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Volume 11
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10.3390/vaccines11050915
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Brief Report

Polyethylene Glycol and Polysorbate 80 Skin Tests in the Context of an Allergic Risk Assessment for Hypersensitivity Reactions to Anti-SARS-CoV-2 mRNA Vaccines

by
Emanuele Nappi
1,
Francesca Racca
1,
Alessandra Piona
2,
Maria Rita Messina
1,
Sebastian Ferri
1,
Donatella Lamacchia
1,
Giuseppe Cataldo
1,
Giovanni Costanzo
1,
Lorenzo Del Moro
1,3,
Francesca Puggioni
1,
Giorgio Walter Canonica
1,4,
Enrico Heffler
1,4,* and
Giovanni Paoletti
1,4
1
Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
2
Allergy Service, Humanitas San Pio X Hospital, 20159 Milano, Italy
3
Department of Clinical and Experimental Medicine, University of Florence, 50121 Firenze, Italy
4
Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
*
Author to whom correspondence should be addressed.
Vaccines 2023, 11(5), 915; https://doi.org/10.3390/vaccines11050915
Submission received: 25 March 2023 / Revised: 20 April 2023 / Accepted: 27 April 2023 / Published: 28 April 2023
Review Reports Versions Notes

Abstract

Concern has arisen about hypersensitivity reactions in patients with allergic reactions to drugs containing polyethylene glycol (PEG) or polysorbate 80 (PS80), excipients of currently available anti-SARS-CoV-2 mRNA vaccines. However, the actual utility of PEG and PS80 skin allergy testing is currently still debated. We retrospectively analyzed all cases of patients on whom we performed allergometric skin tests for PEG and PS80 in the context of a pre-vaccination screening (for patients with multiple hypersensitivity reactions to drugs for which these excipients were among the suspected agents) or following suspected hypersensitivity reactions to anti-SARS-CoV-2 vaccines. A total of 134 tests were performed for PEG and PS80, eight of which produced uninterpretable results (due to dermographism or non-specific reactions). Of the remaining 126 cases (85 pre-vaccinal and 41 post-vaccine reactions), 16 (12.7%) were positive for PEG and/or PS80. Stratifying by clinical indication, there were no statistically significant differences in the proportion of positive tests between patients evaluated in the context of the pre-vaccination screening and those evaluated after a vaccine reaction (10.6% vs. 17.1%, respectively, p = 0.306). Allergometric skin tests for PEG and PS80 in our case series resulted positive in an unexpectedly high proportion of patients, suggesting that testing for allergy to these two excipients should not be ignored in case of reasonable clinical suspicion.
Keywords: SARS-CoV-2; vaccine; allergy; polyethylene glycol; polysorbate; skin tests SARS-CoV-2; vaccine; allergy; polyethylene glycol; polysorbate; skin tests

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MDPI and ACS Style

Nappi, E.; Racca, F.; Piona, A.; Messina, M.R.; Ferri, S.; Lamacchia, D.; Cataldo, G.; Costanzo, G.; Del Moro, L.; Puggioni, F.; et al. Polyethylene Glycol and Polysorbate 80 Skin Tests in the Context of an Allergic Risk Assessment for Hypersensitivity Reactions to Anti-SARS-CoV-2 mRNA Vaccines. Vaccines 2023, 11, 915. https://doi.org/10.3390/vaccines11050915

AMA Style

Nappi E, Racca F, Piona A, Messina MR, Ferri S, Lamacchia D, Cataldo G, Costanzo G, Del Moro L, Puggioni F, et al. Polyethylene Glycol and Polysorbate 80 Skin Tests in the Context of an Allergic Risk Assessment for Hypersensitivity Reactions to Anti-SARS-CoV-2 mRNA Vaccines. Vaccines. 2023; 11(5):915. https://doi.org/10.3390/vaccines11050915

Chicago/Turabian Style

Nappi, Emanuele, Francesca Racca, Alessandra Piona, Maria Rita Messina, Sebastian Ferri, Donatella Lamacchia, Giuseppe Cataldo, Giovanni Costanzo, Lorenzo Del Moro, Francesca Puggioni, and et al. 2023. "Polyethylene Glycol and Polysorbate 80 Skin Tests in the Context of an Allergic Risk Assessment for Hypersensitivity Reactions to Anti-SARS-CoV-2 mRNA Vaccines" Vaccines 11, no. 5: 915. https://doi.org/10.3390/vaccines11050915

APA Style

Nappi, E., Racca, F., Piona, A., Messina, M. R., Ferri, S., Lamacchia, D., Cataldo, G., Costanzo, G., Del Moro, L., Puggioni, F., Canonica, G. W., Heffler, E., & Paoletti, G. (2023). Polyethylene Glycol and Polysorbate 80 Skin Tests in the Context of an Allergic Risk Assessment for Hypersensitivity Reactions to Anti-SARS-CoV-2 mRNA Vaccines. Vaccines, 11(5), 915. https://doi.org/10.3390/vaccines11050915

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