Vaccination against COVID-19 in patients with allergy: experience of the allergological center in Dnipro

Abstract

Vaccination against COVID-19 is the main global preventive measure in the fight against SARS-CoV-2. As the COVID-19 vaccine will be administered to billions of individuals worldwide during the pandemic, there exists a reasonable fear of severe adverse reactions requiring constant vigilance and careful treatment, particularly in individuals with a history of severe allergy. The aim of our study was to develop and implement an algorithm for the safe vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions. From January to June 2022, after signing the informed consent, 126 adult patients with relevant diseases in remission were included in a prospective single-center study. Complaints and case histories were collected from all patients, including comorbidity and medications received, anthropometric data were studied, a standard clinical examination was performed, tryptase in venous blood was measured, the level of control was additionally assessed in patients with asthma using the asthma control test and spirography. According to the results of the study, it was proven that vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions is safe, on condition of prior consultation with an allergist and performing vaccination in a medical institution. The algorithm developed for preparing for vaccination in the mentioned above persons consists of a careful collection of case history; assessment and, in case of absence – achieving control of the underlying disease; analysis and correction of therapy with temporary replacement of medications that are potential cofactors of anaphylaxis; determination of blood tryptase level. For safe vaccination in patients with severe allergic anamnesis, administration of 20 mg of desloratadine before each dose of the vaccine with observation after vaccination within 30 minutes is suggested.

Keywords

• covid-19
• vaccination
• anaphylaxis
• hypersensitivity
• anphylactogenic substances
• tryptase
• immunoglobulin e
• bronchial asthma
• urticaria
• allergic rhinitis
• hay fever
• mastocytosis
• atopic dermatitis
• comorbidity