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Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management : A GRADE assessment and international consensus approach. / Greenhawt, Matthew; Dribin, Timothy E.; Abrams, Elissa M.; Shaker, Marcus; Chu, Derek K.; Golden, David B.K.; Akin, Cem; Anagnostou, Akterini; ALMuhizi, Faisal; Alqurashi, Waleed; Arkwright, Peter; Baldwin, James L.; Banerji, Aleena; Bégin, Philippe; Ben-Shoshan, Moshe; Bernstein, Jonathan; Bingemann, Theresa A.; Bindslev-Jensen, Carsten; Blumenthal, Kim; Byrne, Aideen; Cahill, Julia; Cameron, Scott; Campbell, Dianne; Campbell, Ronna; Cavender, Michael; Chan, Edmond S.; Chinthrajah, Sharon; Comberiati, Pasquale; Eastman, Jacqueline J.; Ellis, Anne K.; Fleischer, David M.; Fox, Adam; Frischmeyer-Guerrerio, Pamela A.; Gagnon, Remi; Garvey, Lene H.; Grayson, Mitchell H.; Isabwe, Ghislaine Annie Clarisse; Hartog, Nicholas; Hendron, David; Horner, Caroline C.; Hourihane, Johnathan O.B.; Iglesia, Edward; Kan, Manstein; Kaplan, Blanka; Katelaris, Constance H.; Kim, Harold; Kelso, John M.; Khan, David A.; Lang, David; Ledford, Dennis; Levin, Michael; Lieberman, Jay A.; Loh, Richard; Mack, Douglas P.; Mazer, Bruce; Mody, Ketan; Mosnaim, Gisele; Munblit, Daniel; Mustafa, S. Shahzad; Nanda, Anil; Nathan, Richard; Oppenheimer, John; Otani, Iris M.; Park, Miguel; Pawankar, Ruby; Perrett, Kirsten P.; Peter, Jonny; Phillips, Elizabeth J.; Picard, Matthieu; Pitlick, Mitchell; Ramsey, Allison; Rasmussen, Trine Holm; Rathkopf, Melinda M.; Reddy, Hari; Robertson, Kara; Rodriguez del Rio, Pablo; Sample, Stephen; Sheshadri, Ajay; Sheik, Javed; Sindher, Sayantani B.; Spergel, Jonathan M.; Stone, Cosby A.; Stukus, David; Tang, Mimi L.K.; Tracy, James M.; Turner, Paul J.; Vander Leek, Timothy K.; Wallace, Dana V.; Wang, Julie; Wasserman, Susan; Weldon, David; Wolfson, Anna R.; Worm, Margitta; Yacoub, Mona Rita.
In:
Journal of Allergy and Clinical Immunology, Vol. 152, No. 2, 2023, p. 309-325.
Research output: Contribution to journal › Review › Research › peer-review
Harvard
Greenhawt, M, Dribin, TE, Abrams, EM, Shaker, M, Chu, DK, Golden, DBK, Akin, C, Anagnostou, A, ALMuhizi, F, Alqurashi, W, Arkwright, P, Baldwin, JL, Banerji, A, Bégin, P, Ben-Shoshan, M, Bernstein, J, Bingemann, TA, Bindslev-Jensen, C, Blumenthal, K, Byrne, A, Cahill, J, Cameron, S, Campbell, D, Campbell, R, Cavender, M, Chan, ES, Chinthrajah, S, Comberiati, P, Eastman, JJ, Ellis, AK, Fleischer, DM, Fox, A, Frischmeyer-Guerrerio, PA, Gagnon, R
, Garvey, LH, Grayson, MH, Isabwe, GAC, Hartog, N, Hendron, D, Horner, CC, Hourihane, JOB, Iglesia, E, Kan, M, Kaplan, B, Katelaris, CH, Kim, H, Kelso, JM, Khan, DA, Lang, D, Ledford, D, Levin, M, Lieberman, JA, Loh, R, Mack, DP, Mazer, B, Mody, K, Mosnaim, G, Munblit, D, Mustafa, SS, Nanda, A, Nathan, R, Oppenheimer, J, Otani, IM, Park, M, Pawankar, R, Perrett, KP, Peter, J, Phillips, EJ, Picard, M, Pitlick, M, Ramsey, A, Rasmussen, TH, Rathkopf, MM, Reddy, H, Robertson, K, Rodriguez del Rio, P, Sample, S, Sheshadri, A, Sheik, J, Sindher, SB, Spergel, JM, Stone, CA, Stukus, D, Tang, MLK, Tracy, JM, Turner, PJ, Vander Leek, TK, Wallace, DV, Wang, J, Wasserman, S, Weldon, D, Wolfson, AR, Worm, M & Yacoub, MR 2023, '
Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach',
Journal of Allergy and Clinical Immunology, vol. 152, no. 2, pp. 309-325.
