The usability of testing skin reaction applying skin prick tests with Comirnaty (Pfizer, USA) vaccine in detecting the risk of developing post-vaccination immediate hypersensitivity response (anaphylaxis) after administration of this vaccine.

Introduction: COVID-19 vaccines became a relevant element of prevention during COVID-19 pandemic. It is worth highlighting the importance of severe allergic post-vaccination reactions. Aim: To evaluate the usability of skin reaction tests using skin prick tests with Comirnaty (Pfizer, USA) vaccine in risk detection of the post-vaccine immediate hypersensitivity reaction (anaphylaxis) after administration of this vaccine [PvIHR(A)]. Material and methods: The analysis embraces 102 people, 85 women and 17 men with a history of immediate hypersensitivity (anaphylaxis) [IHR(A)]. Detailed medical history was collected and skin prick tests were made among participants. The positive and negative test results were illustrated in Figure 1. Results: As it stands in Table 1, considering all participants of the study, a positive result of the skin prick tests was obtained only in 2 cases, a negative result in 99 and 1 result was questionable. The two positive results were found in participants from a group with a previous PvIHR(A) in their past medical history and they decided not to get vaccinated. The one questionable result was of a person that had PvIHR(A) after administration of the first dose of Comirnaty vaccine (Pfizer, USA). This person decided to get vaccinated again and there was no PvIHR(A) observed. Conclusions: COVID-19 vaccination involves a low risk of anaphylaxis. Purposefulness of providing the skin prick tests using the mRNA vaccine is questionable, due to their low sensitivity and low specificity.

Protocol of safe vaccination against COVID-19 in patients with high risk of allergic reactions.

Background: Sars-CoV-2 infections are hazardous, especially to the elderly and patients with comorbidities. With no efficient treatment available, newly developed vaccines are the only way to change the course of the pandemic. However, reports of allergic reactions resulted in some patients and practicing physicians being concerned about the safety of vaccine administration, particularly in people with severe anaphylactic reactions to multiple or unknown factors in their medical history.This study aimed to develop an allergic work-up protocol based on skin prick tests (SPT), intradermal testing (IDT) and intramuscular provocations, and desensitisation which may contribute to diagnosis and management of anti-COVID-19 vaccine allergy. Methods: Two hundred and eighty-five patients were enrolled. Two hundred and five of them entered the study based on severe anaphylactic reaction to unknown or multiple factors in their medical history which disqualified them for standard treatment. Another 80 patients were enrolled after developing an allergic reaction to the first dose of one such vaccine. In all subjects, SPT and IDT were performed. Serum tryptase was assessed in 79 patients randomly chosen from the study group. Results: Two hundred and seventy-seven patients with negative tests were given a vaccine without complications. Seven patients had positive skin tests. In two cases, tests confirmed Comirnaty allergy, while the other five confirmed solely skin sensitisation with no exposure prior to the study. Six patients with positive tests received titrated challenge using desensitisation protocol with a reasonable tolerance. One patient did not consent to desensitisation and one patient resigned despite negative tests. Overall, 283 (99%) patients were vaccinated using this newly developed protocol. Patients with adverse reactions to the first dose of the vaccine before the study had a significantly lower basal serum tryptase concentration (p = 0.001). Conclusion: Skin tests with anti-COVID-19 vaccines are a useful tool in the vaccination protocol. This protocol enables safe immunisation of high-allergy-risk patients even in cases of positive skin tests.

Atypical clinical presentation of Churg-Strauss syndrome with rapidly progressive glomerulonephritis: case report.

The case of a 48-year-old man presented in this paper illustrates an atypical clinical course of Churg-Strauss syndrome with rapidly progressive glomerulonephritis with no signs of bronchial asthma.

Increased sensitization prevalence to common inhalant and food allergens in young adult Polish males.

