agencies' recommendations for prevention and management of COVID-19 vaccine-related allergic reactions, especially in those with a history of allergy.
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Affiliation(s)
- Nicoletta Luxi
- Department of Diagnostics and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| | - Alexia Giovanazzi
- Department of Diagnostics and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| | - Alessandra Arcolaci
- Immunology Unit, University Hospital, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Patrizia Bonadonna
- Asthma Centre and Allergy Unit, University of Verona and Verona University Hospital, Verona, Italy
| | - Maria Angiola Crivellaro
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Paola Maria Cutroneo
- Sicilian Regional Pharmacovigilance Centre, University Hospital of Messina, Messina, Italy
| | - Carmen Ferrajolo
- Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabiana Furci
- Immunology Unit, University Hospital, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Lucia Guidolin
- Asthma Centre and Allergy Unit, University of Verona and Verona University Hospital, Verona, Italy
| | - Ugo Moretti
- Department of Diagnostics and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| | - Elisa Olivieri
- Asthma Centre and Allergy Unit, University of Verona and Verona University Hospital, Verona, Italy
| | - Giuliana Petrelli
- Department of Diagnostics and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| | - Giovanna Zanoni
- Immunology Unit, University Hospital, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Gianenrico Senna
- Asthma Centre and Allergy Unit, University of Verona and Verona University Hospital, Verona, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, Section of Pharmacology, University of Verona, Verona, Italy.
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Anis E, Preis SA, Cedar N, Tal Y, Hershkowitz I, Hershko AY. Reporting of Allergic Reactions During Pfizer-BioNTech BNTT162B2 Vaccination in Israel. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:2969-2976. [PMID: 35872216 PMCID: PMC9356746 DOI: 10.1016/j.jaip.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/22/2022] [Accepted: 07/07/2022] [Indexed: 11/15/2022]
Abstract
Background In December 2020, the Israeli Ministry of Health launched a national vaccination campaign against SARS-CoV-2. Concomitant sporadic reports on anaphylactic responses in other countries raised safety concerns at the outset of this operation. Objective To characterize reports on allergic reactions to coronavirus disease 2019 vaccines. Methods Allergy events were reported by health care professionals throughout the country to Israeli Ministry of Health Division of Epidemiology via a Web-based computerized national vaccine registry. The study period was from December 19, 2020 to September 13, 2021, during which 14,475,979 injections were administered. Results Allergic reactions were reported in 463 subjects, 99.3% of whom received Pfizer-BioNTech BNTT162B2. The reporting rate was 106 per million in December 2020. From January to May 2021, a reduction was observed to 66, 18, 14, eight, and zero per million, and reporting remained low until September. Mean age of subjects was 48.9 ± 16.7 years (range, 15-96 years) with a female preponderance of 78%. Epinephrine was administered in 34 subjects. Validated immediate allergy was observed in only 37 cases (8%), suggesting 2.5 to 3.3 bona fide reactions per million. In subjects with reactions classified as severe (n = 46), plausible allergy was identified in 36% to 41% of cases. A history of allergy was associated with high false reporting of immediate reactions (83%). Allergic events after the first dose did not compromise adherence to subsequent doses. Conclusions Excessive reporting of allergy declined over time and did not affect adherence to vaccination. The existence of previous allergy may affect reporting profiles, but not the occurrence of vaccine allergy.
