Castells M, Demoly P, Tanno L K
Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts, États-Unis.
Department of Allergy, University Hospital of Montpellier, Montpellier, France.
Rev Fr Allergol (2009). 2021 Dec;61(8):8S30-8S35. doi: 10.1016/S1877-0320(21)00439-5. Epub 2021 Dec 30.
Vaccines against COVID-19 are an essential global intervention to control the current pandemic situation. Anaphylactic reactions have rapidly been reported after SARS-CoV2 RNA vaccines. This risk is now measured at 2.5-11/1,000,000 in the context of vaccine safety surveillance programs and only one case was documented to be due to polyethylene glycol. Suggestions for its role are indirect. The COVID-19 vaccination is rolling out vastly and surveillance programs are key to monitor severe adverse reactions, such as anaphylaxis. It is important to restore confidence about vaccination with COVID-19 mRNA and other vaccines and current data confirm their safety with no greater mortality than previous vaccines. Anaphylaxis is a complication that should be recognized immediately, be treated with epinephrine and which is not limiting and allows re-vaccination of some patients with pre-medication. It is important to recognize populations at risk such as women, patients with a history of allergies and anaphylaxis and to recognize the rare patients who have mast cell activating diseases. Anaphylaxis due to vaccine is extremely rare and specific cases should receive individualized investigation and care, highlighting the key role of allergists in the vaccination programmes.
新冠疫苗是控制当前疫情形势的一项重要全球干预措施。在接种严重急性呼吸综合征冠状病毒2（SARS-CoV2）RNA疫苗后，迅速出现了过敏反应报告。在疫苗安全监测计划的背景下，目前这种风险为每100万人中有2.5至11例，且仅有1例被记录为是由聚乙二醇引起的。关于其作用的证据是间接的。新冠疫苗正在大规模推广，监测计划是监测严重不良反应（如过敏反应）的关键。恢复对新冠信使核糖核酸（mRNA）疫苗和其他疫苗接种的信心很重要，目前的数据证实了它们的安全性，其死亡率并不高于先前的疫苗。过敏反应是一种应立即识别的并发症，要用肾上腺素进行治疗，它并非是接种限制因素，对于一些患者进行预处理后可再次接种。识别高危人群（如女性、有过敏和过敏反应病史的患者）以及识别患有肥大细胞活化疾病的罕见患者很重要。疫苗引起的过敏反应极为罕见，特定病例应接受个体化调查和护理，这凸显了过敏症专科医生在疫苗接种计划中的关键作用。
