Safety of mRNA-based COVID-19 vaccination in paediatric patients with a PEG-asparaginase allergy.

Abstract

Background:

Children treated for a malignancy are at risk to develop serious illness from a COVID-19 infection. Pegylated E. coli asparaginase (PEG-asparaginase) is used in the treatment of acute lymphoblastic leukemia. Allergy to this drug is common and both asparaginase and polyethylene glycol (PEG) are identified as possible antigens. The mRNA-based vaccines against COVID-19 contain PEG as a stabilizing component.

Methods:

We developed a protocol to be able to safely vaccinate children with a PEG-asparaginase allergy. All patients with a history of allergy to PEG-asparaginase have been included and skin prick testing for various PEGs was performed before vaccination with the mRNA Pfizer-BioNTech COVID-19 vaccine.

Results:

Twelve children between six and 16 years old were vaccinated, without allergic reaction. None of them got a positive skin prick test for PEG. Ten patients had pre-existing IgG or IgM antibodies against PEG.

Conclusion:

Children with a PEG-asparaginase allergy can be safely vaccinated against COVID-19 with mRNA vaccines containing PEG irrespective of IgG/IgM antibodies to PEG-asparaginase. Routine skin prick testing in patients with PEG-asparaginase allergy does not seem to be of added value.

• Authors: Nancy Broos, Leiah J Brigitha, Annemieke Schuurhof, Heike Röckmann-Helmbach, Wim J E Tissing, Rob Pieters, Inge M van der Sluis, Marike B Stadermann
• Journal: EJC paediatric oncology (EJC Paediatr Oncol) Vol. 1 Pg. 100002 ( 2023) ISSN: 2772-610X [Electronic] Netherlands
• PMID: 38013843 (Publication Type: Journal Article)
• Copyright: © 2022 The Authors.