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Safety of an inactivated, whole-virion COVID-19 vaccine (CoronaVac) in people aged 60 years or older in Hong Kong: a modified self-controlled case series. THE LANCET HEALTHY LONGEVITY 2022; 3:e491-e500. [PMID: 35813276 PMCID: PMC9252509 DOI: 10.1016/s2666-7568(22)00125-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Because evidence on the safety of COVID-19 vaccines in older adults is scarce, we aimed to evaluate the incidence and risk of adverse events after CoronaVac (Sinovac Biotech) vaccination in adults aged 60 years or older. Methods In this modified self-controlled case series, we enrolled adults aged 60 years or older who had received at least one dose of CoronaVac in Hong Kong between Feb 23, 2021, and Jan 31, 2022. We extracted population-based, electronic health record data from the clinical management system of the Hospital Authority on adverse events of special interest (from Jan 1, 2005, to Feb 23, 2022) and patients' demographic information (from Jan 1, 2018, to Jan 31, 2022), previous diagnoses (from Jan 1, 2018, to Jan 31, 2022), medication history (from Jan 1, 2018, to Jan 31, 2022), and laboratory tests, including those for SARS-CoV-2 infection (from Jan 1, 2018, to Jan 31, 2022). Details of vaccination status were provided by the Department of Health of the Hong Kong Government and were linked to data from the Hospital Authority with identity card numbers or passport numbers. Our outcomes were the overall incidence of any adverse event of special interest and the incidence rates of 30 adverse events of special interest, as suggested by the WHO Global Advisory Committee on Vaccine Safety, in the inpatient setting within 21 days (2 days for anaphylaxis) of either the first, second, or third CoronaVac dose compared with a baseline period. Individuals who had a history of a particular event between Jan 1, 2005, and Feb 23, 2021, were excluded from the corresponding analysis. We evaluated the risk of an adverse event of special interest using conditional Poisson regression, adjusting for seasonal effects. Findings Of 1 253 497 individuals who received at least one dose of CoronaVac during the study period, 622 317 (49·6%) were aged at least 60 years and were included in the analysis. Our analysis sample received 1 229 423 doses of CoronaVac and had a mean age of 70·40 years (SD 8·10). 293 086 (47·1%) of 622 317 participants were men and 329 231 (52·9%) were women. The incidence of individual adverse events of interest ranged from 0·00 per 100 000 people to 57·49 per 100 000 people (thromboembolism). The first and third doses of CoronaVac were not associated with a significant excess risk of an adverse event of special interest within 21 days (or 2 days for anaphylaxis) of vaccination. After the second dose, the only significantly increased risk was for anaphylaxis (adjusted incidence rate ratio 2·61, 95% CI 1·08–6·31; risk difference per 100 000 people 0·61, 95% CI 0·03–1·81). Interpretation Because older age is associated with poor outcomes after SARS-CoV-2 infection, the benefits of CoronaVac vaccination in older adults outweigh the risks in regions where COVID-19 is prevalent. Ongoing monitoring of vaccine safety is warranted. Funding The Food and Health Bureau of the Government, Hong Kong Special Administrative Region, China and AIR@InnoHK, administered by the Innovation and Technology Commission. Translation For the Chinese translation of the abstract see Supplementary Materials section.
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Escudero C, Prieto-Montaño P, Audicana MT. Adverse Reactions to Anti-Infective Vaccines: an Emerging Problem in the COVID-19 Era. CURRENT TREATMENT OPTIONS IN ALLERGY 2022; 9:250-272. [PMID: 35789930 PMCID: PMC9244417 DOI: 10.1007/s40521-022-00311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/23/2022]
Abstract
Purpose of review Vaccines are an essential tool for preventing infectious diseases and reducing associated morbidity and mortality. Vaccination has a significant impact at both individual and community levels, and COVID‐19 vaccination programs are a new example of the great value of this public health strategy. However, adverse reactions, especially severe reactions such as anaphylaxis, prevent these programs from progressing properly, thus limiting vaccination uptake in the population. Recent findings The frequency of reactions and types of vaccine components, with special attention to COVID-19 vaccines studies, provides information on the magnitude and causes of adverse events. The understanding of mechanisms involved has made it possible to adequately guide diagnosis, especially to COVID-19 vaccine components, such as polyethylene glycol, trometamol, and polysorbate-80. Summary This review focuses on adverse reactions to vaccines, with emphasis on allergic reactions. A diagnostic pathway is suggested that, on the one hand, enables to take the necessary precautions in persons with a history of allergy to vaccine components or allergic reactions to vaccines and, on the other, supports administration of subsequent doses. The overall objective is to ensure that people with allergy can be vaccinated in the same way as the rest of the population, and that they are offered alternatives where necessary.
