Allergological study in patients vaccinated against COVID-19 with suspected allergic reactions.

IF 2.6 4区医学 Q2 ALLERGY

Allergy Asthma and Clinical Immunology Pub Date : 2022-05-27 DOI:10.1186/s13223-022-00685-z

Vicente Jover Cerdá, Ramón Rodríguez Pacheco, Joan Doménech Witek, Sonia Alonso Hernández, Rafael Durán García, Marina Real Panisello, Francisco Manuel Marco de la Calle

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引用次数: 4

Abstract

Background: One of the main barriers to vaccination against SARS-CoV-2 is the fear of developing hypersensitivity reactions to any of its components. Although these reactions are very rare, it is necessary to establish an effective protocol to detect patients at risk of developing them. The aim of this study was to evaluate hypersensitivity reactions in vaccinated patients in order to allow or not to complete the vaccination protocol.

Methods: Descriptive and cross-sectional study in which patients with suspected hypersensitivity to SARS-CoV-2 vaccines were evaluated. All patients underwent skin prick test (SPT) and/or intradermal test (IDT) with the vaccines and their excipients. In patients with positive IDT with the vaccine, a histopathological and immunohistochemical study was performed by skin biopsy. A basophil activation test (BAT) and a lymphoblastic transformation test (LTT) were also performed.

Results: Sixteen patients with suspected hypersensitivity to SARS-CoV-2 vaccine (12 received Comirnaty^®, 3 received Vaxzevria^®, and 1 received Spikevax^®) were evaluated. Half had immediate hypersensitivity reactions and half had delayed reactions. All SPTs to excipients and vaccines were negative. IDTs with all excipients were negative. IDTs with vaccines were positive in 11 patients and negative in 5. The histological and immunohistochemical study of the two selected patients with positive IDT with vaccine showed T-lymphocyte involvement. BAT and LTT were negative in both cases. The vaccination protocol could be completed in 7 of 16 patients (44%) studied. The remaining 9 patients did not receive the second dose: 5 because vaccination was not required and 4 because they refused to be vaccinated.

Conclusions: Thanks to the allergological and immunohistochemical study, the vaccination protocol could be completed in about half of the patients who presented suspected hypersensitivity reactions to SARS-CoV-2 vaccines. IDTs with vaccines could be a valuable method for assessing the immunogenicity of the vaccines.

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对接种新冠肺炎疫苗并出现疑似过敏反应的患者的过敏学研究。

背景：接种严重急性呼吸系统综合征冠状病毒2型疫苗的主要障碍之一是担心对其任何成分产生超敏反应。尽管这些反应非常罕见，但有必要建立一个有效的方案来检测有发展风险的患者。本研究的目的是评估接种疫苗的患者的超敏反应，以允许或不完成疫苗接种方案。方法：对疑似对严重急性呼吸系统综合征冠状病毒2型疫苗过敏的患者进行描述性和横断面研究。所有患者均接受了疫苗及其赋形剂的皮肤点刺试验（SPT）和/或皮内试验（IDT）。在接种疫苗的IDT阳性患者中，通过皮肤活检进行组织病理学和免疫组织化学研究。还进行了嗜碱性粒细胞活化试验（BAT）和淋巴细胞转化试验（LTT）。结果：对16名疑似对严重急性呼吸系统综合征冠状病毒2型疫苗过敏的患者（12名接受Comirnaty®，3名接受Vaxzevria®，1名接受Spikevax®）进行了评估。一半有立即超敏反应，一半有延迟反应。辅料和疫苗的所有SPT均为阴性。所有赋形剂的IDT均为阴性。接种疫苗的IDT阳性11例，阴性5例。两名接种疫苗的IDT阳性患者的组织学和免疫组织化学研究显示T淋巴细胞受累。BAT和LTT均为阴性。研究的16名患者中有7名（44%）可以完成疫苗接种方案。其余9名患者没有接种第二剂疫苗：5名是因为不需要接种疫苗，4名是因为他们拒绝接种疫苗。结论：由于过敏性和免疫组织化学研究，大约一半对严重急性呼吸系统综合征冠状病毒2型疫苗出现疑似超敏反应的患者可以完成疫苗接种方案。注射疫苗可能是评估疫苗免疫原性的一种有价值的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Allergy Asthma and Clinical Immunology ALLERGY-IMMUNOLOGY

CiteScore

4.30

自引率

3.70%

发文量

审稿时长

12 weeks

期刊介绍： Allergy, Asthma & Clinical Immunology (AACI), the official journal of the Canadian Society of Allergy and Clinical Immunology (CSACI), is an open access journal that encompasses all aspects of diagnosis, epidemiology, prevention and treatment of allergic and immunologic disease. By offering a high-visibility forum for new insights and discussions, AACI provides a platform for the dissemination of allergy and clinical immunology research and reviews amongst allergists, pulmonologists, immunologists and other physicians, healthcare workers, medical students and the public worldwide. AACI reports on basic research and clinically applied studies in the following areas and other related topics: asthma and occupational lung disease, rhinoconjunctivitis and rhinosinusitis, drug hypersensitivity, allergic skin diseases, urticaria and angioedema, venom hypersensitivity, anaphylaxis and food allergy, immunotherapy, immune modulators and biologics, immune deficiency and autoimmunity, T cell and B cell functions, regulatory T cells, natural killer cells, mast cell and eosinophil functions, complement abnormalities.