https://doi.org/10.1016/j.jaci.2023.05.019APA
Greenhawt, M., Dribin, T. E., Abrams, E. M., Shaker, M., Chu, D. K., Golden, D. B. K., Akin, C., Anagnostou, A., ALMuhizi, F., Alqurashi, W., Arkwright, P., Baldwin, J. L., Banerji, A., Bégin, P., Ben-Shoshan, M., Bernstein, J., Bingemann, T. A., Bindslev-Jensen, C., Blumenthal, K., ... Yacoub, M. R. (2023).
Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach.
Journal of Allergy and Clinical Immunology,
152(2), 309-325.
https://doi.org/10.1016/j.jaci.2023.05.019Vancouver
Greenhawt M, Dribin TE, Abrams EM, Shaker M, Chu DK, Golden DBK et al.
Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach.
Journal of Allergy and Clinical Immunology. 2023;152(2):309-325.
https://doi.org/10.1016/j.jaci.2023.05.019Author
Greenhawt, Matthew ; Dribin, Timothy E. ; Abrams, Elissa M. ; Shaker, Marcus ; Chu, Derek K. ; Golden, David B.K. ; Akin, Cem ; Anagnostou, Akterini ; ALMuhizi, Faisal ; Alqurashi, Waleed ; Arkwright, Peter ; Baldwin, James L. ; Banerji, Aleena ; Bégin, Philippe ; Ben-Shoshan, Moshe ; Bernstein, Jonathan ; Bingemann, Theresa A. ; Bindslev-Jensen, Carsten ; Blumenthal, Kim ; Byrne, Aideen ; Cahill, Julia ; Cameron, Scott ; Campbell, Dianne ; Campbell, Ronna ; Cavender, Michael ; Chan, Edmond S. ; Chinthrajah, Sharon ; Comberiati, Pasquale ; Eastman, Jacqueline J. ; Ellis, Anne K. ; Fleischer, David M. ; Fox, Adam ; Frischmeyer-Guerrerio, Pamela A. ; Gagnon, Remi ; Garvey, Lene H. ; Grayson, Mitchell H. ; Isabwe, Ghislaine Annie Clarisse ; Hartog, Nicholas ; Hendron, David ; Horner, Caroline C. ; Hourihane, Johnathan O.B. ; Iglesia, Edward ; Kan, Manstein ; Kaplan, Blanka ; Katelaris, Constance H. ; Kim, Harold ; Kelso, John M. ; Khan, David A. ; Lang, David ; Ledford, Dennis ; Levin, Michael ; Lieberman, Jay A. ; Loh, Richard ; Mack, Douglas P. ; Mazer, Bruce ; Mody, Ketan ; Mosnaim, Gisele ; Munblit, Daniel ; Mustafa, S. Shahzad ; Nanda, Anil ; Nathan, Richard ; Oppenheimer, John ; Otani, Iris M. ; Park, Miguel ; Pawankar, Ruby ; Perrett, Kirsten P. ; Peter, Jonny ; Phillips, Elizabeth J. ; Picard, Matthieu ; Pitlick, Mitchell ; Ramsey, Allison ; Rasmussen, Trine Holm ; Rathkopf, Melinda M. ; Reddy, Hari ; Robertson, Kara ; Rodriguez del Rio, Pablo ; Sample, Stephen ; Sheshadri, Ajay ; Sheik, Javed ; Sindher, Sayantani B. ; Spergel, Jonathan M. ; Stone, Cosby A. ; Stukus, David ; Tang, Mimi L.K. ; Tracy, James M. ; Turner, Paul J. ; Vander Leek, Timothy K. ; Wallace, Dana V. ; Wang, Julie ; Wasserman, Susan ; Weldon, David ; Wolfson, Anna R. ; Worm, Margitta ; Yacoub, Mona Rita. / Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management : A GRADE assessment and international consensus approach. In: Journal of Allergy and Clinical Immunology. 2023 ; Vol. 152, No. 2. pp. 309-325.
