Evidence map›Paper›PMID 36265449›Full record

ArticleInternational archives of allergy and immunology2023

Allergy Workup in the Diagnosis of COVID-19 Vaccines-Induced Hypersensitivity Reactions and Its Impact on Vaccination.

Fiorella Petrelli, Daiana Giannini, Celestino Pucci, Isabella Del Corso, Valeria Rocchi, Maria Pia Dolcher, Giulio Pieve, Federico Pratesi, Paola Migliorini, Ilaria Puxeddu

Open access · bronzeAbstract readComment
In one paragraph

Article in International archives of allergy and immunology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Fiorella PetrelliImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Daiana GianniniImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Celestino PucciImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Isabella Del CorsoImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Valeria RocchiImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Maria Pia DolcherImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Giulio PieveUO Direzione Medica di Presidio, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Federico PratesiImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Paola MiglioriniImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Ilaria PuxedduImmunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
University of Pisa · ITAzienda Ospedaliera Universitaria Pisana · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionImmediate and delayed hypersensitivity reactions (HSR) to COVID-19 vaccines are rare adverse events that need to be prevented, diagnosed, and managed in order to guarantee adherence to the vaccination campaign. The aims of our study were to stratify the risk of HSR to COVID-19 vaccines and propose alternative strategies to complete the vaccination.

methods1,640 subjects were screened for vaccinal eligibility, according to national and international recommendations. Among them, we enrolled for allergy workup 152 subjects, 43 with HSR to COVID-19 vaccines and 109 at high risk of HSR to the first dose. In vivo skin tests with drugs and/or vaccines containing PEG/polysorbates were performed in all of them, using skin prick test and, when negative, intradermal tests. In a subgroup of patients resulted negative to the in vivo skin tests, the programmed dose of COVID-19 vaccine (Pfizer/BioNTech) was administered in graded doses regimen, and detection of neutralizing anti-spike antibodies was performed in these patients after 4 weeks from the vaccination, using the SPIA method.

resultsSkin tests for PEG/polysorbates resulted positive in only 3% (5/152) of patients, including 2 with previous HSR to COVID-19 vaccines and 3 at high risk of HSR to the first dose. Among the 147 patients with negative skin tests, 97% (143/147) were eligible for vaccination and 87% (124/143) of them received safely the programmed COVID-19 vaccine dose. Administration of graded doses of Pfizer/BioNTech vaccine were well tolerated in 17 out of 18 patients evaluated; only 1 developed an HSR during the vaccination, less severe than the previous one, and all developed neutralizing anti-spike antibodies after 4 weeks with values comparable to those subjects who received the vaccine in unfractionated dose.

conclusionOn the whole, the usefulness of the skin tests for PEG/polysorbates seems limited in the diagnosis of HSR to COVID-19 vaccines. Graded doses regimen (Pfizer/BioNTech) is a safe and effective alternative strategy to complete the vaccinal course.

Indexed as

COVID-19HypersensitivityAntibodies, NeutralizingCOVID-19 VaccinesHumansPolysorbatesVaccinationAntibodies, NeutralizingCOVID-19 VaccinesPolysorbatesAllergyCOVID-19Polyethylene glycolPolysorbatesSkin testVaccine

Identifiers

PMID36265449
PMCPMC9747735
OpenAlexW4306950963

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.