Identifying and Managing Those at Risk for Vaccine-Related Allergy and Anaphylaxis
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Immediate hypersensitivity reactions to vaccines, the most severe of which is anaphylaxis, are uncommon events occurring in fewer than 1 in a million doses administered. These reactions are infrequently immunoglobulin E–mediated. Because they are unlikely to recur, a reaction to a single dose of a vaccine is rarely a contraindication to redosing. This narrative review article contextualizes the recent knowledge we have gained from the coronavirus 2019 (COVID-19) pandemic rollout of the new mRNA platform with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines within the much broader context of what is known about immediate reactions to other vaccinations of routine and global importance. We focus on what is known about evidence-based approaches to diagnosis and management and what is new in our understanding of mechanisms of immediate vaccine reactions. Specifically, we review the epidemiology of immediate hypersensitivity vaccine reactions, differential diagnosis for immune-mediated and nonimmune reaction clinical phenotypes, including how to recognize immunization stress–related responses. In addition, we highlight what is known about mechanisms and review the rare but important contribution of excipient allergies and specifically when to consider testing for them as well as other key features that contribute to safe evaluation and management.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Allergy and Clinical Immunology: In Practice |
| Vol/bind | 11 |
| Udgave nummer | 7 |
| Sider (fra-til) | 2008-2022 |
| Antal sider | 15 |
| ISSN | 2213-2198 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
Conflicts of interest: C. A. Stone, Jr., receives funding from an American Academy of Allergy, Asthma & ImmunologyAmerican Academy of Allergy, Asthma & Immunology (AAAAI) Foundation Faculty Development Award. L. H. Garvey receives royalties from UpToDate and consulting fees from Merck and Biomarin, not related to the submitted work. E. J. Phillips reports grants and funding from the National Institutes of Health (NIH) (R01HG010863, R01AI152183, U01AI154659, R13AR078623, UAI109565) and from the National Health and Medical Research Council of Australia; receives Royalties from UpToDate; receives consulting fees from Janssen, Vertex, Biocryst, Regeneron, and Verve; is codirector of the Institute for Immunology and Infectious Diseases (IIID) Pty Ltd that holds a patent for HLA-B∗57:01 testing for abacavir hypersensitivity; and has a patent pending for Detection of Human Leukocyte Antigen-A∗32:01 in connection with Diagnosing Drug Reaction with Eosinophilia and Systemic Symptoms without any financial remuneration and not directly related to the submitted work. The rest of the authors declare that they have no relevant conflicts of interest. No funding has been received for this study.
Funding Information:
Conflicts of interest: C. A. Stone, Jr., receives funding from an American Academy of Allergy, Asthma & Immunology American Academy of Allergy, Asthma & Immunology (AAAAI) Foundation Faculty Development Award. L. H. Garvey receives royalties from UpToDate and consulting fees from Merck and Biomarin, not related to the submitted work. E. J. Phillips reports grants and funding from the National Institutes of Health (NIH) (R01HG010863, R01AI152183, U01AI154659, R13AR078623, UAI109565) and from the National Health and Medical Research Council of Australia; receives Royalties from UpToDate; receives consulting fees from Janssen, Vertex, Biocryst, Regeneron , and Verve; is codirector of the Institute for Immunology and Infectious Diseases (IIID) Pty Ltd that holds a patent for HLA-B∗57:01 testing for abacavir hypersensitivity; and has a patent pending for Detection of Human Leukocyte Antigen-A∗32:01 in connection with Diagnosing Drug Reaction with Eosinophilia and Systemic Symptoms without any financial remuneration and not directly related to the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.
Publisher Copyright:
© 2023 American Academy of Allergy, Asthma & Immunology
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