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. 2021 Oct 24;128(2):161–168.e1. doi: 10.1016/j.anai.2021.10.019

Table 2.

Characteristics of Patients Who Experienced Anaphylaxis

Group # Age(y) Past pertinent allergic history Symptoms ofanaphylaxis Confirmed anaphylaxis
 COVID-19 vaccine PEG prick skin test PEG challenge result Tryptase: reaction/basal (μg/L) Notes
Brighton criteria NIAAD criteria
1 27 Latex allergy, lip fillers, silicone breast implants Generalized hives, SOB, throat and chest tightness, eyelid swelling Level 2 Yes Pfizer Positive at 1:1000 and 1:100 ND ND/4.2
  • -

    Protracted symptoms (more than a week)

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    Positive skin test to triamcinolone acetate (polysorbate 80) and hepatitis A (polysorbate 20)
2 38 Asthma, AR, FA SOB, chest tightness, cough, tracheal pruritus, dizziness No Yes Pfizer Negative Passed ND/ND
  • -

    On dupilumab for asthma

  • -

    Received and tolerated second dosage in high-risk clinic
3 50 Asthma, FA Generalized pruritus, SOB, tongue and throat swelling, difficulty swallowing, No Yes Pfizer Negative Passed ND/7
  • -

    Developed COVID-19 while awaiting second dosage

- Received and tolerated second dosage in high-risk clinic
4 40 Asthma, latex allergy, drug allergy Generalized hives, SOB, chest tightness, tachycardia Level 2 Yes Moderna Negative Passed ND/4
  • -

    Protracted symptoms (5 d)

  • -

    Received second dosage in high-risk clinic; 20 min later developed cough (no other symptoms); postsecond dosage tryptase-3.8
5 46 Asthma, AR, OAS Generalized hives, chest tightness, abdominal pain, diarrhea, rhinorrhea, facial and eyelid swelling Level 2 Yes Moderna Negative Passed ND/ND
  • -

    Received and tolerated second dosage in high-risk clinic
6 32 Asthma, AR, chronic urticaria, FA Generalized itching, hives, SOB No Yes Moderna ND ND ND/ND
  • -

    Patient declined skin test

  • -

    Received and tolerated second dosage in high-risk clinic
7 34 IVC Generalized pruritus, urticaria, nausea, felt very lightheaded and weak Level 2 Yes Moderna ND ND 6/ND
  • -

    Tolerated first dosage; reaction after the second dosage
8 48 IVC, FA Generalized pruritus, lip swelling, SOB, chest and throat tightness, hoarseness No Yes J & J ND ND ND/ND
  • -

    1-dose J & J vaccination completed

Abbreviations: AR, allergic rhinitis; FA, food allergy; J & J, Johnson & Johnson COVID 19 vaccine; IVC, intravenous contrast; ND, not done; NIAID, National Institute of Allergy and Infectious Diseases; OAS, oral allergy syndrome; PEG, polyethylene glycol 3350; SOB, shortness of breathing.