Introduction
Vaccines are the most effective drugs in public health, since they control and prevent the spread of infectious diseases, such as the Covid-19 pandemic. COVID-19 vaccines contain excipients such as polysorbate and polyethylene glycol. The risk of vaccination can be stratified into low, medium and high risk.
Case Description
Three patients with a history of allergies attended consult for an evaluation of COVID-19 vaccination. The first patient had a history of penicillin allergy, classified as a lower risk, recommending observation after vaccination for 15 minutes. The second patient with a history of atopic dermatitis, asthma, allergic rhinitis, and anaphylaxis to ceftriaxone, without previous contact with polysorbates and polyethylene glycol, was categorized as a medium risk. Allergy skin test for the COVID-19 vaccine excipients had negative results, it was recommended to apply any type of COVID-19 vaccine with a 30-minute observation. The third patient with a history of polyethylene glycol allergic reaction was considered high risk, so skin tests were performed for components of the SARS-Cov-2 vaccine, resulting positive in the skin prick testing for polyethylene glycol 1:1, intradermal tests: positive methylprednisolone acetate (1: 100) and positive methylprednisolone succinate (1:100). At the end of the skin tests, she presented cough and nasal itching improving with cetirizine, after resolving she presented urticaria. Applying SARS-Cov2 vaccines containing polyethylene glycol and polysorbate is not recommended in this patient.
Discussion
Patients with a history of allergy to PEG or polysorbate need a prior assessment by the allergist and are qualified to educate and guide patients about covid-19 vaccination.