COVID-19 Vaccination in Mastocytosis: Recommendations of the European Competence Network on Mastocytosis (ECNM) and American Initiative in Mast Cell Diseases (AIM)

Abstract

Mastocytosis is a neoplasm characterized by an accumulation of mast cells in various organs and increased risk for severe anaphylaxis in patients with concomitant allergies. Coronavirus disease 2019 (COVID-19) is a pandemic that is associated with a relatively high rate of severe lung disease and mortality. The mortality is particularly high in those with certain comorbidities and increases with age. Recently, several companies have developed an effective vaccination against COVID-19. Although the reported frequency of severe side effects is low, there is an emerging discussion about the safety of COVID-19 vaccination in patients with severe allergies and mastocytosis. However, even in these patients, severe adverse reactions are rare. We therefore recommend the broad use of COVID-19 vaccination in patients with mastocytosis on a global basis. The only well-established exception is a known or suspected allergy against a constituent of the vaccine. Safety measures, including premedication and postvaccination observation, should be considered in all patients with mastocytosis, depending on the individual personal risk and overall situation in each case. The current article provides a summary of published data, observations, and expert opinion that form the basis of these recommendations.

Keywords: Adverse reaction to medications; COVID-19; Hypersensitivity reactions; Mast cell diseases; Mastocytosis; Vaccine.

Figure 1

European Competence Network on Mastocytosis and American Initiative in Mast Cell Diseases Consensus Guidelines for COVID-19 Vaccine Risk Stratification in Mastocytosis.∗ MCAS, mast cell activation syndrome; PEG, polyethylene glycol. ∗These recommendations are based on expert opinion and have not been evaluated in regard to effectiveness.