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Abstract

The need for mass population vaccination against Covid-19 poses a public health problem. Allergic symptoms occurring after the 1st dose of the vaccine may result in resignation from the admin-istration of the 2nd dose. However, the majority of patients with mild and/or non-immediate symptoms may be safely vaccinated. The only absolute contraindication to administration of the vaccine is an anaphylactic reaction to any of its ingredients. Polyethylene glycol (PEG), widely used as an excipient in various vaccines, is considered the primary cause of allergic reactions associated with administration of Comirnaty (Pfizer/BioNTech) and Covid-19 Vaccine (Moderna) vaccines. However, hypersensitivity to PEG reported to date seems very rare, considering its widespread use in multiple everyday products, including medicines and cosmetics. In the paper, current literature data describing mechanisms of hy-persensitivity reactions to PEG, their clinical symptoms and diagnostic capabilities are presented. Un-doubtedly, the issue of hypersensitivity to PEG warrants further research, while patients with the diagnosis require individual diagnostic and therapeutic approach.
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Authors and Affiliations

Maria Czarnobilska
1
Małgorzata Bulanda
2
Magdalena Kurnik-Łucka
1
Krzysztof Gil
1

  1. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Anaphylaxis is an increasing problem in public health. Th e food allergens (mainly milk, eggs, and peanuts) are the most frequent cause of anaphylaxis in children and youth. In order to defi ne the cause of anaphylaxis, skin tests, the determination of the concentration of specifi c IgE in the blood and basophil activation test are conducted. In vitro tests are preferred due to the risk of allergic response during in vivo tests. Component-resolved diagnosis (CRD) is an additional tool in allergology, recommended in the third level of diagnostics when there are diagnostic doubts aft er the above mentioned tests have been carried out. The paper presents 3 cases of patients with anaphylactic response, and the application of CRD in these patients helped in planning the treatment. Patient 1 is a 4-year-old boy with diagnosed atopic dermatitis and bronchial asthma reported an anaphylactic shock at the age of seven months caused by cow’s milk and the exacerbation of bronchial asthma aft er eating some fruit. Patient 2 is a 35-year-old woman who has had anaphylactic shock three times: in June 2015, 2016, and 2017 and associates these episodes with the consumption of dumplings with a caramel, bun, and the last episode took place during physical exertion few hours aft er eating waffl e. Patient 3 is a 26-year-old man with one-time loss of consciousness after eating mixed nuts and drinking beer. CRD off ers the possibility to conduct a detailed diagnostic evaluation of patients with a history of anaphylactic reaction.

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Authors and Affiliations

Małgorzata Bulanda
Magdalena Leśniak
Judyta Szałkowska
Weronika Madej
Agata Wojtyna
Maria Czarnobilska
Daniel Bulanda
Ewa Czarnobilska

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