Department of Biomedical and Clinical Sciences, Allergy Center, Linköping University, Linköping.
Department of Vaccines, Public Health Agency of Sweden, Solna, Sweden.
Curr Opin Allergy Clin Immunol. 2021 Aug 1;21(4):401-409. doi: 10.1097/ACI.0000000000000762.
Whereas the COVID-19 pandemic has changed our lives worldwide, we hope that vaccination can combat the disease. We propose how to evaluate suspected severe allergic reactions to the vaccines so that as many as possible may be safely vaccinated.
Rare cases of severe allergic reactions after COVID-19 vaccination have been observed, seemingly at a higher frequency than for other vaccines. Few excipients are likely to have caused these reactions. IgE-mediated reactions to polyethylene glycol (PEG) and its derivatives are the most suspected, albeit hitherto unproven, causes. We suggest to make a diagnosis based on skin tests with PEG and PEG derivatives and that these be considered in relation to the decisions required before the first and the second vaccine dose. A vaccine without these excipients is available, but published data about its side effects are limited.
The underlying immunological mechanisms of the rare severe allergic reactions to the COVID-19 vaccines are poorly understood and need to be clarified. Identifying those who have an undiagnosed allergy to PEG and PEG derivatives is crucial before vaccination, and these substances are found in laxatives, cosmetics and in 30% of all our medications today.
尽管 COVID-19 大流行改变了我们的全球生活，但我们仍希望疫苗能够对抗这种疾病。我们提出了如何评估疑似对疫苗的严重过敏反应，以便尽可能安全地为更多人接种疫苗。
观察到 COVID-19 疫苗接种后罕见的严重过敏反应病例，其频率似乎高于其他疫苗。可能只有少数赋形剂引起了这些反应。对聚乙二醇（PEG）及其衍生物的 IgE 介导反应是最受怀疑的原因，尽管迄今尚未得到证实。我们建议根据 PEG 和 PEG 衍生物的皮肤试验做出诊断，并在第一次和第二次疫苗接种前考虑这些反应。有一种不含这些赋形剂的疫苗，但关于其副作用的已发表数据有限。
对 COVID-19 疫苗罕见严重过敏反应的潜在免疫机制了解甚少，需要进一步阐明。在接种疫苗之前，必须确定那些对 PEG 和 PEG 衍生物未确诊过敏的人，这些物质存在于泻药、化妆品和我们今天所有药物中的 30%。
