Allergy to Polyethilenglicole of Anti-SARS CoV2 Vaccine Recipient: A Case Report of Young Adult Recipient and the Management of Future Exposure to SARS-CoV2

Vincenzo Restivo,Ignazio Brusca,Maurizio Raineri,Rosa Onida,Giuseppina Candore,Giorgio Graziano,Ester Caravello,Salvatore Tiralongo,Maria Barrale

doi:10.3390/vaccines9050412

Vincenzo Restivo, Ignazio Brusca + Show 7 more

Open Access

https://doi.org/10.3390/vaccines9050412

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Abstract

The main contraindication to the anti-SARS CoV2 vaccine is an anaphylactic reaction to a vaccine component. The need to vaccinate allergic people who are at higher risk can be of public health interest and this report shows a case of an allergic reaction to PEG of a HCW who had received the first dose of anti-SARS CoV2 vaccine. For 5 h after the administration of the vaccine, she had the appearance of erythematous spots on the face and neck, and a feeling of a slurred mouth and hoarseness. In order to treat the event, she was administered 8 mg intravenous dexamethasone, 1 vial intravenous chlorphenamine maleate, 250 mL intravenous 0.9% NaCl, and conventional oxygen therapy (2 L/min) with complete resolution of the suspected adverse drug reaction. According to the contraindication to the cutaneous test for this patient, BAT was used for further investigations. The patient who suffered the adverse reaction to the COVID-19 vaccine and other five allergic patients who did not report any adverse reaction after the vaccination were tested. There was a significant activation of the vaccine-reactive patient’s basophils with 14.79 CD203chigh% at the concentration of 0.2 mg/mL, while other patients were negative. People who have a confirmed reaction to a vaccine component should undergo further investigation to discover other possible cross-reactions and select the right vaccine to immunize them.

Highlights

The eradication of SARS CoV2 will depend on the possibility of ensuring a wide distribution of effective vaccines and on the population’s compliance with the vaccination itself
Pfizer-BioNTech recently introduced its anti-SARS CoV2 vaccine in the UK, US, and other countries. This is a vaccine based on messenger RNA and the vaccine contains several excipients and lipids, one of which is based on PEG-2000
The patient who suffered the adverse reaction to the COVID-19 vaccine and another five allergic patients who did not report any adverse reaction after the vaccination were tested

Summary

Introduction

The eradication of SARS CoV2 will depend on the possibility of ensuring a wide distribution of effective vaccines and on the population’s compliance with the vaccination itself. Pfizer-BioNTech recently introduced its anti-SARS CoV2 vaccine in the UK, US, and other countries This is a vaccine based on messenger RNA (mRNA) (tozinameran, BNT-162b2) and the vaccine contains several excipients and lipids, one of which is based on PEG-2000. The vaccine components do not differ significantly and the reason for this observed increased reaction rate is unknown This rate of anaphylaxis is significantly higher than was previously reported for one million doses of other vaccines, but is still quite rare (11.1 cases per million vaccine doses of the Pfizer-BioNTech vaccine). This report shows the case of an allergic reaction to PEG in an HCW who had received the first dose of the anti-SARS CoV2 vaccine

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