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Author Notes:

Correspondence: Paul J. Turner, National Heart & Lung Institute Imperial College London Norfolk Place London, W2 1PG, United Kingdom, p.turner@imperial.ac.uk

Author contributions: Drs Turner and Worm wrote the first draft of the manuscript, which was then reviewed, amended, and approved by all co-authors.

Acknowledgements: We thank Drs Sophie Farooque and Alessia Baseggio Conrado (London) for reviewing a draft of this manuscript.

Disclosures: Dr. Ansotegui reports personal fees from Mundipharma, Roxall, Sanofi, MSD, Faes Farma, Hikma, UCB, Astra Zeneca, Stallergenes, Abbott, and Bial, outside the submitted work.

Dr. Cardona reports personal fees from ALK, Allergy Therapeutics, LETI, Thermofisher, Merck, Astrazeneca, and GSK, outside the submitted work. Former chair of the WAO Anaphylaxis Committee. Member of the working group of the EAACI anaphylaxis guidelines. Chair of the SLAAI anaphylaxis Committee.

Dr. Campbell is a part-time employee of DBV Technologies and reports grants from National Health and Medical Research Council of Australia and personal fees from Allergenis, Westmead Fertility Centre, and Financial Markets Foundation for Children.Dr. Ebisawa reports personal fees from Mylan, outside the submitted work. Dr. El-Gamal has nothing to disclose. Dr. Fineman has nothing to disclose. Dr. Geller has nothing to disclose. Dr. Gonzalez-Estrada has nothing to disclose.

Dr. Greenberger reports personal fees from Wolters Kluwer book, Wolters Kluwer Uptodate, and Allergy Therapeutics, outside the submitted work; and Expert testimony: Legal on anaphylaxis. Dr. Leung has nothing to disclose. Dr. Levin has nothing to disclose.

Dr Muraro reports grants and personal fees from Aimmune and personal fees from DVB, Mylan, ALK and Nestle outside the submitted work. Dr. Sanchez Borges has nothing to disclose. Dr. Senna has nothing to disclose. Dr. Sheikh has nothing to disclose. Dr. Tanno has nothing to disclose. Dr. Thong has nothing to disclose.

Dr. Turner reports grants from UK Medical Research Council, NIHR/Imperial BRC, UK Food Standards Agency, End Allergies Together, Jon Moulton Charity Trust; personal fees and non-financial support from Aimmune Therapeutics, DBV Technologies and Allergenis, personal fees and other from ILSI Europe and UK Food Standards Agency, outside the submitted work; current Chairperson of the WAO Anaphylaxis Committee, and joint-chair of the Anaphylaxis Working group of the UK Resuscitation Council.

Dr. Worm reports other from Allergopharma GmbH & Co. KG, other from ALK-Abelló Arzneimittel GmbH, other from Mylan Germany GmbH, other from Leo Pharma GmbH, other from Sanofi-Aventis Deutschland GmbH, other from Regeneron Pharmaceuticals, other from DBV Technologies S.A, other from Stallergenes GmbH, other from HAL Allergie GmbH, other from Bencard Allergie GmbH, other from Aimmune Therapeutics UK Limited, other from Actelion Pharmaceuticals Deutschland GmbH, other from Novartis AG, other from Biotest AG, other from AbbVie Deutschland GmbH & Co. KG, other from Lilly Deutschland GmbH, outside the submitted work.

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Research Funding:

None.

Keywords:

  • COVID-19
  • Anaphylaxis
  • Allergy
  • Immunology
  • Pediatrics
  • Child health
  • Dermatology

COVID-19 vaccine-associated anaphylaxis: A statement of the World Allergy Organization Anaphylaxis Committee

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Journal Title:

World Allergy Organization Journal

Volume:

Volume 14, Number 2

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Article | Final Publisher PDF

Abstract:

Vaccines against COVID-19 (and its emerging variants) are an essential global intervention to control the current pandemic situation. Vaccines often cause adverse events; however, the vast majority of adverse events following immunization (AEFI) are a consequence of the vaccine stimulating a protective immune response, and not allergic in etiology. Anaphylaxis as an AEFI is uncommon, occurring at a rate of less than 1 per million doses for most vaccines. However, within the first days of initiating mass vaccination with the Pfizer-BioNTech COVID-19 vaccine BNT162b2, there were reports of anaphylaxis from the United Kingdom and United States. More recent data imply an incidence of anaphylaxis closer to 1:200,000 doses with respect to the Pfizer-BioNTech vaccine. In this position paper, we discuss the background to reactions to the current COVID-19 vaccines and relevant steps to mitigate against the risk of anaphylaxis as an AEFI. We propose a global surveillance strategy led by allergists in order to understand the potential risk and generate data to inform evidence-based guidance, and thus provide reassurance to public health bodies and members of the public.

Copyright information:

© 2021 The Author(s). Published by Elsevier Inc. on behalf of World Allergy Organization.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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