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Review
. 2021 Mar 15;17(1):29.
doi: 10.1186/s13223-021-00529-2.

COVID-19 vaccine testing & administration guidance for allergists/immunologists from the Canadian Society of Allergy and Clinical Immunology (CSACI)

Timothy K Vander Leek  1 , Edmond S Chan  2 , Lori Connors  3 , Beata Derfalvi  4 , Anne K Ellis  5 , Julia E M Upton  6 , Elissa M Abrams  7   8
Affiliations
Review

COVID-19 vaccine testing & administration guidance for allergists/immunologists from the Canadian Society of Allergy and Clinical Immunology (CSACI)

Timothy K Vander Leek et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Safe and effective vaccines provide the first hope for mitigating the devastating health and economic impacts resulting from coronavirus disease 2019 (COVID-19) and related public health orders. Recent case reports of reactions to COVID-19 vaccines have raised questions about their safety for use in individuals with allergies and those who are immunocompromised. In this document, we aim to address these concerns and provide guidance for allergists/immunologists.

Methods: Scoping review of the literature regarding COVID-19 vaccination, adverse or allergic reactions, and immunocompromise from PubMed over the term of December 2020 to present date. We filtered our search with the terms "human" and "English" and limited the search to the relevant subject age range with the term "adult." Reports resulting from these searches and relevant references cited in those reports were reviewed and cited on the basis of their relevance.

Results: Assessment by an allergist is warranted in any individual with a suspected allergy to a COVID-19 vaccine or any of its components. Assessment by an allergist is NOT required for individuals with a history of unrelated allergies, including to allergies to foods, drugs, insect venom or environmental allergens. COVID-19 vaccines should be offered to immunocompromised patients if the benefit is deemed to outweigh any potential risks of vaccination.

Interpretation: This review provides the first Canadian guidance regarding assessment of an adolescent and adult with a suspected allergy to one of the COVID-19 vaccines currently available, or any of their known allergenic components, and for patients who are immunocompromised who require vaccination for COVID-19. As information is updated this guidance will be updated accordingly.

Keywords: Allergy; Anaphylaxis; COVID-19; Immune deficiency; Immunocompromise; PEG; Vaccine.

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Conflict of interest statement

TV has served on advisory boards and received honoraria from Aralez, Bausch Health, and Pfizer (EpiPen). EC has received research support from DBV Technologies; has been a member of advisory boards for Pfizer, Pediapharm, Leo Pharma, Kaleo, DBV, AllerGenis, Sanofi Genzyme, Bausch Health, Avir Pharma; and is a member of the healthcare advisory board for Food Allergy Canada. LC has been on advisory boards for Abbvie, ALK, Bausch & Lombe, GSK and Sanofi. She has provided speaking engagements for Astra Zeneca, GSK and Sanofi. AE, within the past 12 months, has participated in advisory boards for ALK Abello, AstraZeneca, Aralez, Bausch Health, LEO Pharma, Merck, Novartis, and Pfizer, has been a speaker for ALK Abello, Aralez, AstraZeneca, Medexus, and Mylan. Her institution has received research grants from ALK Abello, Aralez, AstraZeneca, Bayer LLC, Medexus, Novartis, and Regeneron. She has also served as an independent consultant to Bayer LLC and Regeneron. BD has received a research grant from CSL Behring and personal fees from SOBI. JU reports prior consulting for Pfizer (EpiPen), not related to the current work. EA serves on the healthcare advisory board of Food Allergy Canada and receives moderator/speaker fees from GSK, Novartis, and AstraZeneca.

Figures

Fig. 1
Fig. 1
Algorithm of Evaluation in a Patient with a History of Allergy Prior to COVID-19 Vaccination. *Identified allergenic component of the COVID-19 vaccine is polyethylene glycol (PEG). **Unrelated allergic conditions include food allergy (irrespective of severity), allergic rhinitis, asthma, eczema, stinging insect allergy
See this image and copyright information in PMC

References

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