Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Tenon, Département de dermatologie et allergologie, Paris, France.
Allergy Clinic, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark.
Allergy. 2022 Aug;77(8):2292-2312. doi: 10.1111/all.15241. Epub 2022 Mar 5.
Anaphylaxis, which is rare, has been reported after COVID-19 vaccination, but its management is not standardized.
Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre-vaccination screening and management of allergic reactions to COVID-19 vaccines, and literature was analysed.
No death due to anaphylaxis to COVID-19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1-anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2-anaphylaxis to oral/topical PEG containing products; 3-recurrent anaphylaxis of unknown cause; 4-suspected or confirmed allergy to any mRNA vaccine; and 5-confirmed allergy to PEG or derivatives. We recommend a prick-to-prick skin test with the left-over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable.
These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID-19 vaccines and enable more people with history of allergy to be vaccinated.
COVID-19 疫苗接种后罕见报告过敏反应（anaphylaxis），但管理方法尚未标准化。
对药物过敏感兴趣的欧洲药物过敏网络和欧洲过敏与临床免疫学学会成员参与了一项关于 COVID-19 疫苗接种前筛查和过敏反应管理的在线问卷调查，并分析了文献。
科学文献中尚未确认 COVID-19 疫苗过敏反应导致的死亡。潜在过敏原聚乙二醇（PEG）、聚山梨酯和三羟甲基氨基甲烷是赋形剂。作者提出对有以下病史的人群进行过敏评估：1-对含有 PEG 或衍生物的注射药物或疫苗过敏；2-对含 PEG 的口服/局部产品过敏；3-原因不明的复发性过敏；4-疑似或确诊对任何 mRNA 疫苗过敏；5-对 PEG 或衍生物确诊过敏。建议使用剩余溶液进行点刺试验，避免浪费。点刺试验面板应包括 PEG 4000 或 3500、PEG 2000 和聚山梨酯 80。体外试验的价值存在争议。
这些建议将使我们更好地了解 COVID-19 疫苗过敏反应的管理和机制，使更多有过敏史的人能够接种疫苗。