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Affiliation(s)
- Prinsa Shrestha
- Department of Internal Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
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Csuth À, Nopp A, Storsaeter J, Nilsson L, Jenmalm MC. COVID-19 vaccines and anaphylaxis-evaluation with skin prick testing, basophil activation test and Immunoglobulin E. Clin Exp Allergy 2022; 52:812-819. [PMID: 35384115 PMCID: PMC9111551 DOI: 10.1111/cea.14143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/27/2022] [Accepted: 03/19/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Àgnes Csuth
- Department of Biomedical and Clinical Sciences, Allergy Center, Linköping University, Linköping, Sweden
| | - Anna Nopp
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Jann Storsaeter
- Department of Vaccines, Public Health Agency of Sweden, Solna, Sweden
| | - Lennart Nilsson
- Department of Biomedical and Clinical Sciences, Allergy Center, Linköping University, Linköping, Sweden
| | - Maria C Jenmalm
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Seirafianpour F, Pourriyahi H, Gholizadeh Mesgarha M, Pour Mohammad A, Shaka Z, Goodarzi A. A systematic review on mucocutaneous presentations after COVID-19 vaccination and expert recommendations about vaccination of important immune-mediated dermatologic disorders. Dermatol Ther 2022; 35:e15461. [PMID: 35316551 PMCID: PMC9111423 DOI: 10.1111/dth.15461] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications.
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Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Homa Pourriyahi
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | | | - Arash Pour Mohammad
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Zoha Shaka
- Faculty of MedicineIran University of Medical SciencesTehranIran
- Systematic Review and Meta‐Analysis Expert Group (SRMEG)Universal Scientific Education and Research NetworkTehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical SciencesTehranIran
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TAŞ F, ERDEMCİ F, AŞIR F, MARAŞLI M, DEVECİ E. Histopathological examination of the placenta after delivery in pregnant women with COVID-19. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1100731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction: COVID-19 is a viral disease generated by a new coronavirus named SARS-CoV-2. The consequences of this virus on the human placenta and the newborn are still unclear. IL-6 can disturb the placenta's immunological homeostasis and be employed as an inflammatory marker for the poor prognosis of COVID-19 infection. Bax has some features like being a key protein regulating apoptotic mechanisms and plays an important role in both maintaining dynamic balance and integrity in the placenta as in many tissues. This study aims to indicate the impact of COVID-19 on inflammation and apoptotic pathways in the placenta by using IL-6 and Bax antibodies.
Material and Method: COVID-19 positive (n:10) and COVID-19 negative (n:10) normotensive placentas were included. Haematoxylin-eosin staining and immunohistochemical staining (IL-6 and Bax antibodies) were applied. Statistical data of immunohistochemical (IL-6 and Bax expression) staining results were assessed by analyzing the H-score. Biochemical parameters were recorded. Group means were analyzed with a nonparametric Kruskal Wallis Test.
Results: In the COVID-19 group, increased syncytial knots, fibrin deposition, inflammation, fibrinoid necrosis, neutrophil accumulation were observed. The COVID-19 group had considerably higher levels of IL-6 and Bax expression than the control group. Furthermore, COVID-19 patients had statistically lower WBC and higher CRP values than normotensive patients.
