Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy
Although allergic responses to the mRNA COVID-19 vaccines are rare, recent reports have suggested that a small number of individuals with allergy to polyethylene glycol (PEG), a component of the mRNA lipid nanoshell, may be at increased risk of anaphylaxis following vaccination. In this report, we d...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Allergy |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/falgy.2021.715844/full |
| _version_ | 1819067406734065664 |
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| author | Morgan D. McSweeney Manoj Mohan Scott P. Commins Samuel K. Lai Samuel K. Lai Samuel K. Lai Samuel K. Lai |
| author_facet | Morgan D. McSweeney Manoj Mohan Scott P. Commins Samuel K. Lai Samuel K. Lai Samuel K. Lai Samuel K. Lai |
| author_sort | Morgan D. McSweeney |
| collection | DOAJ |
| description | Although allergic responses to the mRNA COVID-19 vaccines are rare, recent reports have suggested that a small number of individuals with allergy to polyethylene glycol (PEG), a component of the mRNA lipid nanoshell, may be at increased risk of anaphylaxis following vaccination. In this report, we describe a case of a patient who received an mRNA COVID-19 vaccine, experienced anaphylaxis, and was subsequently confirmed to have anti-PEG allergy by skin prick testing. The patient had previously noticed urticaria after handling PEG powder for their occupation and had a history of severe allergic response to multiple other allergens. Importantly, as many as 70% of people possess detectable levels of anti-PEG antibodies, indicating that the detection of such antibodies does not imply high risk for an anaphylactic response to vaccination. However, in people with pre-existing anti-PEG antibodies, the administration of PEGylated liposomes may induce higher levels of antibodies, which may cause accelerated clearance of other PEGylated therapeutics a patient may be receiving. It is important to improve awareness of PEG allergy among patients and clinicians. |
| first_indexed | 2024-12-21T16:17:45Z |
| format | Article |
| id | doaj.art-7bcc3d3447d44db7b6e94384610c9ab5 |
| institution | Directory Open Access Journal |
| issn | 2673-6101 |
| language | English |
| last_indexed | 2024-12-21T16:17:45Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Allergy |
| spelling | doaj.art-7bcc3d3447d44db7b6e94384610c9ab52022-12-21T18:57:39ZengFrontiers Media S.A.Frontiers in Allergy2673-61012021-09-01210.3389/falgy.2021.715844715844Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG AllergyMorgan D. McSweeney0Manoj Mohan1Scott P. Commins2Samuel K. Lai3Samuel K. Lai4Samuel K. Lai5Samuel K. Lai6Mucommune, LLC, Durham, NC, United StatesOkemos Allergy Center, Okemos, MI, United StatesDivision of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina—Chapel Hill, Chapel Hill, NC, United StatesMucommune, LLC, Durham, NC, United StatesDivision of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina—Chapel Hill, Chapel Hill, NC, United StatesDepartment of Microbiology and Immunology, University of North Carolina—Chapel Hill, Chapel Hill, NC, United StatesDepartment of Biomedical Engineering, University of North Carolina—Chapel Hill, Chapel Hill, NC, United StatesAlthough allergic responses to the mRNA COVID-19 vaccines are rare, recent reports have suggested that a small number of individuals with allergy to polyethylene glycol (PEG), a component of the mRNA lipid nanoshell, may be at increased risk of anaphylaxis following vaccination. In this report, we describe a case of a patient who received an mRNA COVID-19 vaccine, experienced anaphylaxis, and was subsequently confirmed to have anti-PEG allergy by skin prick testing. The patient had previously noticed urticaria after handling PEG powder for their occupation and had a history of severe allergic response to multiple other allergens. Importantly, as many as 70% of people possess detectable levels of anti-PEG antibodies, indicating that the detection of such antibodies does not imply high risk for an anaphylactic response to vaccination. However, in people with pre-existing anti-PEG antibodies, the administration of PEGylated liposomes may induce higher levels of antibodies, which may cause accelerated clearance of other PEGylated therapeutics a patient may be receiving. It is important to improve awareness of PEG allergy among patients and clinicians.https://www.frontiersin.org/articles/10.3389/falgy.2021.715844/fullvaccine allergyvaccine adverse eventanaphylaxispolyethylene glycolanti-PEG antibodiesliposome |
| spellingShingle | Morgan D. McSweeney Manoj Mohan Scott P. Commins Samuel K. Lai Samuel K. Lai Samuel K. Lai Samuel K. Lai Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy Frontiers in Allergy vaccine allergy vaccine adverse event anaphylaxis polyethylene glycol anti-PEG antibodies liposome |
| title | Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy |
| title_full | Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy |
| title_fullStr | Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy |
| title_full_unstemmed | Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy |
| title_short | Anaphylaxis to Pfizer/BioNTech mRNA COVID-19 Vaccine in a Patient With Clinically Confirmed PEG Allergy |
| title_sort | anaphylaxis to pfizer biontech mrna covid 19 vaccine in a patient with clinically confirmed peg allergy |
| topic | vaccine allergy vaccine adverse event anaphylaxis polyethylene glycol anti-PEG antibodies liposome |
| url | https://www.frontiersin.org/articles/10.3389/falgy.2021.715844/full |
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