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. 2021 Dec;9(12):4470-4472.e1.
doi: 10.1016/j.jaip.2021.09.039. Epub 2021 Oct 6.

Tolerability of polysorbate 80-containing COVID-19 vaccines in confirmed polyethylene glycol-allergic patients

Toon Ieven  1 , Thomas Van Weyenbergh  2 , Martijn Vandebotermet  2 , David Devolder  3 , Christine Breynaert  1 , Rik Schrijvers  4
Affiliations

Tolerability of polysorbate 80-containing COVID-19 vaccines in confirmed polyethylene glycol-allergic patients

Toon Ieven et al. J Allergy Clin Immunol Pract. 2021 Dec.
No abstract available

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Figures

Figure 1
Figure 1
Flowchart for the diagnostic evaluation prior to COVID-19 vaccination in patients with a history of PEG allergy. A careful review of the medical records in cooperation with allied health professionals can help identify patients with subsequent tolerated exposure to PS80, eligible for vaccination with a PS80-containing vaccine. If subsequent PS80 tolerability is absent or unclear, the patient should be referred to an allergist for further evaluation (skin testing with PEG and PS80 to identify a safe vaccine alternative can be considered). ∗In patients with double-negative skin tests despite a suggestive clinical history, a graded oral challenge to PEG can be considered on a case-by-case level, in a monitored setting. †In patients with positive skin tests to both PEG and PS80, no safe U.S. Food and Drug Administration– or European Medicines Agency-approved alternative is currently available. In selected cases in which the risk of not vaccinating would outweigh the potential risk of anaphylaxis, a (graded) vaccine challenge could be considered after informed consent or shared decision making and only in a monitored setting with personnel trained in the recognition and management of anaphylaxis.
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