Skip to main content
. 2021 Dec 4;77(7):2200–2210. doi: 10.1111/all.15183

TABLE 4.

Characteristics and vaccination management of new patients with confirmed PEG allergy

Age Sex Elicitor Reaction Skin test results Interpretation Management
73 M Colon cleansing solution (=PEG 3350) 30 min after third or fourth cup of PEG‐preparation palmar erythema, generalized itch, dizziness

SPT: Pos. to PEG 3350, 4000

Neg. to: PEG 2000, PEG 6000, PS 80

IDT: Pos. to PEG 3350, 4000, 6000. After IDT generalized itch and palmar erythema

Neg. to PEG 2000 and PS 80

BAT: Pos. to PEG 4000, 6000, Comirnaty®, Moderna

Neg. to PEG 2000, 3350, PS80, Vaxzevria®

No OCT was performed because of systemic reaction after skin test

High risk for reaction to mRNA‐containing COVID‐19 vaccines. Low risk for reaction to Vaxzevria® because of negative skin tests and BAT and thus unlikely cross‐reactivity to polysorbate 80

mRNA vaccination avoidance

DNA vaccination against COVID‐19 indicated.

Tolerated first shot of fractionated Vaxzevria® (0.1 mL; 0.4 mL) under inpatient emergency preparedness, without premedication

59 F

(1) Colon cleansing solution Movicol Orange® (=PEG 3350)

(2) Corticosteroid +local anesthetic injection (lidocaine/triamcinolone, + PEG)

(1) 1 h after intake of Moviprep Orange® swelling of hands, generalized urticaria, nausea, vomiting, diarrhea

(2) Few min after injection of Lidocaine/Triamcinolon‐ preparation generalized urticaria, dyspnea, dizziness

SPT: Pos. to PEG 4000, 6000

Neg. to PEG 2000, PS80, Moviprep Orange

After SPT nausea and dizziness

BAT: Pos. to Moderna‐vaccine,

Neg. to PEG 2000, 3350, 4000, 6000, PS80, Comirnaty®, Vaxzevria®

No OCT was performed because of systemic reaction after skin test

High risk for reaction to mRNA‐containing COVID‐19 vaccines. Low risk for reaction to Vaxzevria® because of negative skin tests and BAT and thus unlikely cross‐reactivity to polysorbate 80

Subcutaneous challenge to triamcinolone, articaine negative.

mRNA vaccination avoidance. DNA vaccination against COVID‐19 recommended as in other patients but not yet done

28 F

(1) Cold medication sirup (PEG 6000)

(2) Local anesthetic injection (mepivacaine, contains PEG)

(3) Colon cleansing solution (Movicol®, is PEG 3350)

(4) Iodide solution (cont. PEG)

(1) Few min after intake throat swelling, dyspnea, generalized pruritus

(2) Few min after injection urticaria, dyspnea, drop in blood pressure, runny nose

(3) 5 min after intake urticaria, dyspnea, drop in blood pressure.

(4) One hour after application (foot) urticaria

2013: SPT: Pos. to: PEG 4000

After SPT generalized urticaria

2021: SPT Neg. to: PEG 2000, 4000, 6000, PS 80, Comirnaty®

IDT Pos. to: Comirnaty®. Generalized urticaria 1 h after IDT

Neg. to: PEG 2000, 4000, 6000, PS 80, Vaxzevria®

BAT: Neg. to PEG 2000, 4000, 6000, PS 80, Vaxzevria®

Pos. to: Comirnaty®, Moderna‐vaccine

No OCT was performed because of systemic reaction after skin test

High risk for reaction to mRNA‐containing COVID‐19 vaccines. Low risk for reaction to Vaxzevria® because of negative skin tests and BAT and thus unlikely cross‐reactivity to polysorbate 80

mRNA vaccination avoidance

DNA vaccination against COVID‐19 indicated.

Tolerated first shot of fractionated Vaxzevria® (0.1 mL; 0.4 mL) under inpatient emergency preparedness, without premedication

Abbreviations: BAT, basophil activation test; IDT, intradermal test; mi, minutes; Neg, negative; OCT, oral challenge test; PEG, polyethylene glycol; Pos, positive; PS80, polysorbate 80; SPT, skin prick test.