Department for Dermatology and Venereology, Kepler University Hospital, Linz, Austria.
Center for Medical Research, Johannes Kepler University, Linz, Austria.
Front Immunol. 2024 May 17;15:1324987. doi: 10.3389/fimmu.2024.1324987. eCollection 2024.
The COVID vaccination program with new types of vaccinations and early reports of allergic reactions to vaccines led to vaccination hesitancy in patients with allergies. In this study, we aimed to characterize patients who present at an allergy center with specific questions regarding risk assessment to COVID vaccines in comparison to regular allergy center patients.
A total of 50 patient charts of patients with risk assessment for COVID vaccination (COV group) and 50 regular allergy center patients (ALL group) were assessed for documented allergies, comorbidities, total IgE, and tryptase levels and hospital anxiety and depression score (HADS). Skin prick testing (SPT) with additives of COVID vaccines [polyethylene glycol (PEG), polysorbate] were performed if indicated based on medical history.
Patients who presented for examination prior to a possible COVID vaccination were mostly female (86%) and had more frequently reported allergic reactions to drugs in the past, but only in a minor group (28%) were the reactions qualified as anaphylaxis. The group COV patients scored significantly higher in the HADS for anxiety and depression than the regular group ALL patients. The same trend was observed when data were corrected for gender. It is worth noting that patients without any prior contact to COVID vaccines scored comparable regarding anxiety to patients with prior reaction to COVID vaccinations, but significantly higher in the depression score. In 19 patients (38%) who met the indications for SPT for the suspicious contents PEG and Polysorbate 80, the tests did not show a positive result. Furthermore, 84% of patients underwent the prick test, but only 15% of patients who received consultation alone agreed to vaccination at our center. No vaccination-related event was documented in these patients.
In conclusion, vaccination hesitancy was frequently elicited by negative experiences with drugs and putative drug allergies. Female patients predominate in this patient group, and the anxiety and depression scores were significantly elevated. Allergological workup, including SPT, led to a high rate of subsequent vaccinations, whereas a discussion with the patients about risks and individualized advice for vaccination without testing only rarely resulted in documented vaccinations.
新型疫苗的 COVID 接种计划和早期疫苗过敏反应报告导致过敏患者对接种犹豫不决。在这项研究中，我们旨在描述在过敏中心就诊的患者，他们对 COVID 疫苗的风险评估提出了具体问题，与常规过敏中心患者进行比较。
评估了 50 名接受 COVID 疫苗接种风险评估的患者（COV 组）和 50 名常规过敏中心患者（ALL 组）的病历，记录过敏症、合并症、总 IgE 和类胰蛋白酶水平以及医院焦虑和抑郁评分（HADS）。根据病史，如果有指征，进行 COVID 疫苗添加剂（聚乙二醇[PEG]、聚山梨醇酯）的皮肤点刺试验（SPT）。
前来接受可能的 COVID 疫苗接种前检查的患者大多为女性（86%），并且过去更频繁地报告过药物过敏反应，但只有少数（28%）患者的反应被定性为过敏反应。COV 组患者的 HADS 焦虑和抑郁评分明显高于 ALL 组患者。当按性别校正数据时，也观察到了同样的趋势。值得注意的是，与之前对 COVID 疫苗接种有反应的患者相比，没有任何先前接触 COVID 疫苗的患者在焦虑方面的评分相当，但在抑郁方面的评分明显更高。在 19 名（38%）符合 PEG 和聚山梨醇酯 80 可疑内容物 SPT 指征的患者中，试验未显示阳性结果。此外，84%的患者接受了点刺试验，但只有 15%的仅接受咨询的患者同意在我们中心接种疫苗。在这些患者中没有记录到与疫苗接种相关的事件。
总之，接种犹豫不决通常是由药物的负面经历和疑似药物过敏引起的。女性患者在该患者群体中占主导地位，焦虑和抑郁评分明显升高。包括 SPT 在内的过敏检查导致随后接种疫苗的比例很高，而与患者讨论风险和个体化接种建议而不进行检测很少导致有记录的接种。
