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

Humans COVID-19 Vaccines / adverse effects GRADE Approach Consensus Vaccine Excipients COVID-19 / prevention & control Hypersensitivity, Immediate Anaphylaxis Excipients
COVID-19 SARS-CoV-2 allergic reactions anaphylaxis mRNA COVID-19 vaccine polyethylene glycol polysorbate 80 repeat allergic reactions skin testing vaccination

Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
08 2023
Historique:
received: 12 04 2023
revised: 08 05 2023
accepted: 11 05 2023
medline: 7 8 2023
pubmed: 10 6 2023
entrez: 9 6 2023
Statut: ppublish

Résumé

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.

Identifiants

DOI: 10.1016/j.jaci.2023.05.019 PMID: 37295474 PMC: PMC10247143
pubmed: 37295474
pii: S0091-6749(23)00746-7
doi: 10.1016/j.jaci.2023.05.019
pmc: PMC10247143
pii:
doi:

Substances chimiques

COVID-19 Vaccines 0
Vaccine Excipients 0
Excipients 0

Types de publication

Journal Article Review Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

309-325

Subventions

Organisme : AHRQ HHS
ID : K12 HS026395
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI109565
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR001426
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001425
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI150295
Pays : United States

Informations de copyright

Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.

Auteurs

Matthew 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.

Timothy E 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.

Elissa M Abrams (EM)

Department of Pediatrics and Child Health, Section of Allergy and Immunology, The University of Manitoba, Winnipeg, Canada.

Marcus Shaker (M)

Dartmouth-Hitchcock Medical Center, Section of Allergy and Immunology, Lebanon, NH; Dartmouth Geisel School of Medicine, Hanover, NH.

Derek K 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.

David B K Golden (DBK)

Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Bethesda.

Cem Akin (C)

Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan School, Ann Arbor, Mich.

Akterini 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.

Faisal ALMuhizi (F)

Division of Allergy and Clinical Immunology, Department of Internal Medicine, Security Forces Hospital Program, Riyadh, Arabia.

Waleed Alqurashi (W)

Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, Canada.

Peter Arkwright (P)

Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom.

James L Baldwin (JL)

Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan School, Ann Arbor, Mich.

Aleena Banerji (A)

Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

Philippe Bégin (P)

Centre Hospital Universitaire Sainte-Justine, Montreal, Canada.

Moshe Ben-Shoshan (M)

Division of Allergy, Immunology, and Dermatology, Department of Pediatrics, McGill University Health Center-Montreal Children's Hospital, Montreal, Canada.

Jonathan Bernstein (J)

Division of Immunology, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio.

Theresa A Bingemann (TA)

Division of Allergy, Immunology, and Rheumatology, University of Rochester School of Medicine and Dentistry, Rochester, NY.

Carsten Bindslev-Jensen (C)

Department of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis, Odense, Denmark.

Kim Blumenthal (K)

Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

Aideen Byrne (A)

Department of Paediatrics, School of Medicine, Trinity College Dublin, Dublin, Ireland.

Julia Cahill (J)

University of Alberta, Faculty of Medicine, Calgary, Canada.

Scott Cameron (S)

Allergy Victoria, Victoria, British Columbia, Canada.

Dianne Campbell (D)

The Children's Hospital at Westmead, Sydney, Australia.

Ronna Campbell (R)

Department of Emergency Medicine, Mayo Clinic, Rochester.

Michael Cavender (M)

Carilion Clinic, Verona, Va.

Edmond S Chan (ES)

Division of Allergy and Immunology, BC Children's Hospital, The University of British Columbia, Vancouver, Canada.

Sharon 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.

Pasquale Comberiati (P)

Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.

Jacqueline J Eastman (JJ)

Corewell Health Allergy and Immunology, Grand Rapids, Mich; Michigan State University College of Human Medicine, Grand Rapids, Mich.

Anne K Ellis (AK)

Division of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, Canada.

David M Fleischer (DM)

Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo.

Adam Fox (A)

Guys's and St Tomas's Hospital National Health Service Foundation Trust, London, Mass.

Pamela A 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.

Remi Gagnon (R)

Clinique Spécialisée en Allergie de la Capitale, Québec, Canada.

Lene H 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.

Mitchell H Grayson (MH)

Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.

Ghislaine Annie Clarisse Isabwe (GAC)

Division of Allergy, Immunology, and Dermatology, Department of Pediatrics, McGill University Health Center-Montreal Children's Hospital, Montreal, Canada.

Nicholas Hartog (N)

Corewell Health Allergy and Immunology, Grand Rapids, Mich; Michigan State University College of Human Medicine, Grand Rapids, Mich.

David Hendron (D)

Access Health Care Physicians LLC, New Port Richey, Fla.

Caroline C Horner (CC)

Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Mo.

Johnathan O'B Hourihane (JO)

Department of Paediatrics, Royal College of Surgeons, Dublin, Ireland.

Edward Iglesia (E)

Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn.

Manstein Kan (M)

Fraser Allergy, Langley, Canada.

Blanka Kaplan (B)

Division of Allergy and Immunology, Northwell Health, New York, NY.

Constance H Katelaris (CH)

Campbelltown Hospital, Western Sydney University, Sydney, Australia.

Harold 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.

