Table II.
Patients with positive skin testing results
| Timing of reaction | Age, y | Sex | History | Dose 1 Reaction | Skin test results | Dose 2 outcome | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Allergies or allergic reaction | History of anaphylaxis | Vaccine | Onset of symptoms (h) | Signs and symptoms | Treatment | Treatment setting/disposition | Ring and Messmer grade | |||||
| Immediate (<4-h) reaction | 46 | F | Hymenoptera venom | Yes (Hymenoptera venom) | Moderna | 0.16 | Dizziness, nausea, difficulty swallowing, swelling of eyes and tongue, hives | Diphenhydramine | Home | 1 | Methylprednisolone acetate IDT 4 mg/mL (10 ×14 mm) Refresh IDT 1:10 (9 × 21 mm) |
Tolerated Janssen |
| 40 | F | None | No | Pfizer | 0.16 | Flushing, tachycardia, tongue itching, swelling of fingers, vomiting, diarrhea | Diphenhydramine, intravenous fluids, intramuscular epinephrine, methylprednisolone succinate, ondansetron. | Emergency department | 1 | MiraLAX skin prick test 1:100 (6 × 25 mm) | Recommended not to receive dose 2 | |
| 26 | F | Ginger | No | Moderna | 0.25 | Wheezing | No treatment needed | Home | 2 | Methylprednisolone acetate IDT 0.4 mg/mL (16 × 44 mm) | Tolerated Moderna | |
| 56 | F | Omalizumab, cefaclor, sulfonamide antibiotics, tree nuts, shellfish, latex | No | Moderna | 0.3 | Stinging in eyes, tingling of tongue and lips, mild itching | Cetirizine, famotidine | Home | 0 | Refresh IDT 1:100 (8 × 11 mm) | Pretreated with cetirizine 10 mg and prednisone 20 mg. At 5 min after receiving dose 2 (Moderna), patient experienced pruritus. Treated with cetirizine 20 mg | |
| 49 | F | None | No | Moderna | 1 | Flushing, hives, itching | Fexofenadine | Home | 1 | Refresh IDT (5 × 15 mm) | Tolerated Moderna | |
| 26 | F | Environmental | No | Moderna | 3 | Wheezing, chest tightness, dry cough | Albuterol | Home | 2 | Methylprednisolone acetate IDT 0.4 mg/mL (10 × 20 mm) Refresh IDT 1:100 (8 × 18 mm) |
Tolerated Moderna | |
| 54 | M | None | No | Moderna | 3 | Itching, lip swelling | No treatment needed | Home | 1 | Refresh IDT 1:100 (9 × 21 mm) | 4-6 h after receiving dose 2 (Moderna), patient experienced lip swelling, which self-resolved | |
| 42 | F | Penicillin, hymenoptera venom | No | Moderna | 4 | Hives | No treatment needed | Home | 1 | Refresh IDT 1:100 (6 × 24 mm) | Tolerated Moderna | |
| Delayed (>4-h) reaction | 28 | F | None | No | Moderna | 10-12 | Itching, hives | No treatment needed | Home | 1 | Refresh IDT 1:100 (4 × 12 mm) | Awaiting vaccination |
| 29 | F | Penicillin | No | Moderna | 12-16 | Palpitations, diarrhea, delayed hives | Loperamide | Home | 0 | Refresh IDT 1:100 (7 × 18 mm) | Tolerated Moderna | |
| 33 | F | None | No | Moderna | 12-24 | Diffuse hives | Diphenhydramine | Home | 1 | Refresh IDT 1:100 (10 × 40 mm) | Tolerated Moderna | |
| 24 | F | Environmental | No | Moderna | 18-24 | Wheezing, chest tightness, hives, itching | Diphenhydramine, topical hydrocortisone | Home | 1 | Methylprednisolone acetate IDT 0.4 mg/mL (9 × 22 mm) Refresh IDT 1:100 (13 × 32 mm) |
Tolerated Moderna | |
| 49 | F | None | No | Pfizer | 20 | Tongue swelling, sneezing, nasal congestion, itchy eyes, chest congestion, cough, swelling of fingers | Diphenhydramine, Acetaminophen, pseudoephedrine | Home | 1 | Refresh IDT 1:100 (12 × 20 mm) | Patient preference not to receive dose 2 | |
| 19 | F | Peanut, tree nuts | Yes (peanut, tree nuts) | Moderna | 48 | Hives, throat closing | Diphenhydramine | Home | 1 | Refresh IDT 1:10 (11 × 17 mm) | Pretreated with cetirizine 10 mg and prednisone 20 mg. At 20 min after receiving dose 2 (Moderna), patient experienced dizziness, numbness in legs and fingers, and warm feeling in throat. Treated with cetirizine 10 mg | |
IDT, intradermal test.
Clinical characteristics, details of the first dose reaction, skin testing result, and details of the second dose for patients with positive skin testing results are provided.