Conclusion: COVID-19 has been linked to placental inflammation and trophoblast cell damage, both of which can result in major maternal and fetal problems during pregnancy. We found intense IL-6 expression in the placentas of pregnant women with COVID-19 infection. A rise in IL-6 levels triggers CRP production, and this increase is linked to the severity of COVID-19 as a risk factor. Also, we suggested that COVID-19 infection triggers the apoptotic process in placental tissue by increasing the expression of the proapoptotic Bax protein. It is clinically very significant to follow up COVID-19 positive pregnancies for maternal and fetal health. During this follow-up, IL-6 and Bax expression levels in the placenta, together with histopathological findings and serum CRP levels, can guide the evaluation of the prognosis, severity and response to treatment of the disease.
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Sanyaolu A, Okorie C, Marinkovic A, Prakash S, Williams M, Haider N, Mangat J, Hosein Z, Balendra V, Abbasi AF, Desai P, Jain I, Utulor S, Abioye A. Current advancements and future prospects of COVID-19 vaccines and therapeutics: a narrative review. Ther Adv Vaccines Immunother 2022; 10:25151355221097559. [PMID: 35664358 PMCID: PMC9160920 DOI: 10.1177/25151355221097559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/12/2022] [Indexed: 11/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has made a global impact on the daily lives of humanity, devastating health systems, and cataclysmically affecting the world's economy. Currently, the Standard Public Health Protective practices consist of but are not limited to wearing masks, social distancing, isolating sick and exposed people, and contact tracing. Scientists around the globe undertook swift scientific efforts to develop safe and effective therapeutics and vaccines to combat COVID-19. Presently, as of mid-March 2022, 57.05% of the world population have been fully vaccinated, and 65.3% of the United States of America's (USA) total population have been fully vaccinated while 76.7% have received at least one dose of the vaccine. This article explores the various vaccines created through modern science and technology, including their safety, efficacy, and mechanism of action. Although the vaccines produced are up to 95.0% efficacious, their efficacy wanes over time, underscoring the need for booster doses. Also, vaccination has not been able to prevent "breakthrough" infections. The limitations of the SARS-CoV-2 vaccines indicate that further measures are required to ensure a firm control of the COVID-19 pandemic. Therefore, the Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the use of certain therapeutic agents because they have shown remarkable clinical outcomes. Several therapeutic agents for the treatment of mild-to-moderate COVID-19 include Gilead's remdesivir, Regeneron's casirivimab and imdevimab combination, Eli Lilly's baricitinib and remdesivir combination, Pfizer's co-packaged nirmatrelvir tablets and ritonavir tablets, and Merck's molnupiravir capsules. Hence concerted efforts in early and accurate diagnosis, education on the COVID-19 virulence, transmission and preventive measures, global vaccination, and therapeutic agents could bring this COVID-19 pandemic under control across the globe.
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Affiliation(s)
- Adekunle Sanyaolu
- Federal Ministry of Health, Department of Public Health, New Federal Secretariat Complex, Phase III, Ahmadu Bello Way, Central Business District, FCT, Abuja, Nigeria
| | | | | | | | | | - Nafees Haider
- All Saints University School of Medicine, Roseau, Dominica
| | - Jasmine Mangat
- Caribbean Medical University School of Medicine, Willemstad, Curacao
| | - Zaheeda Hosein
- Caribbean Medical University School of Medicine, Willemstad, Curacao
| | | | | | - Priyank Desai
- American University of Saint Vincent School of Medicine, Kingstown, Saint Vincent, and the Grenadines
| | - Isha Jain
- Windsor University School of Medicine, Cayon, Saint Kitts, and Nevis
| | - Stephen Utulor
- School of Medicine, International University of the Health Sciences, Basseterre, Saint Kitts, and Nevis
| | - Amos Abioye
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA
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Jover Cerdá V, Rodríguez Pacheco R, Doménech Witek J, Alonso Hernández S, Durán García R, Real Panisello M, Marco de la Calle FM. Allergological study in patients vaccinated against COVID-19 with suspected allergic reactions. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2022; 18:43. [PMID: 35624518 PMCID: PMC9136194 DOI: 10.1186/s13223-022-00685-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/08/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND One of the main barriers to vaccination against SARS-CoV-2 is the fear of developing hypersensitivity reactions to any of its components. Although these reactions are very rare, it is necessary to establish an effective protocol to detect patients at risk of developing them. The aim of this study was to evaluate hypersensitivity reactions in vaccinated patients in order to allow or not to complete the vaccination protocol. METHODS Descriptive and cross-sectional study in which patients with suspected hypersensitivity to SARS-CoV-2 vaccines were evaluated. All patients underwent skin prick test (SPT) and/or intradermal test (IDT) with the vaccines and their excipients. In patients with positive IDT with the vaccine, a histopathological and immunohistochemical study was performed by skin biopsy. A basophil activation test (BAT) and a lymphoblastic transformation test (LTT) were also performed. RESULTS Sixteen patients with suspected hypersensitivity to SARS-CoV-2 vaccine (12 received Comirnaty®, 3 received Vaxzevria®, and 1 received Spikevax®) were evaluated. Half had immediate hypersensitivity reactions and half had delayed reactions. All SPTs to excipients and vaccines were negative. IDTs with all excipients were negative. IDTs with vaccines were positive in 11 patients and negative in 5. The histological and immunohistochemical study of the two selected patients with positive IDT with vaccine showed T-lymphocyte involvement. BAT and LTT were negative in both cases. The vaccination protocol could be completed in 7 of 16 patients (44%) studied. The remaining 9 patients did not receive the second dose: 5 because vaccination was not required and 4 because they refused to be vaccinated. CONCLUSIONS Thanks to the allergological and immunohistochemical study, the vaccination protocol could be completed in about half of the patients who presented suspected hypersensitivity reactions to SARS-CoV-2 vaccines. IDTs with vaccines could be a valuable method for assessing the immunogenicity of the vaccines.
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Affiliation(s)
- Vicente Jover Cerdá
- Allergology Department, General University Hospital of Elda, Ctra. De Sax, s/n - 03600 Elda, Alicante, Spain.
| | - Ramón Rodríguez Pacheco
- Allergology Department, General University Hospital of Elda, Ctra. De Sax, s/n - 03600 Elda, Alicante, Spain
| | - Joan Doménech Witek
- Allergology Department, General University Hospital of Elda, Ctra. De Sax, s/n - 03600 Elda, Alicante, Spain
| | | | - Rafael Durán García
- Pathologic Anatomy Department, General University Hospital of Elda, Alicante, Spain
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Chiang V, Saha C, Yim J, Au EYL, Kan AKC, Hui KSH, Li TS, Lo WLW, Hong YD, Ye J, Ng C, Ko WWK, Ho CTK, Lau CS, Quan J, Li PH. The Role of the Allergist in Coronavirus Disease 2019 Vaccine Allergy Safety: A Pilot Study on a "Hub-and-Spoke" Model for Population-Wide Allergy Service. Ann Allergy Asthma Immunol 2022; 129:308-312.e1. [PMID: 35605815 PMCID: PMC9121691 DOI: 10.1016/j.anai.2022.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 02/06/2023]
Abstract
Background Hong Kong started its coronavirus disease 2019 (COVID-19) vaccination program in February 2021. A territory-wide Vaccine Allergy Safety (VAS) clinic was set up to assess individuals deemed at “higher risk” of COVID-19 vaccine-associated allergies. A novel “hub-and-spoke” model was piloted to tackle the overwhelming demand of services by allowing nonallergists to conduct assessment. Objective To evaluate the outcomes of the VAS hub-and-spoke model for allergy assessment. Methods Records of patients attending the VAS hub-and-spoke Clinics between March and August 2021 were reviewed (n = 2725). We studied the overall results between the Hub (allergist led) and Spoke (nonallergist led) Clinics. The Hub and the Hong Kong West Cluster Spoke Clinic were selected for subgroup analysis as they saw the largest number of patients (n = 1411). Results A total of 2725 patients were assessed under the VAS hub-and-spoke model. Overall, 2324 patients (85.3%) were recommended to proceed with vaccination. Allergists recommended significantly more patients for vaccination than nonallergists (odds ratio = 21.58; P < .001). Subgroup analysis revealed that 881 of 1055 (83.5%) patients received their first dose of COVID-19 vaccination safely after assessment. Among those recommended vaccination, more patients assessed by allergists received their first dose of vaccination (odds ratio = 4.18; P < .001). Conclusion The hub-and-spoke model has proven to be successful for the vaccination campaign. This study has illustrated the crucial role of allergists in countering vaccine hesitancy. Results from the study revealed considerable differences in outcomes between allergist-led and nonallergist-led clinics. Precise reasons for these differences warrant further evaluation. We are hopeful that the hub-and-spoke model can be similarly adapted for other allergist-integrative services in the future.
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Affiliation(s)
- Valerie Chiang
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Chinmoy Saha
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jackie Yim
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Elaine Y L Au
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Andy K C Kan
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kong Siu Harris Hui
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Tin Sum Li
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Wing Lam Whitney Lo
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Yuh Dong Hong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jiaxi Ye
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Carmen Ng
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Welchie W K Ko
- Department of Family Medicine and Primary Healthcare, Hong Kong West Cluster, Hospital Authority, Kowloon, Hong Kong
| | - Carmen T K Ho
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Chak Sing Lau
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jianchao Quan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Philip H Li
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong.
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Bian S, Li L, Wang Z, Cui L, Xu Y, Guan K, Zhao B. Allergic Reactions After the Administration of COVID-19 Vaccines. Front Public Health 2022; 10:878081. [PMID: 35655467 PMCID: PMC9152252 DOI: 10.3389/fpubh.2022.878081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022] Open
Abstract
Background Data on allergic reactions after the administration of coronavirus disease (COVID-19) vaccines are limited. Our aim is to analyze reports of allergic reactions after COVID-19 vaccine administration. Methods The Vaccine Adverse Event Reporting System database was searched for reported allergic reactions after the administration of any of the COVID-19 vaccines from December 2020 to June 2021. After data mapping, the demographic and clinical characteristics of the reported cases were analyzed. Potential factors associated with anaphylaxis were evaluated using multivariable logistic regression models. Results In total, 14,611 cases were reported. Most cases of allergic reactions comprised women (84.6%) and occurred after the first dose of the vaccine (63.6%). Patients who experienced anaphylaxis were younger (mean age 45.11 ± 5.6 vs. 47.01 ± 6.3 years, P < 0.001) and had a higher prevalence of a history of allergies, allergic rhinitis, asthma, and anaphylaxis than those who did not (P < 0.05). A history of allergies (odds ratio (OR) 1.632, 95% confidence interval (CI) 1.467-1.816, P < 0.001), asthma (OR 1.908, 95%CI 1.677-2.172, P < 0.001), and anaphylaxis (OR 7.164, 95%CI 3.504-14.646, P < 0.001) were potential risk factors for anaphylaxis. Among the 8,232 patients with reported outcomes, 16 died. Conclusions Female predominance in allergic reaction cases after the receipt of COVID-19 vaccines was observed. Previous histories of allergies, asthma, or anaphylaxis were risk factors for anaphylaxis post-vaccination. People with these risk factors should be monitored more strictly after COVID-19 vaccination.
