Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy.
Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy.
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DOI：
10.3389/falgy.2021.715844
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发表时间：
2021
影响因子：
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通讯作者：
Lai SK
中科院分区：
文献类型：
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作者：
McSweeney MD;Mohan M;Commins SP;Lai SK
尽管对mRNA COVID-19疫苗的过敏反应很罕见，但最近的报告表明，少数对mRNA脂质纳米壳的一种成分聚乙二醇（PEG）过敏的个体在接种疫苗后发生过敏反应的风险可能会增加。在这份报告中，我们描述了一例接受mRNA COVID-19疫苗的患者，发生了过敏反应，随后通过皮肤点刺试验证实了抗PEG过敏。该患者之前曾因其职业接触PEG粉末后发现荨麻疹，并有对多种其他过敏原的重度过敏反应史。重要的是，多达70%的人具有可检测水平的抗PEG抗体，这表明检测到此类抗体并不意味着对疫苗接种的过敏反应的高风险。然而，在预先存在抗PEG抗体的人群中，PEG化脂质体的给药可能会诱导更高水平的抗体，这可能会导致患者可能接受的其他PEG化治疗药物的加速清除。提高患者和临床医生对PEG过敏的认识非常重要。
Although allergic responses to the mRNA COVID-19 vaccines are rare, recent reports have suggested that a small number of individuals with allergy to polyethylene glycol (PEG), a component of the mRNA lipid nanoshell, may be at increased risk of anaphylaxis following vaccination. In this report, we describe a case of a patient who received an mRNA COVID-19 vaccine, experienced anaphylaxis, and was subsequently confirmed to have anti-PEG allergy by skin prick testing. The patient had previously noticed urticaria after handling PEG powder for their occupation and had a history of severe allergic response to multiple other allergens. Importantly, as many as 70% of people possess detectable levels of anti-PEG antibodies, indicating that the detection of such antibodies does not imply high risk for an anaphylactic response to vaccination. However, in people with pre-existing anti-PEG antibodies, the administration of PEGylated liposomes may induce higher levels of antibodies, which may cause accelerated clearance of other PEGylated therapeutics a patient may be receiving. It is important to improve awareness of PEG allergy among patients and clinicians.