Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach.

Autor: Greenhawt M; Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo. Electronic address: Matthew.Greenhawt@childrenscolorado.org., Dribin TE; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio., Abrams EM; Department of Pediatrics and Child Health, Section of Allergy and Immunology, The University of Manitoba, Winnipeg, Canada., Shaker M; Dartmouth-Hitchcock Medical Center, Section of Allergy and Immunology, Lebanon, NH; Dartmouth Geisel School of Medicine, Hanover, NH., Chu DK; Faculty of Medicine, and the Department of McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada; The Research Institute of St. Joe's Hamilton, Hamilton, Canada; Evidence in Allergy Group, McMaster University Medical Centre, Hamilton, Canada., Golden DBK; Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Bethesda., Akin C; Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan School, Ann Arbor, Mich., Anagnostou A; Section of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Baylor College of Medicine, Houston, Tex; Section of Immunology, Allergy and Retrovirology, Department of Pediatrics, Texas Children's Hospital, Houston, Tex., ALMuhizi F; Division of Allergy and Clinical Immunology, Department of Internal Medicine, Security Forces Hospital Program, Riyadh, Arabia., Alqurashi W; Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, Canada., Arkwright P; Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom., Baldwin JL; Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan School, Ann Arbor, Mich., Banerji A; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass., Bégin P; Centre Hospital Universitaire Sainte-Justine, Montreal, Canada., Ben-Shoshan M; Division of Allergy, Immunology, and Dermatology, Department of Pediatrics, McGill University Health Center-Montreal Children's Hospital, Montreal, Canada., Bernstein J; Division of Immunology, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio., Bingemann TA; Division of Allergy, Immunology, and Rheumatology, University of Rochester School of Medicine and Dentistry, Rochester, NY., Bindslev-Jensen C; Department of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis, Odense, Denmark., Blumenthal K; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass., Byrne A; Department of Paediatrics, School of Medicine, Trinity College Dublin, Dublin, Ireland., Cahill J; University of Alberta, Faculty of Medicine, Calgary, Canada., Cameron S; Allergy Victoria, Victoria, British Columbia, Canada., Campbell D; The Children's Hospital at Westmead, Sydney, Australia., Campbell R; Department of Emergency Medicine, Mayo Clinic, Rochester., Cavender M; Carilion Clinic, Verona, Va., Chan ES; Division of Allergy and Immunology, BC Children's Hospital, The University of British Columbia, Vancouver, Canada., Chinthrajah S; Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, Calif; Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, Calif., Comberiati P; Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy., Eastman JJ; Corewell Health Allergy and Immunology, Grand Rapids, Mich; Michigan State University College of Human Medicine, Grand Rapids, Mich., Ellis AK; Division of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, Canada., Fleischer DM; Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo., Fox A; Guys's and St Tomas's Hospital National Health Service Foundation Trust, London, Mass., Frischmeyer-Guerrerio PA; Laboratory of Allergic Diseases, Food Allergy Research Section, National Institutes of Allergy and Infectious Diseases, the National Institutes of Health, Bethesda, Md., Gagnon R; Clinique Spécialisée en Allergie de la Capitale, Québec, Canada., Garvey LH; Allergy Clinic, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Grayson MH; Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio., Isabwe GAC; Division of Allergy, Immunology, and Dermatology, Department of Pediatrics, McGill University Health Center-Montreal Children's Hospital, Montreal, Canada., Hartog N; Corewell Health Allergy and Immunology, Grand Rapids, Mich; Michigan State University College of Human Medicine, Grand Rapids, Mich., Hendron D; Access Health Care Physicians LLC, New Port Richey, Fla., Horner CC; Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Mo., Hourihane JO; Department of Paediatrics, Royal College of Surgeons, Dublin, Ireland., Iglesia E; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn., Kan M; Fraser Allergy, Langley, Canada., Kaplan B; Division of Allergy and Immunology, Northwell Health, New York, NY., Katelaris CH; Campbelltown Hospital, Western Sydney University, Sydney, Australia., Kim H; Faculty of Medicine, and the Department of McMaster University, Hamilton, Canada; Division of Clinical Immunology and Allergy, Department of Medicine, Western University, St Joseph's Health Care, London (Canada), Mass., Kelso JM; Division of Allergy, Asthma, and Immunology, Scripps Clinic, San Diego, Calif., Khan DA; Division of Allergy and Immunology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Tex., Lang D; Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio., Ledford D; Division of Allergy