Risk stratification through allergy history: single-centre experience of specialized COVID-19 vaccine clinic.

Abstract

Anaphylaxis is a rare side-effect of COVID-19 vaccines. To (a) provide direct advice and reassurance to certain persons with a history of anaphylaxis/complex allergy, in addition to that available in national guidelines, and (b) to provide a medically supervised vaccination, a specialist regional vaccine allergy clinic was established. The main objective was to determine if risk stratification through history can lead to safe COVID-19 vaccination for maximum population coverage. A focused history was taken to establish contraindications to giving COVID-19 vaccines. People who reported a high-risk allergy history were given a vaccine not containing the excipient thought to have directly caused previous anaphylaxis. All vaccines were monitored for 30 min after administration. A total of 206 people were vaccinated between 6 July 2021 and 31 August 2021; Comirnaty (Pfizer-BioNTech) (n = 34), and Janssen (n = 172). In total, 78% were women. Ninety-two people (45%) reported a high-risk allergy history. There were no cases of anaphylaxis. Three people developed urticaria and one of these also developed transient tachycardia. One vaccinee developed a pseudoseizure. Two of 208 people (<1%) referred during this time declined vaccination based on personal preference, despite the assessment of low clinical risk. In our experience, all vaccines with high-risk allergy histories were administered Pfizer BioNTech or Janssen Covid-19 vaccines uneventfully following screening based on allergy-focussed history. Our data support that drug allergy is not associated with a higher risk of vaccine-related anaphylaxis but may act to guide the administration of alternate vaccines to people with polyethylene glycol/polysorbate 80/trometamol allergies or anaphylaxis after the first dose.

• Authors: Daniel Lyons, Cliodhna Murray, Siobhan Hannigan, Jacklyn Sui, Salma Alamin, Niall Conlon, Mary Keogan, Khairin Khalib, Chris Fitzpatrick, Jonathan O'B Hourihane, Michael Carey, J David M Edgar
• Journal: Clinical and experimental immunology (Clin Exp Immunol) Vol. 209 Issue 2 Pg. 182-187 (08 19 2022) ISSN: 1365-2249 [Electronic] England
• PMID: 35753019 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Immunology. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• COVID-19 Vaccines
• Vaccines

Topics

• Anaphylaxis (etiology)
• COVID-19 (prevention & control)
• COVID-19 Vaccines (adverse effects)
• Female
• Humans
• Male
• Risk Assessment
• Vaccines