Allergologie und Immunologie, Klinik für Dermatologie, Venerologie und Allergologie, Campus Charité Mitte, Universitätsmedizin Berlin, Berlin, Germany.
Klinik und Poliklinik für Dermatologie, Comprehensive Allergy Center (CAC), Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany.
Allergy. 2022 Nov;77(11):3426-3434. doi: 10.1111/all.15414. Epub 2022 Jul 4.
Systemic allergic reactions to vaccines are very rare. In this study we assessed the management and outcome of suspected SARS-CoV-2 vaccine hypersensitivity.
Totally, 334 individuals underwent an allergy work up regarding SARS-CoV-2 vaccination (group A: 115 individuals suspected to be at increased risk for vaccine-related reactions before vaccination and group B: 219 patients with reactions after COVID vaccination). The large majority of the SPT/IDT with the vaccines were negative; however, we identified in 14.1% (n = 47) a possible sensitization to the SARS-CoV-2 vaccine and/or its ingredients defined as one positive skin test. Of the 219 individuals (group B) who experienced symptoms suspicious for a hypersensitivity reaction after vaccination, 214 were reported after the first vaccination with a mRNA vaccine (157 mRNA (Comirnaty®, 38 Spikevax®) and 18 with a vector vaccine (Vaxzevria®), 5 cases were after the second vaccination.
The symptom profile in group B was as follows: skin symptoms occurred in 115 cases (n = 59 angioedema, n = 50 generalized urticaria and n = 23 erythema/flush. Seventy individuals had cardiovascular, 53 respiratory and 17 gastrointestinal symptoms. Of the overall 334 individuals, 78 patients tolerated (re)-vaccination (out of skin test positive/negative 7/19 from group A and 17/35 from group B).
Proven IgE-mediated hypersensitivity to SARS-CoV-2 vaccines is extremely rare and not increased in comparison with reported hypersensitivity to other vaccines. The value of skin tests is unclear and nonspecific reactions, in particular when intradermal testing is applied, should be considered.
疫苗全身过敏反应非常罕见。在这项研究中，我们评估了疑似 SARS-CoV-2 疫苗过敏的处理和结果。
共有 334 人接受了 SARS-CoV-2 疫苗过敏检查（A 组：115 人在接种疫苗前被认为有更高的疫苗相关反应风险；B 组：219 人在接种 COVID 疫苗后出现反应）。绝大多数 SPT/IDT 与疫苗均为阴性；然而，我们发现 14.1%（n=47）的人可能对 SARS-CoV-2 疫苗及其成分过敏，定义为一项皮肤测试阳性。在 219 名（B 组）接种疫苗后出现疑似过敏反应症状的个体中，214 名报告在接种第一剂 mRNA 疫苗后出现症状（157 名接种 Comirnaty®，38 名接种 Spikevax®），18 名接种腺病毒载体疫苗（Vaxzevria®），5 名在接种第二剂后出现症状。
B 组的症状谱如下：115 例出现皮肤症状（59 例血管性水肿，50 例全身性荨麻疹，23 例红斑/潮红）。70 例有心血管症状，53 例有呼吸系统症状，17 例有胃肠道症状。在 334 名患者中，78 名患者（无论皮肤试验阳性/阴性，A 组有 7/19 例，B 组有 17/35 例）耐受（重新）接种疫苗。
对 SARS-CoV-2 疫苗的 IgE 介导的过敏反应极为罕见，与其他疫苗报道的过敏反应相比没有增加。皮肤试验的价值尚不清楚，应考虑非特异性反应，尤其是当进行皮内试验时。
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