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      Cómo proceder ante personal sanitario alérgico a la vacuna de ARNm contra el COVID-19 Translated title: How to deal with healthcare workers allergic to COVID-19 mrna vaccine

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          Abstract

          RESUMEN. Notifican al Servicio de Prevención y Riesgos Laborales el caso de una enfermera de 37 años que refiere rinorrea acuosa y prurito generalizado 10-15 minutos tras la administración de la primera dosis vacunal generada por BioNTech/Pfizer. Presenta: eritema facial, habón maxilar y constantes normales. ¿Cómo debe actuar el Servicio de Prevención y Riesgos Laborales (SPRL) frente a una trabajadora sanitaria que sufre una reacción alérgica a la vacuna de ARNm contra el COVID-19? Este caso clínico llama la atención sobre medidas preventivas habituales como la vacunación pero también sobre otras como la colaboración entre diferentes servicios hospitalarios, el manejo y diagnóstico por Alergología, seguimiento del Servicio de Prevención y notificación de efectos vacunales adversos por Farmacología Clínica. La coordinación entre estos servicios resulta fundamental para el correcto manejo de trabajadores afectados por reacciones adversas frente a la primera dosis vacunal contra el COVID-19 pudiendo quedar vacunados y protegidos.

          Translated abstract

          ABSTRACT The Occupational Risk and Prevention Service is notified the case of a 37-year-old nurse who reported watery rhinorrhea and generalized itching 10-15 minutes after first dose of the vaccine produced by BioNTech/Pfizer’s administration. She presents: facial erythema, maxillary wheal and normal constants. How should the Occupational Risk and Prevention Service should deal with a health worker who suffers an allergic reaction to the mRNA vaccine against COVID-19? This clinical case draws attention to common preventive measures such as vaccination, but also to others such as collaboration between different hospital services, management and diagnosis by Allergology, follow-up by the Occupational Risk and Prevention Service and notification of adverse vaccine effects by Clinical Pharmacology. Coordination between these services is essential for the correct management of workers affected by adverse reactions to the first vaccine dose against COVID-19, being the workers able to be vaccinated and protected.

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          Most cited references6

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          COVID-19 Vaccine-associated Anaphylaxis and Allergic Reactions: Consensus Statements of the KAAACI Urticaria/Angioedema/Anaphylaxis Working Group

          In the era of novel coronavirus epidemics, vaccines against coronavirus disease 2019 (COVID-19) have been recognized as the most effective public health interventions to control the pandemic. An adverse event following immunization (AEFI) is defined as any untoward occurrence following immunization, and the majority of AEFIs are caused by protective immune responses stimulated by vaccines. Most of the reported AEFIs are not serious, and many are not immunologically mediated or even reproducible on re-exposure. However, uncommon severe allergic adverse reactions, such as anaphylaxis or other allergic reactions, can occur after vaccinations. Confirmed allergic reactions to vaccines may be caused by residual non-human protein, preservatives, or stabilizers in the vaccine formulation (also known as excipients). There are 2 main potential allergenic/immunogenic excipients in COVID-19 vaccines, polyethylene glycol (PEG) and polysorbate 80. PEG, also known as macrogol, is an ingredient in various laxatives and injectable formulations, such as depot steroids. Polysorbate 80 is present in various medical products, creams, ointments, lotions, and medication tablets. Contraindications to the administration of COVID-19 vaccines include a previous history of severe allergic reactions to the first dose of COVID-19 vaccine or proven hypersensitivity to a vaccine component, such as PEG or polysorbate 80. Anaphylaxis or other allergic reactions following immunization can cause fear and loss of confidence in the safety of vaccines among the public. A better understanding of these events is thought to help alleviate concerns about the current COVID-19 vaccines and provide reassurance to the general population by analyzing the exact incidence of anaphylaxis and potential risk factors. COVID-19 vaccine-associated anaphylaxis could be prevented and managed by risk stratification based on our local and global experience.
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            Hypersensitivity Reactions to Vaccines: Current Evidence and Standards for SARS-CoV-2 Vaccines.

            The first reports of hypersensitivity reactions following the rollout of COVID-19 vaccination programs have raised public concern. Given the recent availability and novel mechanisms of COVID-19 vaccines, there is limited data on possible hypersensitivity reactions. Although it seems rare, the incidence of anaphylaxis for approved COVID-19 vaccines has been suggested as being higher when compared to previous vaccines. Adequate risk assessment, recognition, classification, and management of hypersensitivity reactions is crucial to ensure safe immunization and avoid misinformation and vaccine hesitancy. In this review, we present an overview of the types of hypersensitivity reactions that can potentially occur due to vaccination and the possible allergenic components of COVID-19 vaccines, as well as a suggestion for causality and risk assessment for the BNT162b2, mRNA-1273 and AZD1222 vaccines.
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              mRNA Vaccínes to Prevent COVID-19 Disease and Reported Allergíc Reactíons: Current Evídence and Suggested Approach

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                Author and article information

                Journal
                medtra
                Revista de la Asociación Española de Especialistas en Medicina del Trabajo
                Rev Asoc Esp Espec Med Trab
                Asociación Española de Especialistas en Medicina del Trabajo (Madrid, Madrid, Spain )
                1132-6255
                2022
                : 31
                : 3
                : 295-299
                Affiliations
                [2] Majadahonda orgnameHospital Universitario Puerta de Hierro Majadahonda orgdiv1Servicio de Prevención y Riesgos Laborales Spain
                [4] Majadahonda orgnameHospital Universitario Puerta de Hierro Majadahonda orgdiv1Servicio de Alergología Spain
                [3] Majadahonda orgnameHospital Universitario Puerta de Hierro Majadahonda orgdiv1Servicio de Prevención y Riesgos Laborales Spain
                [1] Majadahonda orgnameHospital Universitario Puerta de Hierro Majadahonda orgdiv1Servicio de Prevención y Riesgos Laborales Spain
                Article
                S1132-62552022000300007 S1132-6255(22)03100300007
                5c1f2ecc-e903-47fd-a2a9-fbae6a4938e3

                This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

                History
                : 04 September 2022
                : 09 August 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 6, Pages: 5
                Product

                SciELO Spain

                Categories
                Caso Clínico

                Medicina del Trabajo,Hipersensibilidad,Vacunas COVID-19,Occupational Medicine,Health Personnel,Hipersensitivity,COVID-19 Vaccines,Personal Sanitario

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