@article{16e49415f21e4fc4a2550c7f80081f72,
title = "EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines",
abstract = "The first approved COVID-19 vaccines include Pfizer/BioNTech BNT162B2, Moderna mRNA-1273 and AstraZeneca recombinant adenoviral ChAdOx1-S. Soon after approval, severe allergic reactions to the mRNA-based vaccines that resolved after treatment were reported. Regulatory agencies from the European Union, Unites States and the United Kingdom agree that vaccinations are contraindicated only when there is an allergy to one of the vaccine components or if there was a severe allergic reaction to the first dose. This position paper of the European Academy of Allergy and Clinical Immunology (EAACI) agrees with these recommendations and clarifies that there is no contraindication to administer these vaccines to allergic patients who do not have a history of an allergic reaction to any of the vaccine components. Importantly, as is the case for any medication, anaphylaxis may occur after vaccination in the absence of a history of allergic disease. Therefore, we provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres. We also describe potentially allergenic/immunogenic components of the approved vaccines and propose a workup to identify the responsible allergen. Close collaboration between academia, regulatory agencies and vaccine producers will facilitate approaches for patients at risks, such as incremental dosing of the second injection or desensitization. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimize the risk of allergic reactions to COVID-19 vaccines and to facilitate their broader and safer use.",
keywords = "COVID, SARS-CoV, virus",
author = "Milena Sokolowska and Thomas Eiwegger and Markus Ollert and Torres, {Maria J.} and Domingo Barber and {Del Giacco}, Stefano and Marek Jutel and Nadeau, {Kari C.} and Oscar Palomares and Rabin, {Ronald L.} and Carmen Riggioni and Stefan Vieths and Ioana Agache and Shamji, {Mohamed H.}",
note = "Funding Information: Dr. Sokolowska declares scientific grants from the Swiss National Science Foundation and GSK. Dr. Eiwegger reports to act as local PI for company sponsored trials by DBV and sub‐investigator for Regeneron and holds grants from Innovation fund Denmark and CIHR. He is co‐Investigator or scientific lead in three investigator initiated oral immunotherapy trials supported by the Food Allergy and Anaphylaxis Program SickKids and serves as associate editor for Allergy. He/his laboratory received unconditional/kind contributions from Macro Array Diagnostics and ALK. He holds advisory board roles for ALK. Dr. Torres reports grants or personal fees from European Commission, SEAIC, ISCIII, Diater laboratory, Leti laboratory and Aimmune Therapeutics. Dr. Barber reports grants and/or personal fees from ALK and Aimmune. Dr. Nadeau reports grants from NIAID, NHLBI, NIEHS, FARE, and other from WAO, Cour Pharma, Before Brands, Alladapt, Latitude, IgGenix, ITN and NIH clinical research centres. In addition, Dr. Nadeau has the following pending patents: Inhibition of Allergic Reaction to Peanut Allergen using an IL‐33 Inhibitor, Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy, Basophil Activation Based Diagnostic Allergy Test, Granulocyte‐based Methods for Detecting and Monitoring Immune System Disorders, Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders, Mixed Allergen Compositions and Methods for Using the Same, and Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation. Dr. Palomares reports research grants from InmunoTek S.L., Novartis and Mineco. Dr. Palomares has received fees for giving scientific lectures or participation in Advisory Boards from: Allergy Therapeutics, Amgen, AstraZeneca, Diater, GSK, Inmunotek S.L, Novartis, Sanofi‐Genzyme and Stallergenes. Dr. Vieths reports personal fees from Swiss Society for Allergy and Immunology, Schattauer Allergologie Handbuch, Elsevier Nahrungsmittelallergien und Intoleranzen, Karger Food Allergy: Molecular Basis and Clinical Practice, non‐financial support from German Research Foundation, European Directorate for the Quality of Medicines and Health Care, EAACI, GDCh, AKM Allergiekongress, International Union of Immunological Societies, and SEAIC. Dr. Agache serves as associate editor of Allergy and CTA. Dr. Shamji, Dr. Jutel, Dr. Ollert, Dr. Rabin, Dr. Del Giacco and Dr. Riggioni declare no COI related to this paper. Publisher Copyright: {\textcopyright} 2021 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.",
year = "2021",
month = jun,
doi = "10.1111/all.14739",
language = "English",
volume = "76",
pages = "1629--1639",
journal = "Allergy: European Journal of Allergy and Clinical Immunology",
issn = "0105-4538",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "6",
}