Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, California.
Ann Allergy Asthma Immunol. 2022 Jul;129(1):35-39. doi: 10.1016/j.anai.2022.01.026. Epub 2022 Jan 31.
To provide updated information on the evaluation and management of adverse reactions to vaccines.
PubMed (MEDLINE) search since publication of a practice parameter in 2012.
Original articles and guidelines on adverse reactions to vaccines, including vaccines against severe acute respiratory syndrome coronavirus 2 or coronavirus disease 2019 (COVID-19).
Current guidelines conclude that patients with egg allergy are not at increased risk for reaction to egg-based influenza vaccines. Except for gelatin, most patients with allergy to vaccine constituents tolerate vaccines containing them. Most patients who have immediate reactions after receiving COVID-19 vaccines go on to receive a subsequent dose uneventfully.
The risk of reactions to vaccination should be weighed against the risk of having a vaccine-preventable disease if the vaccine is withheld. There is no need to ask about egg allergy before the administration of influenza vaccines, including on screening forms. In most cases, an allergy to a vaccine constituent is not a contraindication to the vaccine containing it. Patients who have had possible anaphylactic reactions to vaccines should be evaluated by an allergist rather than simply being labeled allergic, because most can go on to receive subsequent doses. Most immediate reactions to COVID-19 vaccines are not allergic, and care should be taken to not label such reactions as anaphylactic. The role, if any, of polyethylene glycol in these reactions has yet to be revealed.
提供疫苗不良反应评估和管理的最新信息。
自 2012 年发布实践参数以来，在 PubMed（MEDLINE）上进行搜索。
关于疫苗不良反应的原始文章和指南，包括针对严重急性呼吸综合征冠状病毒 2 或 2019 年冠状病毒病（COVID-19）的疫苗。
目前的指南得出结论，对鸡蛋过敏的患者接种基于鸡蛋的流感疫苗不会增加不良反应的风险。除了明胶外，大多数对疫苗成分过敏的患者可耐受含有这些成分的疫苗。大多数在接种 COVID-19 疫苗后立即出现反应的患者随后会顺利接种下一剂疫苗。
如果疫苗被推迟，接种疫苗的风险应与发生可通过疫苗预防的疾病的风险相权衡。在接种流感疫苗之前，包括在筛查表上，无需询问鸡蛋过敏史。在大多数情况下，对疫苗成分的过敏不是含有该成分的疫苗的禁忌症。曾对疫苗发生过可能的过敏反应的患者应由过敏症专家进行评估，而不是简单地贴上过敏标签，因为大多数患者可以继续接种后续剂量。大多数 COVID-19 疫苗的即刻反应并非过敏，应注意不要将这些反应标记为过敏反应。聚乙二醇在这些反应中的作用（如果有的话）尚未揭示。
