Table 3.

Patients Referred for Evaluation After Positive Excipient Testing.

Patient	Comorbidities	Initial reaction	First Positive testing	Second testing	COVID-19 vaccine
1	Drug allergy Environmental allergy Urticaria Anxiety	Miralax prep complicated by vomiting and abdominal pain	(+) Miralax IDT 1:100 (+) Refresh eyedrops IDT 1:10	Declined	Declined
2	Drug allergy Food allergy Environmental allergy Asthma Anaphylaxis Atopic dermatitis Anxiety	Documented reactions to 52 allergens in EMR	Reportedly (+) PEG testing	(−) Miralax SPT 1:1 (170 mg/mL) (−) Methylprednisolone acetate IDT 1:10 (4 mg/mL)	Received Pfizer
3	Drug allergy Anaphylaxis Anxiety	Syncope following methylprednisolone acetate, lidocaine, and bupivacaine injection	(+) Miralax SPT 1:100, 1:10, 1:1 (+) Methylprednisolone acetate SPT 1:10, 1:1	(−) Miralax SPT 1:1 (170 mg/mL) (−) Methylprednisolone acetate IDT 1:10 (4 mg/mL) Negative local anesthetic testing Tolerated sequential challenges with methylprednisolone acetate 16 mg intramuscularly, lidocaine 10 mg subcutaneously, bupivacaine 7.5 mg subcutaneously	Declined

Abbreviations: COVID-19, coronavirus disease 2019; EMR, electronic medical record; PEG, polyethylene glycol; SPT, skin prick test.