Bibtex
@article{a1e927e83ae140c69fe1cfdbc8c79650,
title = "Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach",
abstract = "This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against >15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.",
keywords = "allergic reactions, anaphylaxis, COVID-19, mRNA COVID-19 vaccine, polyethylene glycol, polysorbate 80, repeat allergic reactions, SARS-CoV-2, skin testing, vaccination",
author = "Matthew Greenhawt and Dribin, {Timothy E.} and Abrams, {Elissa M.} and Marcus Shaker and Chu, {Derek K.} and Golden, {David B.K.} and Cem Akin and Akterini Anagnostou and Faisal ALMuhizi and Waleed Alqurashi and Peter Arkwright and Baldwin, {James L.} and Aleena Banerji and Philippe B{\'e}gin and Moshe Ben-Shoshan and Jonathan Bernstein and Bingemann, {Theresa A.} and Carsten Bindslev-Jensen and Kim Blumenthal and Aideen Byrne and Julia Cahill and Scott Cameron and Dianne Campbell and Ronna Campbell and Michael Cavender and Chan, {Edmond S.} and Sharon Chinthrajah and Pasquale Comberiati and Eastman, {Jacqueline J.} and Ellis, {Anne K.} and Fleischer, {David M.} and Adam Fox and Frischmeyer-Guerrerio, {Pamela A.} and Remi Gagnon and Garvey, {Lene H.} and Grayson, {Mitchell H.} and Isabwe, {Ghislaine Annie Clarisse} and Nicholas Hartog and David Hendron and Horner, {Caroline C.} and Hourihane, {Johnathan O.B.} and Edward Iglesia and Manstein Kan and Blanka Kaplan and Katelaris, {Constance H.} and Harold Kim and Kelso, {John M.} and Khan, {David A.} and David Lang and Dennis Ledford and Michael Levin and Lieberman, {Jay A.} and Richard Loh and Mack, {Douglas P.} and Bruce Mazer and Ketan Mody and Gisele Mosnaim and Daniel Munblit and Mustafa, {S. Shahzad} and Anil Nanda and Richard Nathan and John Oppenheimer and Otani, {Iris M.} and Miguel Park and Ruby Pawankar and Perrett, {Kirsten P.} and Jonny Peter and Phillips, {Elizabeth J.} and Matthieu Picard and Mitchell Pitlick and Allison Ramsey and Rasmussen, {Trine Holm} and Rathkopf, {Melinda M.} and Hari Reddy and Kara Robertson and {Rodriguez del Rio}, Pablo and Stephen Sample and Ajay Sheshadri and Javed Sheik and Sindher, {Sayantani B.} and Spergel, {Jonathan M.} and Stone, {Cosby A.} and David Stukus and Tang, {Mimi L.K.} and Tracy, {James M.} and Turner, {Paul J.} and {Vander Leek}, {Timothy K.} and Wallace, {Dana V.} and Julie Wang and Susan Wasserman and David Weldon and Wolfson, {Anna R.} and Margitta Worm and Yacoub, {Mona Rita}",
note = "Publisher Copyright: {\textcopyright} 2023",
year = "2023",
doi = "10.1016/j.jaci.2023.05.019",
language = "English",
volume = "152",
pages = "309--325",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",
number = "2",
}
RIS
TY - JOUR
T1 - Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management
T2 - A GRADE assessment and international consensus approach
AU - Greenhawt, Matthew
AU - Dribin, Timothy E.