and Immunology, Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla., Levin M; Division of Paediatric Allergology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Lieberman JA; Division of Allergy and Immunology, The University of Tennessee, Memphis, Tenn., Loh R; Immunology Department, Perth Children's Hospital, Perth, Australia., Mack DP; Department of Pediatrics, McMaster University, Hamilton, Canada; Halton Pediatric Allergy, Burlington, Canada., Mazer B; Division of Allergy, Immunology, and Dermatology, Department of Pediatrics, McGill University Health Center-Montreal Children's Hospital, Montreal, Canada., Mody K; Elite Sports Medicine Institute Ltd, Westmont, Ill., Mosnaim G; Division of Pulmonary, Allergy and Critical Care, Department of Medicine, NorthShore University Health System, Evanston, Ill., Munblit D; Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, Mass., Mustafa SS; Rochester Regional Health, University of Rochester School of Medicine and Dentistry, Rochester, NY., Nanda A; Division of Allergy and Immunology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Tex; Asthma and Allergy Center, Lewisville and Flower Mound, Dallas, Tex., Nathan R; Idaho Falls Infectious Diseases, Idaho Falls, Idaho., Oppenheimer J; University of Medicine and Dentistry of New Jersey, Rutgers University School of Medicine, New Brunswick, NJ., Otani IM; Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California San Francisco, San Francisco, Calif., Park M; Division of Allergic Diseases, Mayo Clinic, Rochester., Pawankar R; Department of Pediatrics, Nippon Medical School, Tokyo, Japan., Perrett KP; Division of Pulmonary, Allergy and Critical Care, Department of Medicine, NorthShore University Health System, Evanston, Ill; Population Allergy Group and the Centre for Food and Allergy Research, Murdoch Children's Research Institute, University of Melbourne, University of Melbourne, Royal Children's Hospital, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia., Peter J; Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town and the Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town., Phillips EJ; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn., Picard M; Hôspital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada., Pitlick M; Division of Allergic Diseases, Mayo Clinic, Rochester., Ramsey A; Rochester Regional Health, University of Rochester School of Medicine and Dentistry, Rochester, NY., Rasmussen TH; Department of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis, Odense, Denmark., Rathkopf MM; Allergy and Asthma Associates of Allen, Allen, Tex., Reddy H; Allergy, Asthma and Immunology Center of Alaska, Anchorage, Alaska; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash., Robertson K; Division of Clinical Immunology and Allergy, St Joseph's Health Care, London (Canada), Mass; Schulich School of Medicine and Dentistry, Western University, St Joseph's Health Care, London (Canada), Mass., Rodriguez Del Rio P; Allergy Department, University Hospital Niño Jesus, Madrid, Spain., Sample S; Memorial Hospital and Health Care Center, Jasper, Ind., Sheshadri A; Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Tex., Sheik J; Kaiser Permanente Los Angeles Medical Center, Los Angeles, Calif., Sindher SB; Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, Calif; Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Palo Alto, Calif., Spergel JM; Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pa., Stone CA; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn., Stukus D; Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio., Tang MLK; Department of Allergy Immunology, Murdoch Children's Research Institute, Melbourne, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia., Tracy JM; Allergy, Asthma, and Immunology Associates PC, Omaha, Neb; Department of Pediatrics, University of Nebraska School of Medicine, Omaha, Neb., Turner PJ; Imperial College Healthcare National Health Service Trust, London, Mass; Royal Brompton and Harefield National Health Service Foundation Trust, London, Mass., Vander Leek TK; Pediatric Allergy and Immunology, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada., Wallace DV; Nova Southeastern University College of Allopathic Medicine, Fort Lauderdale, Fla., Wang J; Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY., Wasserman S; Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Canada., Weldon D; Baylor Scott and White Clinic, College Station, Tex., Wolfson AR; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass., Worm M; Division of Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany., Yacoub MR; Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Unit of Immunology, Rheumatology, Allergy and Rare Diseases, Segrate, Milan, Italy.
Jazyk: angličtina
Zdroj: The Journal of allergy and clinical immunology [J Allergy Clin Immunol] 2023 Aug; Vol. 152 (2), pp. 309-325. Date of Electronic Publication: 2023 Jun 07.
DOI: 10.1016/j.jaci.2023.05.019
Abstrakt: This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against >15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.
(Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: