EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines.
Identifieur interne : 000079 ( Main/Exploration ); précédent : 000078; suivant : 000080EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines.
Auteurs : Milena Sokolowska [Suisse] ; Thomas Eiwegger [Canada] ; Markus Ollert [Luxembourg (pays), Danemark] ; Maria J. Torres [Espagne] ; Domingo Barber [Espagne] ; Stefano Del Giacco [Italie] ; Marek Jutel [Pologne] ; Kari C. Nadeau [États-Unis] ; Oscar Palomares [Espagne] ; Ronald L. Rabin [États-Unis] ; Carmen Riggioni [Singapour, Espagne] ; Stefan Vieths [Allemagne] ; Ioana Agache [Roumanie] ; Mohamed H. Shamji [Royaume-Uni]Source :
- Allergy [ 1398-9995 ] ; 2021.
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 desensitisation. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimise the risk of allergic reactions to COVID-19 vaccines and to facilitate their broader and safer use.
DOI: 10.1111/all.14739
PubMed: 33452689
Affiliations:
- Allemagne, Canada, Danemark, Espagne, Italie, Luxembourg (pays), Pologne, Roumanie, Royaume-Uni, Singapour, Suisse, États-Unis
- Angleterre, Californie, Canton de Zurich, Catalogne, Communauté de Madrid, Grand Londres, Maryland, Ontario
- Barcelone, Londres, Madrid, Stanford (Californie), Toronto, Zurich
- Université Stanford, Université de Toronto, Université de Zurich, Université nationale de Singapour
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines.</title><author><name sortKey="Sokolowska, Milena" sort="Sokolowska, Milena" uniqKey="Sokolowska M" first="Milena" last="Sokolowska">Milena Sokolowska</name><affiliation wicri:level="4"><nlm:affiliation>Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich</wicri:regionArea><orgName type="university">Université de Zurich</orgName><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Eiwegger, Thomas" sort="Eiwegger, Thomas" uniqKey="Eiwegger T" first="Thomas" last="Eiwegger">Thomas Eiwegger</name><affiliation wicri:level="1"><nlm:affiliation>Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Department of Immunology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Immunology, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Ollert, Markus" sort="Ollert, Markus" uniqKey="Ollert M" first="Markus" last="Ollert">Markus Ollert</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.</nlm:affiliation><country xml:lang="fr">Luxembourg (pays)</country><wicri:regionArea>Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette</wicri:regionArea><wicri:noRegion>Esch-sur-Alzette</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author><author><name sortKey="Torres, Maria J" sort="Torres, Maria J" uniqKey="Torres M" first="Maria J" last="Torres">Maria J. Torres</name><affiliation wicri:level="1"><nlm:affiliation>AllergyClinical Unit, Hospital Regional Universitario de Málaga-UMA-ARADyAL, Málaga, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>AllergyClinical Unit, Hospital Regional Universitario de Málaga-UMA-ARADyAL, Málaga</wicri:regionArea><wicri:noRegion>Málaga</wicri:noRegion></affiliation></author><author><name sortKey="Barber, Domingo" sort="Barber, Domingo" uniqKey="Barber D" first="Domingo" last="Barber">Domingo Barber</name><affiliation wicri:level="3"><nlm:affiliation>Facultad de Medicina, Departamento de Ciencias Médicas Básicas, Instituto de Medicina Molecular Aplicada (IMMA), Universidad San Pablo-CEU, CEU Universities, Madrid, España.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Facultad de Medicina, Departamento de Ciencias Médicas Básicas, Instituto de Medicina Molecular Aplicada (IMMA), Universidad San Pablo-CEU, CEU Universities, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Del Giacco, Stefano" sort="Del Giacco, Stefano" uniqKey="Del Giacco S" first="Stefano" last="Del Giacco">Stefano Del Giacco</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Sciences and Public Health, University of Cagliari, Cagliari</wicri:regionArea><wicri:noRegion>Cagliari</wicri:noRegion></affiliation></author><author><name sortKey="Jutel, Marek" sort="Jutel, Marek" uniqKey="Jutel M" first="Marek" last="Jutel">Marek Jutel</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Department of Clinical Immunology, Wrocław Medical University, Wrocław</wicri:regionArea><wicri:noRegion>Wrocław</wicri:noRegion></affiliation></author><author><name sortKey="Nadeau, Kari C" sort="Nadeau, Kari C" uniqKey="Nadeau K" first="Kari C" last="Nadeau">Kari C. Nadeau</name><affiliation wicri:level="4"><nlm:affiliation>Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford University, Stanford, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford University, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford (Californie)</settlement></placeName><orgName type="university">Université Stanford</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford (Californie)</settlement></placeName><orgName type="university">Université Stanford</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Allergy, Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Allergy, Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford (Californie)</settlement></placeName><orgName type="university">Université Stanford</orgName></affiliation></author><author><name sortKey="Palomares, Oscar" sort="Palomares, Oscar" uniqKey="Palomares O" first="Oscar" last="Palomares">Oscar Palomares</name><affiliation wicri:level="3"><nlm:affiliation>Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Rabin, Ronald L" sort="Rabin, Ronald L" uniqKey="Rabin R" first="Ronald L" last="Rabin">Ronald L. Rabin</name><affiliation wicri:level="2"><nlm:affiliation>Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Riggioni, Carmen" sort="Riggioni, Carmen" uniqKey="Riggioni C" first="Carmen" last="Riggioni">Carmen Riggioni</name><affiliation wicri:level="4"><nlm:affiliation>Allergy and Clinical Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Allergy and Clinical Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore</wicri:regionArea><orgName type="university">Université nationale de Singapour</orgName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Institut de Recerca Sant Joan de Déu, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Institut de Recerca Sant Joan de Déu, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Vieths, Stefan" sort="Vieths, Stefan" uniqKey="Vieths S" first="Stefan" last="Vieths">Stefan Vieths</name><affiliation wicri:level="1"><nlm:affiliation>Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen</wicri:regionArea><wicri:noRegion>63225, Langen</wicri:noRegion><wicri:noRegion>63225, Langen</wicri:noRegion><wicri:noRegion>Langen</wicri:noRegion></affiliation></author><author><name sortKey="Agache, Ioana" sort="Agache, Ioana" uniqKey="Agache I" first="Ioana" last="Agache">Ioana Agache</name><affiliation wicri:level="1"><nlm:affiliation>Transylvania University, Brasov, Romania.</nlm:affiliation><country xml:lang="fr">Roumanie</country><wicri:regionArea>Transylvania University, Brasov</wicri:regionArea><wicri:noRegion>Brasov</wicri:noRegion></affiliation></author><author><name sortKey="Shamji, Mohamed H" sort="Shamji, Mohamed H" uniqKey="Shamji M" first="Mohamed H" last="Shamji">Mohamed H. Shamji</name><affiliation wicri:level="3"><nlm:affiliation>Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London. Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London. Asthma UK Centre in Allergic Mechanisms of Asthma, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33452689</idno><idno type="pmid">33452689</idno><idno type="doi">10.1111/all.14739</idno><idno type="wicri:Area/Main/Corpus">000035</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000035</idno><idno type="wicri:Area/Main/Curation">000035</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000035</idno><idno type="wicri:Area/Main/Exploration">000035</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines.</title><author><name sortKey="Sokolowska, Milena" sort="Sokolowska, Milena" uniqKey="Sokolowska M" first="Milena" last="Sokolowska">Milena Sokolowska</name><affiliation wicri:level="4"><nlm:affiliation>Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich</wicri:regionArea><orgName type="university">Université de Zurich</orgName><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Eiwegger, Thomas" sort="Eiwegger, Thomas" uniqKey="Eiwegger T" first="Thomas" last="Eiwegger">Thomas Eiwegger</name><affiliation wicri:level="1"><nlm:affiliation>Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Department of Immunology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Immunology, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Ollert, Markus" sort="Ollert, Markus" uniqKey="Ollert M" first="Markus" last="Ollert">Markus Ollert</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.</nlm:affiliation><country xml:lang="fr">Luxembourg (pays)</country><wicri:regionArea>Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette</wicri:regionArea><wicri:noRegion>Esch-sur-Alzette</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author><author><name sortKey="Torres, Maria J" sort="Torres, Maria J" uniqKey="Torres M" first="Maria J" last="Torres">Maria J. Torres</name><affiliation wicri:level="1"><nlm:affiliation>AllergyClinical Unit, Hospital Regional Universitario de Málaga-UMA-ARADyAL, Málaga, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>AllergyClinical Unit, Hospital Regional Universitario de Málaga-UMA-ARADyAL, Málaga</wicri:regionArea><wicri:noRegion>Málaga</wicri:noRegion></affiliation></author><author><name sortKey="Barber, Domingo" sort="Barber, Domingo" uniqKey="Barber D" first="Domingo" last="Barber">Domingo Barber</name><affiliation wicri:level="3"><nlm:affiliation>Facultad de Medicina, Departamento de Ciencias Médicas Básicas, Instituto de Medicina Molecular Aplicada (IMMA), Universidad San Pablo-CEU, CEU Universities, Madrid, España.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Facultad de Medicina, Departamento de Ciencias Médicas Básicas, Instituto de Medicina Molecular Aplicada (IMMA), Universidad San Pablo-CEU, CEU Universities, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Del Giacco, Stefano" sort="Del Giacco, Stefano" uniqKey="Del Giacco S" first="Stefano" last="Del Giacco">Stefano Del Giacco</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Sciences and Public Health, University of Cagliari, Cagliari</wicri:regionArea><wicri:noRegion>Cagliari</wicri:noRegion></affiliation></author><author><name sortKey="Jutel, Marek" sort="Jutel, Marek" uniqKey="Jutel M" first="Marek" last="Jutel">Marek Jutel</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Department of Clinical Immunology, Wrocław Medical University, Wrocław</wicri:regionArea><wicri:noRegion>Wrocław</wicri:noRegion></affiliation></author><author><name sortKey="Nadeau, Kari C" sort="Nadeau, Kari C" uniqKey="Nadeau K" first="Kari C" last="Nadeau">Kari C. Nadeau</name><affiliation wicri:level="4"><nlm:affiliation>Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford University, Stanford, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford University, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford (Californie)</settlement></placeName><orgName type="university">Université Stanford</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford (Californie)</settlement></placeName><orgName type="university">Université Stanford</orgName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Allergy, Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Allergy, Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford (Californie)</settlement></placeName><orgName type="university">Université Stanford</orgName></affiliation></author><author><name sortKey="Palomares, Oscar" sort="Palomares, Oscar" uniqKey="Palomares O" first="Oscar" last="Palomares">Oscar Palomares</name><affiliation wicri:level="3"><nlm:affiliation>Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Rabin, Ronald L" sort="Rabin, Ronald L" uniqKey="Rabin R" first="Ronald L" last="Rabin">Ronald L. Rabin</name><affiliation wicri:level="2"><nlm:affiliation>Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Riggioni, Carmen" sort="Riggioni, Carmen" uniqKey="Riggioni C" first="Carmen" last="Riggioni">Carmen Riggioni</name><affiliation wicri:level="4"><nlm:affiliation>Allergy and Clinical Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Allergy and Clinical Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore</wicri:regionArea><orgName type="university">Université nationale de Singapour</orgName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Institut de Recerca Sant Joan de Déu, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Institut de Recerca Sant Joan de Déu, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Vieths, Stefan" sort="Vieths, Stefan" uniqKey="Vieths S" first="Stefan" last="Vieths">Stefan Vieths</name><affiliation wicri:level="1"><nlm:affiliation>Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen</wicri:regionArea><wicri:noRegion>63225, Langen</wicri:noRegion><wicri:noRegion>63225, Langen</wicri:noRegion><wicri:noRegion>Langen</wicri:noRegion></affiliation></author><author><name sortKey="Agache, Ioana" sort="Agache, Ioana" uniqKey="Agache I" first="Ioana" last="Agache">Ioana Agache</name><affiliation wicri:level="1"><nlm:affiliation>Transylvania University, Brasov, Romania.</nlm:affiliation><country xml:lang="fr">Roumanie</country><wicri:regionArea>Transylvania University, Brasov</wicri:regionArea><wicri:noRegion>Brasov</wicri:noRegion></affiliation></author><author><name sortKey="Shamji, Mohamed H" sort="Shamji, Mohamed H" uniqKey="Shamji M" first="Mohamed H" last="Shamji">Mohamed H. Shamji</name><affiliation wicri:level="3"><nlm:affiliation>Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London. Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London. Asthma UK Centre in Allergic Mechanisms of Asthma, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">Allergy</title><idno type="eISSN">1398-9995</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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 desensitisation. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimise the risk of allergic reactions to COVID-19 vaccines and to facilitate their broader and safer use.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33452689</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1398-9995</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jan</Month><Day>16</Day></PubDate></JournalIssue><Title>Allergy</Title><ISOAbbreviation>Allergy</ISOAbbreviation></Journal><ArticleTitle>EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1111/all.14739</ELocationID><Abstract><AbstractText>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 desensitisation. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimise the risk of allergic reactions to COVID-19 vaccines and to facilitate their broader and safer use.</AbstractText><CopyrightInformation>This article is protected by copyright. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sokolowska</LastName><ForeName>Milena</ForeName><Initials>M</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-9710-6685</Identifier><AffiliationInfo><Affiliation>Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eiwegger</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-2914-7829</Identifier><AffiliationInfo><Affiliation>Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Immunology, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ollert</LastName><ForeName>Markus</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Torres</LastName><ForeName>Maria J</ForeName><Initials>MJ</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-5228-471X</Identifier><AffiliationInfo><Affiliation>AllergyClinical Unit, Hospital Regional Universitario de Málaga-UMA-ARADyAL, Málaga, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barber</LastName><ForeName>Domingo</ForeName><Initials>D</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-5488-5700</Identifier><AffiliationInfo><Affiliation>Facultad de Medicina, Departamento de Ciencias Médicas Básicas, Instituto de Medicina Molecular Aplicada (IMMA), Universidad San Pablo-CEU, CEU Universities, Madrid, España.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Del Giacco</LastName><ForeName>Stefano</ForeName><Initials>S</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-4517-1749</Identifier><AffiliationInfo><Affiliation>Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jutel</LastName><ForeName>Marek</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nadeau</LastName><ForeName>Kari C</ForeName><Initials>KC</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-2146-2955</Identifier><AffiliationInfo><Affiliation>Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford University, Stanford, CA, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Allergy, Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Palomares</LastName><ForeName>Oscar</ForeName><Initials>O</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-4516-0369</Identifier><AffiliationInfo><Affiliation>Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rabin</LastName><ForeName>Ronald L</ForeName><Initials>RL</Initials><AffiliationInfo><Affiliation>Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Riggioni</LastName><ForeName>Carmen</ForeName><Initials>C</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-8745-0228</Identifier><AffiliationInfo><Affiliation>Allergy and Clinical Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institut de Recerca Sant Joan de Déu, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vieths</LastName><ForeName>Stefan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Agache</LastName><ForeName>Ioana</ForeName><Initials>I</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-7994-364X</Identifier><AffiliationInfo><Affiliation>Transylvania University, Brasov, Romania.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shamji</LastName><ForeName>Mohamed H</ForeName><Initials>MH</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-3425-3463</Identifier><AffiliationInfo><Affiliation>Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London. Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>01</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>Denmark</Country><MedlineTA>Allergy</MedlineTA><NlmUniqueID>7804028</NlmUniqueID><ISSNLinking>0105-4538</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>1</Month><Day>16</Day><Hour>5</Hour><Minute>41</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>1</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33452689</ArticleId><ArticleId IdType="doi">10.1111/all.14739</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li><li>Canada</li><li>Danemark</li><li>Espagne</li><li>Italie</li><li>Luxembourg (pays)</li><li>Pologne</li><li>Roumanie</li><li>Royaume-Uni</li><li>Singapour</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Californie</li><li>Canton de Zurich</li><li>Catalogne</li><li>Communauté de Madrid</li><li>Grand Londres</li><li>Maryland</li><li>Ontario</li></region><settlement><li>Barcelone</li><li>Londres</li><li>Madrid</li><li>Stanford (Californie)</li><li>Toronto</li><li>Zurich</li></settlement><orgName><li>Université Stanford</li><li>Université de Toronto</li><li>Université de Zurich</li><li>Université nationale de Singapour</li></orgName></list><tree><country name="Suisse"><region name="Canton de Zurich"><name sortKey="Sokolowska, Milena" sort="Sokolowska, Milena" uniqKey="Sokolowska M" first="Milena" last="Sokolowska">Milena Sokolowska</name></region></country><country name="Canada"><noRegion><name sortKey="Eiwegger, Thomas" sort="Eiwegger, Thomas" uniqKey="Eiwegger T" first="Thomas" last="Eiwegger">Thomas Eiwegger</name></noRegion><name sortKey="Eiwegger, Thomas" sort="Eiwegger, Thomas" uniqKey="Eiwegger T" first="Thomas" last="Eiwegger">Thomas Eiwegger</name><name sortKey="Eiwegger, Thomas" sort="Eiwegger, Thomas" uniqKey="Eiwegger T" first="Thomas" last="Eiwegger">Thomas Eiwegger</name></country><country name="Luxembourg (pays)"><noRegion><name sortKey="Ollert, Markus" sort="Ollert, Markus" uniqKey="Ollert M" first="Markus" last="Ollert">Markus Ollert</name></noRegion></country><country name="Danemark"><noRegion><name sortKey="Ollert, Markus" sort="Ollert, Markus" uniqKey="Ollert M" first="Markus" last="Ollert">Markus Ollert</name></noRegion></country><country name="Espagne"><noRegion><name sortKey="Torres, Maria J" sort="Torres, Maria J" uniqKey="Torres M" first="Maria J" last="Torres">Maria J. Torres</name></noRegion><name sortKey="Barber, Domingo" sort="Barber, Domingo" uniqKey="Barber D" first="Domingo" last="Barber">Domingo Barber</name><name sortKey="Palomares, Oscar" sort="Palomares, Oscar" uniqKey="Palomares O" first="Oscar" last="Palomares">Oscar Palomares</name><name sortKey="Riggioni, Carmen" sort="Riggioni, Carmen" uniqKey="Riggioni C" first="Carmen" last="Riggioni">Carmen Riggioni</name></country><country name="Italie"><noRegion><name sortKey="Del Giacco, Stefano" sort="Del Giacco, Stefano" uniqKey="Del Giacco S" first="Stefano" last="Del Giacco">Stefano Del Giacco</name></noRegion></country><country name="Pologne"><noRegion><name sortKey="Jutel, Marek" sort="Jutel, Marek" uniqKey="Jutel M" first="Marek" last="Jutel">Marek Jutel</name></noRegion></country><country name="États-Unis"><region name="Californie"><name sortKey="Nadeau, Kari C" sort="Nadeau, Kari C" uniqKey="Nadeau K" first="Kari C" last="Nadeau">Kari C. Nadeau</name></region><name sortKey="Nadeau, Kari C" sort="Nadeau, Kari C" uniqKey="Nadeau K" first="Kari C" last="Nadeau">Kari C. Nadeau</name><name sortKey="Nadeau, Kari C" sort="Nadeau, Kari C" uniqKey="Nadeau K" first="Kari C" last="Nadeau">Kari C. Nadeau</name><name sortKey="Rabin, Ronald L" sort="Rabin, Ronald L" uniqKey="Rabin R" first="Ronald L" last="Rabin">Ronald L. Rabin</name></country><country name="Singapour"><noRegion><name sortKey="Riggioni, Carmen" sort="Riggioni, Carmen" uniqKey="Riggioni C" first="Carmen" last="Riggioni">Carmen Riggioni</name></noRegion></country><country name="Allemagne"><noRegion><name sortKey="Vieths, Stefan" sort="Vieths, Stefan" uniqKey="Vieths S" first="Stefan" last="Vieths">Stefan Vieths</name></noRegion></country><country name="Roumanie"><noRegion><name sortKey="Agache, Ioana" sort="Agache, Ioana" uniqKey="Agache I" first="Ioana" last="Agache">Ioana Agache</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Shamji, Mohamed H" sort="Shamji, Mohamed H" uniqKey="Shamji M" first="Mohamed H" last="Shamji">Mohamed H. Shamji</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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