Restivo Vincenzo, Candore Giuseppina, Barrale Maria, Caravello Ester, Graziano Giorgio, Onida Rosa, Raineri Maurizio, Tiralongo Salvatore, Brusca Ignazio
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy.
Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy.
Vaccines (Basel). 2021 Apr 21;9(5):412. doi: 10.3390/vaccines9050412.
The main contraindication to the anti-SARS CoV2 vaccine is an anaphylactic reaction to a vaccine component. The need to vaccinate allergic people who are at higher risk can be of public health interest and this report shows a case of an allergic reaction to PEG of a HCW who had received the first dose of anti-SARS CoV2 vaccine. For 5 h after the administration of the vaccine, she had the appearance of erythematous spots on the face and neck, and a feeling of a slurred mouth and hoarseness. In order to treat the event, she was administered 8 mg intravenous dexamethasone, 1 vial intravenous chlorphenamine maleate, 250 mL intravenous 0.9% NaCl, and conventional oxygen therapy (2 L/min) with complete resolution of the suspected adverse drug reaction. According to the contraindication to the cutaneous test for this patient, BAT was used for further investigations. The patient who suffered the adverse reaction to the COVID-19 vaccine and other five allergic patients who did not report any adverse reaction after the vaccination were tested. There was a significant activation of the vaccine-reactive patient's basophils with 14.79 CD203chigh% at the concentration of 0.2 mg/mL, while other patients were negative. People who have a confirmed reaction to a vaccine component should undergo further investigation to discover other possible cross-reactions and select the right vaccine to immunize them.
抗SARS-CoV2疫苗的主要禁忌证是对疫苗成分的过敏反应。为处于较高风险的过敏人群接种疫苗具有公共卫生意义，本报告展示了1例接种第1剂抗SARS-CoV2疫苗的医护人员对聚乙二醇（PEG）发生过敏反应的病例。接种疫苗后5小时，她的面部和颈部出现红斑，并有口齿不清和声音嘶哑的感觉。为治疗该事件，给她静脉注射了8毫克地塞米松、1支静脉注射马来酸氯苯那敏、250毫升静脉注射0.9%氯化钠，并进行常规氧疗（2升/分钟），疑似药物不良反应完全消退。根据该患者皮肤试验的禁忌证，采用嗜碱性粒细胞活化试验（BAT）进行进一步检查。对该例COVID-19疫苗不良反应患者以及其他5例接种疫苗后未报告任何不良反应的过敏患者进行了检测。在浓度为0.2毫克/毫升时，疫苗反应性患者的嗜碱性粒细胞有显著活化，CD203c高表达率为14.79%，而其他患者为阴性。对疫苗成分有确诊反应的人应接受进一步检查，以发现其他可能的交叉反应，并选择合适的疫苗对他们进行免疫接种。