AU - Abrams, Elissa M.
AU - Shaker, Marcus
AU - Chu, Derek K.
AU - Golden, David B.K.
AU - Akin, Cem
AU - Anagnostou, Akterini
AU - ALMuhizi, Faisal
AU - Alqurashi, Waleed
AU - Arkwright, Peter
AU - Baldwin, James L.
AU - Banerji, Aleena
AU - Bégin, Philippe
AU - Ben-Shoshan, Moshe
AU - Bernstein, Jonathan
AU - Bingemann, Theresa A.
AU - Bindslev-Jensen, Carsten
AU - Blumenthal, Kim
AU - Byrne, Aideen
AU - Cahill, Julia
AU - Cameron, Scott
AU - Campbell, Dianne
AU - Campbell, Ronna
AU - Cavender, Michael
AU - Chan, Edmond S.
AU - Chinthrajah, Sharon
AU - Comberiati, Pasquale
AU - Eastman, Jacqueline J.
AU - Ellis, Anne K.
AU - Fleischer, David M.
AU - Fox, Adam
AU - Frischmeyer-Guerrerio, Pamela A.
AU - Gagnon, Remi
AU - Garvey, Lene H.
AU - Grayson, Mitchell H.
AU - Isabwe, Ghislaine Annie Clarisse
AU - Hartog, Nicholas
AU - Hendron, David
AU - Horner, Caroline C.
AU - Hourihane, Johnathan O.B.
AU - Iglesia, Edward
AU - Kan, Manstein
AU - Kaplan, Blanka
AU - Katelaris, Constance H.
AU - Kim, Harold
AU - Kelso, John M.
AU - Khan, David A.
AU - Lang, David
AU - Ledford, Dennis
AU - Levin, Michael
AU - Lieberman, Jay A.
AU - Loh, Richard
AU - Mack, Douglas P.
AU - Mazer, Bruce
AU - Mody, Ketan
AU - Mosnaim, Gisele
AU - Munblit, Daniel
AU - Mustafa, S. Shahzad
AU - Nanda, Anil
AU - Nathan, Richard
AU - Oppenheimer, John
AU - Otani, Iris M.
AU - Park, Miguel
AU - Pawankar, Ruby
AU - Perrett, Kirsten P.
AU - Peter, Jonny
AU - Phillips, Elizabeth J.
AU - Picard, Matthieu
AU - Pitlick, Mitchell
AU - Ramsey, Allison
AU - Rasmussen, Trine Holm
AU - Rathkopf, Melinda M.
AU - Reddy, Hari
AU - Robertson, Kara
AU - Rodriguez del Rio, Pablo
AU - Sample, Stephen
AU - Sheshadri, Ajay
AU - Sheik, Javed
AU - Sindher, Sayantani B.
AU - Spergel, Jonathan M.
AU - Stone, Cosby A.
AU - Stukus, David
AU - Tang, Mimi L.K.
AU - Tracy, James M.
AU - Turner, Paul J.
AU - Vander Leek, Timothy K.
AU - Wallace, Dana V.
AU - Wang, Julie
AU - Wasserman, Susan
AU - Weldon, David
AU - Wolfson, Anna R.
AU - Worm, Margitta
AU - Yacoub, Mona Rita
N1 - Publisher Copyright:
© 2023
PY - 2023
Y1 - 2023
N2 - This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against >15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.
AB - This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against >15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.
KW - allergic reactions
KW - anaphylaxis
KW - COVID-19
KW - mRNA COVID-19 vaccine
KW - polyethylene glycol
KW - polysorbate 80
KW - repeat allergic reactions
KW - SARS-CoV-2
KW - skin testing
KW - vaccination
UR - http://www.scopus.com/inward/record.url?scp=85165645010&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2023.05.019
DO - 10.1016/j.jaci.2023.05.019
M3 - Review
C2 - 37295474
AN - SCOPUS:85165645010
VL - 152
SP - 309
EP - 325
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
SN - 0091-6749
IS - 2
ER -
