Risk of severe allergic reactions to COVID‐19 vaccines among patients with allergic skin diseases – practical recommendations. A position statement of ETFAD with external experts

Since the introduction of active vaccination against SARS-CoV-2 infection, there has been a debate about risk developing severe allergic or anaphylactic reactions among individuals with history allergy.1, 2 Indeed, rare cases have reported in United Kingdom and North America.3 By February 2021, rate 4.5 occurred 1 million patients vaccinated mRNA-based COVID-19 vaccines,1, 3 which is higher than generally expected to vaccinations around one million.4, 5 Warnings subsequently issued that ‘persons allergies’ should not be vaccinated, leading confusion vaccinating physicians. Therefore, European Task Force Atopic Dermatitis (ETFAD) – addition statement on use systemic immunomodulatory treatments for atopic dermatitis (AD) during vaccination6 discusses putative vaccines suffering from skin diseases give practical recommendations. Generally, are rare, due hypersensitivity components formulation vaccine such as conjugating agents, preservatives, metals, stabilizers, adjuvants contaminants.5 In case vaccines, apart mRNA, protein vector, possible elicitor anaphylaxis could other ingredients as, example, polyethylene glycol (PEG) present both BioNTech/Pfizer (Comirnaty) Moderna (mRNA-1273) vaccines; additives may contained under development like AZD-1222, NVX.CoV2373 Ad26.DOV2.S. Based available data, safety tolerability appear better of, smallpox vaccines.7, 8 The general recommendation AD according their local national plan.6, 7 Patients including do per se an increased any vaccine. Precautions taken where drugs general, especially vaccinations, mastocytosis idiopathic anaphylaxis. All these undergo drug allergy diagnostic work-up prior vaccination.2, acute flare eczema actively treated but delayed patients. same holds true urticaria diseases.5 selected cases, anti-allergic medication vaccination, combined histamine H1 H2 receptor antagonists plus oral glucocorticoids considered, it done peri-operative radiographic contrast media.9 Such observed 30 min after injection. Clear contraindications exist at moment only documented respective anaphylaxis, treatment includes intramuscular epinephrine main pharmacotherapy. Epinephrine auto-injectors centres well balanced electrolyte solutions volume replacement.9, 10 Nearly all can registered today. Precautionary measures very small subgroup patients, those Knowledge side-reactions improved physicians medical health personnel centres. None. Dr. Ring advisor speaker AbbVie, Allergika, Sanofi-Genzyme, Pfizer, Bencard, LEO Pharma, Mylan. Thyssen attended advisory boards Eli-Lilly, Regeneron, Abbvie received honorarium Abbvie, research grants Regeneron Sanofi-Genzyme. Vestergaard investigator, speaker, consultant Novartis, Sanofi, LeoPharma Eli Lilly. Dr Barbarot principal board member, Pierre Fabre Laboratory, Bioderma, Laboratoire La Roche Posay, Janssen, Leo-Pharma, Amgen, de Bruin-Weller consultant, and/or Almirall, Arena, Lilly, Galderma, Leo Sanofi-Genzym. Bieber GSK, Celgene, AnaptysBio, MedImmune, Chugai, Fabre, Asana Biosciences, LEO, Galapagos/MorphoSys, BioVerSys, Kymab, Glenmark, Astellas, Daiichi-Sankyo, MenloTx, Dermavant, Allmiral. T. was Investigator Allmiral, Böhringer-Ingelheim, Daichi-Sankyo, Dermavant/Roivant, DermTreat, DS RAPT/FLX Bio, Incyte, L´Oréal, Sanofi/Regeneron, UCB. founder non-profit biotech company “Davos Biosciences”. Gutermuth member Taïeb investigator Johnson Johnson, Modilac, Sanofi. Seneschal Weidinger institutional Pharma L‘Oreal, performed consultancies lectured educational events sponsored by involved performing clinical trials pharmaceutical industries manufacture used dermatitis. Trzeciak Sanofi Genzyme, Mead Johnson. Cork Consultant Galapagos, Boots, L’Oreal, Reckitt Benckiser, Oxagen, Johnson&Johnson, Hyphens, Procter&Gamble, Menlo, Perrigo. Paul Boehringer, Lilly & Co, Merck, UCB pharma, Flohr chief UK National Institute Health Research-funded TREAT (ISRCTN15837754) SOFTER (Clinicaltrials.gov: NCT03270566) UK-Irish Systemic Therapy Register (A-STAR; ISRCTN11210918) Union Horizon 2020-funded BIOMAP Consortium (http://www.biomap-imi.eu/). His department also investigator-led funding Heratizadeh reports personal fees Beiersdorf, Hans Karrer, Nutricia, Meda, outside submitted work. Darsow gave advice talks grant following companies: ALK-Abello, Sanofi-Regeneron Simon AstraZeneca, Genzyme. Torrelo acted participant Chernyshov, Stalder, Svensson Kunz no conflict interest. Gelmetti Bayer, Galderma Pfizer Pharma. Szalai psoriasis von Kobyletzki De Raeve scientific and/ non-financial support Sanofi-Genzyme Bioderma. Fölster-Holst being consultant/Advisor Beiersdorf AG, Neubourg, Novartis Inc., Sanofi-Aventis Laboratories, Sanofi-Aventis. Christen-Zaechs advisor, Posey, Procter Gamble Hijnen LeoPharma, MedImmune/Astrazeneca, ThermoFisher. Gieler Sebamed organization education programs Germany Bangert Mylan, Celgene AbbVie Elli Galderma. Spuls past 111017 041217 (unpaid), departmental independent different since December 2019 NL registry, many e.g. dermatitis, financial compensation paid department/hospital and, Chief (CI) phototherapy registry (TREAT NL) adults children SECURE-AD registry. Wollenberg Pharmaceuticals, Inc. honoraria Loreal, Deleuran Fabre. This independently through authors’ academic university hospital affiliations.