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Affiliation(s)
- Sainan Bian
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Lisha Li
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Zixi Wang
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Le Cui
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Yingyang Xu
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Kai Guan
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Bin Zhao
- Pharmacy Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Novembre E, Tosca M, Caffarelli C, Calvani M, Cardinale F, Castagnoli R, Chiappini E, Cravidi C, Del Giudice MM, Duse M, Licari A, Manti S, Martelli A, Ricci G, Pingitore G, Marseglia GL. Management of BNT162b2 mRNA COVID-19 vaccine in children aged 5-11 years with allergies, asthma, and immunodeficiency: consensus of the Italian Society of Pediatric Allergy and Immunology (SIAIP). Ital J Pediatr 2022; 48:76. [PMID: 35578294 PMCID: PMC9109428 DOI: 10.1186/s13052-022-01272-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/04/2022] [Indexed: 01/31/2023] Open
Abstract
BNT162b2 vaccine, developed by BioNTech and Pfizer ha recently approved for use in children aged 5 to 11 years. Recent data show evidence of safety on the administration and serious adverse events have been rarely reported. However, allergic systemic reactions could occur. In some cases, a correct allergic evaluation allows identifying patients at risk of developing an anaphylactic reaction. Risk assessment of allergic reactions to COVID-19 vaccines is useful to limit contraindications to vaccination and help to safely vaccinate people supposed to be at risk of allergic reactions.
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Affiliation(s)
- Elio Novembre
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | | | - Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, Parma, Italy.
| | - Mauro Calvani
- Operative Unit of Pediatrics, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Fabio Cardinale
- Pediatric Unit, Azienda Ospedaliero-Universitaria "Policlinico- Giovanni XXIII, Bari, Italy
| | - Riccardo Castagnoli
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Elena Chiappini
- Paediatric Infectious Diseases Unit, Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, Florence, Italy
| | | | - Michele Miraglia Del Giudice
- Department of Woman and Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marzia Duse
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Amelia Licari
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Sara Manti
- Pediatric Respiratory Unit, Department of Clinical and Experimental Medicine, San Marco Hospital, University of Catania, Catania, Italy
| | | | - Giampaolo Ricci
- Alma Mater Studiorum, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Gian Luigi Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Poudel KM, Shah N, Prakash M, Deo SK, Bhandari S, Poudel TR. Determinants of associated events following AZD1222 (Covishield) vaccination in a high-risk population in Nepal. BMC Infect Dis 2022; 22:422. [PMID: 35505278 PMCID: PMC9062853 DOI: 10.1186/s12879-022-07406-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/19/2022] [Indexed: 12/23/2022] Open
Abstract
Background Vaccination is the most effective method to prevent the spread of infectious diseases and helps reduce mortality rate and economic costs associated with the pandemic. Despite these advantages, misinformation on vaccine safety and efficacy can lead to increased hesitation towards vaccination. This study reports the incidence of adverse events following Covishield vaccination, their associated factors, medication used for their management, and attitudes about vaccine safety. Methods A cross-sectional study was conducted from the sample of Covishield-vaccinated individuals from a secondary hospital, two primary health centres, and 36 health posts in eastern Nepal. Individuals (n = 602) were randomly sampled from a population (n = 1013) who had received the first dose of Covishield, namely frontline workers and other high-risk populations. The second-round follow-up had 516 participants. Association of incidence and severity of post-vaccination events with socio-demographic variables, comorbidity status, and medication use were estimated. Results Among the 79.9% of participants who reported adverse events after receiving the first dose, two-thirds of complaints were mild (67.4%, 95% CI 63.2–71.6) with the most common complaint being pain at the injection site (86.5%). Paracetamol or its combination with NSAIDs were used in the majority of cases (95.2%). After the second dose, only 31.2% (95% CI 27.2–35.2) reported adverse events, the overwhelming majority of which were mild (95.7%) and required a lower frequency of medication (7.5% vs. 26.0%). Adverse event following immunization were significantly associated with being 18–30 years old (χ2 = 16.9, df = 3, p < 0.001) and female gender (χ2 = 5.2, df = 1, p < 0.05). Prior to the first dose, 86.0% of participants (95% CI 83.3–88.8%) perceived the vaccine to be safe, and 96.0% recommended the vaccine post-vaccination, while 96.8% were interested in receiving the second dose. AEFI severity was negatively associated with vaccine recommendation to the peers (odds-ratio 0.062, p < 0.05) following the first dose, whereas, the optimistic pre-vaccination perception was associated with positive vaccine recommendation post-vaccination (odds-ratio 28.658, p < 0.01). Conclusions Overall, vaccination-associated events were mild and majority were managed with paracetamol or its combination. Effective counselling about adverse events before vaccination should be prioritized to reduce hesitation and fear. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07406-2.
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Affiliation(s)
- Kapil Madi Poudel
- Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, 44600, Nepal.,Dhankuta Institute of Health Science, Dhankuta, 56800, Nepal
| | - Neha Shah
- Dhankuta Institute of Health Science, Dhankuta, 56800, Nepal.,BP Koirala Institute of Health Sciences, Dharan, 56700, Nepal
| | - Manab Prakash
- Central Department of Economics, Tribhuvan University, Kirtipur, 44600, Nepal
| | | | - Sunita Bhandari
- BP Koirala Institute of Health Sciences, Dharan, 56700, Nepal
| | - Tika Ram Poudel
- GoldenGate International College, Tribhuvan University, Kathmandu, 44600, Nepal.
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49
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Qamar N, Rukh G, Khan SN. Vaccines for Covid-19: An Insight on Their Effectiveness and Adverse Effects. J Med Virol 2022; 94:3554-3560. [PMID: 35474583 PMCID: PMC9088412 DOI: 10.1002/jmv.27810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/06/2022]
Abstract
An Era of SARS-COVID-19 out broke with a high contagious percentage around the globe has been the subject of multi-agency research aimed at generating vaccines for active immunization. Scientists across the world are joining hands for the advanced tie-ups between the medical start-ups and the pharmaceutical industries for devices and vaccines development to hinder the progress of this outbreak. Moreover, the questions that need to be answered are how to improve the effectiveness and efficacy of vaccines with reduced side effects and the required doses of vaccines for enhanced surveillance. In this review article, we have discussed the effectiveness and efficacy of different Covid-19 vaccines. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Naila Qamar
- Department of Medical Lab Technology, The University of Haripur, Khyber Pakhtunkhwa, (22620), Pakistan
| | - Gul Rukh
- Department of Biomedical Sciences, Pak-Austria Fachhochschule Institute of Applied Sciences and Technology, Khanpur Road Mang, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Sadiq Noor Khan
- Department of Medical Lab Technology, The University of Haripur, Khyber Pakhtunkhwa, (22620), Pakistan
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50
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Benyamna Y, Marraha F, Al Faker I, Chahoub H, Rahmani N, Rkiek Y, Kabbou S, Soussi Tanani D, Gallouj S. Site Injection Reaction, Maculopapular Rash, and Rosacea Exacerbation after COVID-19 Vaccination. Case Rep Dermatol Med 2022; 2022:9944727. [PMID: 35433058 PMCID: PMC9008489 DOI: 10.1155/2022/9944727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
To date, the occurrence of adverse events following immunization after COVID-19 vaccine is rare, and their report is still very poor; however, causality assessment is conducted to identify the associated cause, if they occur. In this case report, we present a case of an association of three cutaneous manifestations (maculopapular exanthem with enanthem, site injection reaction, and rosacea exacerbation) occurring three days after taking the first dose of AstraZeneca AZD1222 vaccine.
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Affiliation(s)
- Younes Benyamna
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Farah Marraha
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Ibtissam Al Faker
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Hanane Chahoub
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Najlae Rahmani
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Yasmine Rkiek
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Soukayna Kabbou
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Driss Soussi Tanani
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
- Department of Pharmacology and Pharmacovigilance, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
| | - Salim Gallouj
- Department of Dermatology, University Hospital Center of Tangier, Tetouan, Al Hoceima, Morocco
- Faculty of Medicine and Pharmacy Tangier, Abdelmalek Essaadi University, Tangier, Morocco
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