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European Annals of Allergy and Clinical Immunology ISSN 1764-1489

2023

Contents »

The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey


Maria Carmela Montera1, Annaclaudia Giordano annaclaudiagiordano@hotmail.it2, Chiara Asperti3,4, Arianna Aruanno5,6, Claudio Enrico Barzaghi7, Donatella Bignardi8, Paolo Borrelli9, Luisa Bommarito10, Moira Busa11, Paolo Calafiore12, Valentina Carusi5, Massimo Cinquini13, Gabriele Cortellini14, Roberto Cocchi15, Francesca D'Auria16, Francesco De Caro2, Antongiulio Demonte17, Elisabetta Di Leo18, Michela Di Lizia12, Alessia Di Rienzo5, Federica Fumagalli19, Paola Kihlgren16, Fabio Lodi Rizzini13,20, Donatella Macchia21, Giuseppina Manzotti22, Alessandro Maria Marra7, Palmiro Mileto13,20, Sabrina Mietta10, Marcello Montagni16, Eustachio Nettis23, Eleonora Nucera5,6, Silvia Peveri16 , Daniele Pivetta13,20, Mario Pirisi24, Giuseppe A. Ramirez 3,4, Federica Rivolta25, Angela Rizzi5,6, Alfonso Savoia26, Alfonso Pedicini26, Alessandro Scarpa11, Giuliana Zisa27, Mona-Rita Yacoub3

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Doi
10.23822/EurAnnACI.1764-1489.291

Summary
Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine.The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods.  This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient)  or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC  guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362  (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p<0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.  

Key words

PEG; skin test; vaccines; anaphylaxis; COVID-19. 

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