Health
ACAAI Revises Guidelines for Allergic Reactions After COVID-19 Vaccination
The American College of Allergy, Asthma and Immunology (ACAAI) has updated its guidelines on the risk of allergic reactions after administration of the COVID-19 vaccine. It currently contains information on screening, observation periods, and options to refrain from a second dose after it has been documented. Allergic reaction From the first dose.
ACAAI’s COVID-19 Vaccine Task Force monitors real-time data from sources reporting allergic reactions after COVID-19 vaccine and has the latest recommendations from the US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration. Reflects. (FDA).
New guidance
The new guidelines screen patients to determine the potential risk of an allergic reaction to any of the three vaccines, and if the individual has a history of severe allergic reactions, a board-certified allergist or immunologist. We are asking you to contact us for further evaluation.
According to the CDC guidance, individuals who exhibit any severe or immediate allergic reaction within 4 hours of receiving the first COVID-19 dose should not receive a second dose.
In addition, patients who have experienced any severe or immediate allergic reaction, such as hives, swelling, wheezing, or who have questions related to the risk of an allergic reaction, should consult a local board-certified allergist / immunologist. Please introduce. More care and advice.
In general, the vaccine should be given in a medical environment where anaphylaxis can be treated, and all recipients should be observed for 15-30 minutes after injection. The majority of reported cases of anaphylaxis occur within 15 minutes of administration.
Finally, neither the mRNA vaccine nor the adenoviral vector vaccine should be given to individuals with a history of severe allergic reactions to certain vaccine components.
Allergic reaction
The specific component that causes anaphylaxis has not yet been identified, but polyethylene glycol (PEG), a component of the two mRNA vaccines, is known to cause anaphylaxis. In addition, Polysorbate 80, a component of the Johnson & Johnson vaccine, can cause anaphylaxis and cross-react with PEG.
Patients with an allergic reaction to PEG should not be given the mRNA vaccine, but vaccination with the adenoviral vector vaccine can be considered.
Currently, the CDC recommends adenovirus vector vaccines instead of a second dose of mRNA vaccine for patients who respond to the first dose and wait at least 28 days between doses.
According to CDC guidance, polysorbate allergy is no longer a contraindication to mRNA vaccination, but it is a precautionary measure and should be considered for consultation due to potential cross-reactivity hypersensitivity between the components of mRNA and adenoviral vector vaccines. There is. Also, for patients with polysorbate allergies, a minimum observation period of 30 minutes is required after mRNA vaccination.
Data on the risk of patients with a history of allergic reactions associated with mast cell activation syndrome / idiopathic anaphylaxis are also very limited but evolving.
According to current data, allergic reactions to all vaccines are generally rare, and the incidence of anaphylaxis is estimated to be 1.31 with 1 million doses. For the first two COVID-19 vaccines to receive an Emergency Use Authorization (EUA) from the FDA, the anaphylactic rate as of January 29 was 5 million for the Pfizer-BioNTech mRNA-based vaccine and 2.5 million for the Moderna vaccine. ..
The anaphylaxis rate of the recently approved Johnson & Johnson vaccine has not yet been reported.
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