John M Kelso (JM)

Division of Allergy, Asthma, and Immunology, Scripps Clinic, San Diego, Calif.

David A Khan (DA)

Division of Allergy and Immunology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Tex.

David Lang (D)

Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.

Dennis Ledford (D)

Division of Allergy and Immunology, Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla.

Michael Levin (M)

Division of Paediatric Allergology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Jay A Lieberman (JA)

Division of Allergy and Immunology, The University of Tennessee, Memphis, Tenn.

Richard Loh (R)

Immunology Department, Perth Children's Hospital, Perth, Australia.

Douglas P Mack (DP)

Department of Pediatrics, McMaster University, Hamilton, Canada; Halton Pediatric Allergy, Burlington, Canada.

Bruce Mazer (B)

Division of Allergy, Immunology, and Dermatology, Department of Pediatrics, McGill University Health Center-Montreal Children's Hospital, Montreal, Canada.

Ketan Mody (K)

Elite Sports Medicine Institute Ltd, Westmont, Ill.

Gisele Mosnaim (G)

Division of Pulmonary, Allergy and Critical Care, Department of Medicine, NorthShore University Health System, Evanston, Ill.

Daniel Munblit (D)

Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, Mass.

S Shahzad Mustafa (SS)

Rochester Regional Health, University of Rochester School of Medicine and Dentistry, Rochester, NY.

Anil 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.

Richard Nathan (R)

Idaho Falls Infectious Diseases, Idaho Falls, Idaho.

John Oppenheimer (J)

University of Medicine and Dentistry of New Jersey, Rutgers University School of Medicine, New Brunswick, NJ.

Iris M Otani (IM)

Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California San Francisco, San Francisco, Calif.

Miguel Park (M)

Division of Allergic Diseases, Mayo Clinic, Rochester.

Ruby Pawankar (R)

Department of Pediatrics, Nippon Medical School, Tokyo, Japan.

Kirsten P 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.

Jonny 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.

Elizabeth J 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.

Matthieu Picard (M)

Hôspital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada.

Mitchell Pitlick (M)

Division of Allergic Diseases, Mayo Clinic, Rochester.

Allison Ramsey (A)

Rochester Regional Health, University of Rochester School of Medicine and Dentistry, Rochester, NY.

Trine Holm Rasmussen (TH)

Department of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis, Odense, Denmark.

Melinda M Rathkopf (MM)

Allergy and Asthma Associates of Allen, Allen, Tex.

Hari Reddy (H)

Allergy, Asthma and Immunology Center of Alaska, Anchorage, Alaska; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash.

Kara 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.

Pablo Rodriguez Del Rio (P)

Allergy Department, University Hospital Niño Jesus, Madrid, Spain.

Stephen Sample (S)

Memorial Hospital and Health Care Center, Jasper, Ind.

Ajay Sheshadri (A)

Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Tex.

Javed Sheik (J)

Kaiser Permanente Los Angeles Medical Center, Los Angeles, Calif.

Sayantani B 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.

Jonathan M 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.

Cosby A Stone (CA)

Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn.

David Stukus (D)

Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.

Mimi L K 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.

James M Tracy (JM)

Allergy, Asthma, and Immunology Associates PC, Omaha, Neb; Department of Pediatrics, University of Nebraska School of Medicine, Omaha, Neb.

Paul J Turner (PJ)

Imperial College Healthcare National Health Service Trust, London, Mass; Royal Brompton and Harefield National Health Service Foundation Trust, London, Mass.

Timothy K Vander Leek (TK)

Pediatric Allergy and Immunology, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.

Dana V Wallace (DV)

Nova Southeastern University College of Allopathic Medicine, Fort Lauderdale, Fla.

Julie 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.

Susan Wasserman (S)

Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Canada.

David Weldon (D)

Baylor Scott and White Clinic, College Station, Tex.

Anna R Wolfson (AR)

Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

Margitta 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.

Mona-Rita Yacoub (MR)

Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Unit of Immunology, Rheumatology, Allergy and Rare Diseases, Segrate, Milan, Italy.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Updated guidance regarding the risk of...
questionsmedicales.fr › Mélanges complexes › Produits biologiques › Vaccins › Vaccins antiviraux › Vaccins contre la COVID-19 › Updated guidance regarding the risk of...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Évaluation des résultats des patients › Approche GRADE › Updated guidance regarding the risk of...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Pensée (activité mentale) › Prise de décision › Consensus › Updated guidance regarding the risk of...
questionsmedicales.fr › Actions chimiques et utilisations › Utilisations spécialisées de produits chimiques › Excipients pharmaceutiques › Excipients › Excipients vaccinaux › Updated guidance regarding the risk of...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Updated guidance regarding the risk of...
questionsmedicales.fr › Maladies du système immunitaire › Hypersensibilité › Hypersensibilité immédiate › Updated guidance regarding the risk of...
questionsmedicales.fr › Maladies du système immunitaire › Hypersensibilité › Hypersensibilité immédiate › Anaphylaxie › Updated guidance regarding the risk of...
questionsmedicales.fr › Actions chimiques et utilisations › Utilisations spécialisées de produits chimiques › Excipients pharmaceutiques › Excipients › Updated guidance regarding the risk of...