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BRIEF RESEARCH REPORT article

Front. Allergy
Sec. Drug, Venom & Anaphylaxis
Volume 5 - 2024 | doi: 10.3389/falgy.2024.1502285
This article is part of the Research Topic Anaphylaxis Challenges: Idiopathic and Rare Causes View all 11 articles

Challenges in Diagnosing Polyethylene Glycol and Polysorbate 80 Allergies: Implications for Allergic Reactions in COVID-19 mRNA Vaccination Program: Experience from Qatar

Provisionally accepted
Sami Aqel Sami Aqel 1*Sherin Thalappil Sherin Thalappil 1Asaad Imameldin Asaad Imameldin 1Dalal Mudawi Dalal Mudawi 1Muna Al Maslamani Muna Al Maslamani 2Abdullatif Al- Khal Abdullatif Al- Khal 2Hassan Mobayed Hassan Mobayed 1Maryam Ali Al-Nesf Al-Mansouri Maryam Ali Al-Nesf Al-Mansouri 1Tayseer Ibrahim Tayseer Ibrahim 1
  • 1 Hamad Medical Corporation, Doha, Qatar
  • 2 Communicable Disease Center, Hamad General Hospital, Doha, Qatar

The final, formatted version of the article will be published soon.

    Introduction: COVID-19 vaccination has been a key intervention in reducing the severity of symptoms; however, concerns about vaccine safety, particularly regarding allergic reactions, arose early on. This study aimed to review the practical aspects of using allergy skin testing for COVID-19 vaccine excipients in patients with a history of allergic reactions developed following mRNA COVID-19 vaccination. Methods: A retrospective chart review was conducted for patients who reported allergic reactions after the COVID-19 vaccine and underwent allergy skin testing for COVID-19 vaccine excipients in Qatar. The testing protocol, developed based on published data during the pandemic, included skin prick (SPT) and intradermal (ID) testing using medications containing polysorbate 80 and polyethylene glycol (PEG). Results: Of the 88 patients reviewed, 38 reported different allergic reactions following mRNA COVID-19 vaccination. Anaphylaxis was reported in 21.1% of the patients, while the remaining experienced less severe allergic reactions. All patients underwent SPT and ID testing with PEG and polysorbate 80. By SPT, two patients tested positive for PEG and none for polysorbate 80. By ID, seven tested positive for polysorbate 80 and one for PEG. Among patients who experienced anaphylaxis, 50% had positive allergy test results. Twenty-three percent of patients with negative test results could receive additional vaccine doses without adverse reactions. Conclusion: Managing patients with a history of allergic reactions to the COVID-19 vaccine is challenging. In our cohort, most patients had mild allergic reactions following vaccination. Excipients' allergy skin testing has helped to reduce vaccine hesitancy despite its questionable utility in clinical practice.

    Keywords: Allergy testing, Anaphylaxis, Excipients, COVID-19 vaccines, Polyethylene glycol allergy, Polysorbate allergy, Qatar

    Received: 26 Sep 2024; Accepted: 27 Dec 2024.

    Copyright: © 2024 Aqel, Thalappil, Imameldin, Mudawi, Al Maslamani, Al- Khal, Mobayed, Al-Nesf Al-Mansouri and Ibrahim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sami Aqel, Hamad Medical Corporation, Doha, Qatar

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.