Janssen COVID-19 vaccine tolerated in 10 patients with confirmed polyethylene glycol allergy

Diagnostic accuracy of vaccine and vaccine excipient testing in the setting of allergic reactions to COVID‐19 vaccines: A systematic review and meta‐analysis

“…Case series have been published which also suggested that PEG allergic patients may tolerate PS containing vaccines (or vice‐versa). 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 Currently, it is hypothesized that these reactions occur primarily through a non‐IgE mediated mechanism, which is supported by recent meta‐analytic data demonstrating a low risk of repeat reactions with 2nd doses, and could explain the poor test accuracy in this present analysis. 3 …”

“…Case series have been published which also suggested that PEG allergic patients may tolerate PS containing vaccines (or vice-versa). [41][42][43][44][45][46][47][48][49][50][51][52] Currently, it is hypothesized that these reactions occur primarily through a non-IgE mediated mechanism, which is supported by recent meta-analytic data demonstrating a low risk of repeat reactions with 2nd doses, and could explain the poor test accuracy in this present analysis. 3 While the pooled data in this analysis show testing has poor sensitivity, the high specificity does not indicate that these tests accurately identify persons who are not allergic to the vaccine.…”

What have we learned about the allergenicity and adverse reactions associated with the severe acute respiratory syndrome coronavirus 2 vaccines: One year later

“…[63][64][65][66] In addition, patients with known PEG anaphylaxis have tolerated the Janssen and AstraZeneca vaccines containing the PEG derivative polysorbate 80, despite being intradermal skin test positive to polysorbate 80 in 3 of 10 cases. 67,68 Patients known to have PEG anaphylaxis have also tolerated the mRNA vaccines despite being skin test positive to polysorbate 80 or the mRNA vaccine. 69 Importantly, tolerance of an mRNA vaccine in those with histories of PEG anaphylaxis does not suggest tolerance of PEG reagents.…”

Effects of Vaccination against COVID-19 in Chronic Spontaneous and Inducible Urticaria (CSU/CIU) Patients: A Monocentric Study

“…As reported by Gambichler et al, type I allergic reactions following COVID-19 vaccinations is mainly due to polyethylene glycole (PEG) and structurally-related polysorbate-80 were considered as potential triggers of both IgE and non-IgE-mediated reactions [ 19 , 20 , 21 ]. According to recently published data, there is no convincing evidence of the clinical relevance of hypersensitivity reactions in PEG/Polysorbate sensitized patients who received COVID 19-mRNA vaccines [ 22 ]. In this regard, according to the German Society of Allergology and Clinical Immunology (DGAKI) and the German Society for Applied Allergology (AeDA) position paper, omalizumab should be continued during the vaccination period, and systemic antihistamines do not impact the vaccination effect [ 23 ].…”