Numerous epidemiological studies concluded recently have suggested that the prevalence of allergic diseases has increased, which mainly results from an increase in the prevalence of atopic diseases. The problem is even more difficult because the number of people sensitized, who are prone to fall ill, exceeds the number of people presently ill. The prevalence of sensitization to atopic allergens and its time dynamic is still unknown. The aim of the study was to determine the prevalence of atopic sensitization in the population of young Polish males and to compare these findings with those obtained 16 years before. The present study was performed on a group of 156 randomized healthy men, voluntary blood donors, aged 18-27 years. Having filled out a questionnaire, they underwent skin prick tests (SPTs) to common inhalant allergens. They also had a blood sample taken to have serum total IgE concentration and allergen-specific IgE (asIgE) determined to inhalant and food allergens. Positive SPT findings to at least one allergen were found in 50 (32%) subjects, and in equivocal 12 (8%). In 54 (35%) subjects asIgE to inhalant allergens was found, including 11 (7%) who had been tested for food allergens. The most common sensitizing allergen was house dust mite (20%), followed by grass/rye pollen (17%), while mould spore was the least common (4%). In town dwellers, positive SPTs were found in 41%, and were positive in 19% of people living in rural areas. While comparing the present findings with those of a similar study carried out in 1986, we found that in the last 16 years there had been a 52% increase in the prevalence of asIgE to atopic allergens. This means that the percentage of sensitized people can be estimated to have increased at a rate of approximately 3.25%/year.

[Increased sensitization prevalence to common inhalant and food allergens in young Polish males]. / Narastanie czestosci uczulen na pospolite alergeny wziewne i pokarmowe u mlodych mezczyzn w Polsce.

UNLABELLED: Numerous epidemiological studies concluded recently have suggested that the prevalence of allergic diseases has increased, which mainly results from an increase in the prevalence of atopic diseases. The prevalence of sensitization to atopic allergens and its time dynamicity is unknown nowadays. THE AIM OF THE STUDY: has been to find the prevalence of atopic sensitization in the population of young Polish males and to compare these findings with those obtained 16 years before. MATERIAL AND METHODS: The present study was performed on a group of 156 randomized healthy men, voluntary blood donors, aged 18-27 years. Having filled out a questionnaire, they had a blood sample taken to have serum total IgE concentration and allergen-specific IgE (asIgE) determined to inhalant and food allergens. RESULTS: In 54 (35%) subjects asIgE to inhalant allergens was found, including 11 (7%) who had been tested for food allergens. While comparing the present findings with those of a similar study carried out in 1986, we found that in the last 16 years there had been a 52% increase in the prevalence of asIgE to atopic allergens. This means that the percentage of sensitized people can be estimated to have increased at a rate of approximately 3.25%/year. CONCLUSION: At present, 27% of young men in Poland whose history finding for an allergic disease is negative, are diagnosed with allergy to atopic allergens.

[Hypersensitivity to poppy seeds]. / Nadwrazliwosc na nasiona maku.

UNLABELLED: Hypersensitivity to poppy seeds is rare and it may develop due to immune (allergy) and non-immune reactions of fulminant course. Two cases of hypersensitivity to poppy seeds are presented: in a 21-year-old woman and 32-year-old man in whom life-threatening symptoms and signs of anaphylaxis (SSA) developed after consumption of poppy seeds in various situations, e.g in the street after consumption of a roll with poppy seeds or a cake prepared on a moulding board on which poppy seeds were previously squeezed. In the case of the woman, history data pointed to familial and individual occurrence of atopy, and positive cutaneous prick tests with allergens of grass/crop and weed pollen and tree pollen (birch, hazel) as well as hazelnuts. In the man the anamnesis and skin prick tests were negative. Serum concentrations of allergen-specific IgE (asIgE) for poppy seeds and, additionally, for food allergens, which, according to patients, also could be the cause of SSA: celery, pineapple, mixture of spices and nuts were determined. In the woman elevated concentrations of asIgE for celery (class 2) and nut mixture (class 2) with negative result for poppy were noted, whereas in the man elevated concentrations of asIgE for poppy (class 2) and nut mixture (class 2) were found. Additionally, in the male patient skin tests were performed with topical anesthetics and narcotic analgesics derived from poppy (morphine, codeine) finding positive reactions to xylocaine and codeine. CONCLUSIONS: The two presented cases illustrate that hypersensitivity to poppy seeds may occur in IgE-dependent or non-immune mechanisms and the presence of atopy is not decisive of its mechanism.