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Paul P, Janjua E, AlSubaie M, Ramadorai V, Mushannen B, Vattoth AL, Khan W, Bshesh K, Nauman A, Mohammed I, Bouhali I, Khalid M, Zakaria D. Anaphylaxis and Related Events Post-COVID-19 Vaccination: A Systematic Review. J Clin Pharmacol 2022; 62:1335-1349. [PMID: 35794852 PMCID: PMC9349886 DOI: 10.1002/jcph.2120] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19), induced by the SARS CoV-2 virus, is responsible for a global pandemic following widespread transmission and death. Several vaccines have been developed to counter this public health crisis using both novel and conventional methods. Following approval based on promising efficacy and safety data, the AstraZeneca, Janssen, Moderna, Pfizer/BioNTech, and SinoVac vaccines have been administered globally among different populations with various reported side effects. Reports of life-threatening anaphylaxis following administration were of particular concern for both healthcare providers and the public. A systematic literature search using PubMed, Embase, Scopus, Web of Science, Science Direct, MedRxiv, and Lens.org databases identified relevant studies reporting anaphylaxis following vaccine administration. This systematic review includes 41 studies reporting anaphylaxis out of 19908 studies that were retrieved for screening. A total of 7942 cases, including 43 deaths, were reported across 14 countries. Most cases occurred following the administration of the first dose. Importantly, the benefits of vaccination far outweigh the risks of anaphylaxis. Subsequently, as populations continue to get vaccinated, it is important for healthcare providers to be able to recognize individuals at risk of developing anaphylaxis. Furthermore, they must be familiar with both the clinical hallmarks and treatment of anaphylactic reactions to minimize long term sequalae and prevent death in vaccinated individuals. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Pradipta Paul
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Emmad Janjua
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Mai AlSubaie
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Vinutha Ramadorai
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Beshr Mushannen
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | | | - Wafa Khan
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Khalifa Bshesh
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Areej Nauman
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Ibrahim Mohammed
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar.,Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA
| | - Imane Bouhali
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Mohammed Khalid
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Dalia Zakaria
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
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Chirumbolo S. Vaccination hesitancy and the "myth" on mRNA-based vaccines in Italy in the COVID-19 era: Does urgency meet major safety criteria? J Med Virol 2021; 93:4049-4053. [PMID: 33666240 PMCID: PMC8014645 DOI: 10.1002/jmv.26922] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 12/16/2022]
Abstract
Coronavirus disease 2019 (COVID-19) vaccination campaign in Italy has started with a huge perplexity about vaccine efficacy, vaccine-borne adverse effects and vaccine clinical trial studies. In this commentary I tried to elucidate these issues, which represent a fundamental topic to be thoroughly addressed in COVID-19 pandemic.
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Affiliation(s)
- Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
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3
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Lefebvre M, Vignier N, Pitard B, Botelho-Nevers E, Wyplosz B, Cohen R, Epaulard O. COVID-19 vaccines: Frequently asked questions and updated answers. Infect Dis Now 2021; 51:319-333. [PMID: 33681861 PMCID: PMC7910656 DOI: 10.1016/j.idnow.2021.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/23/2021] [Indexed: 12/29/2022]
Abstract
At the end of December 2019, China notified the World Health Organization about a viral pneumonia epidemic soon to be named COVID-19, of which the infectious agent, SARS-CoV-2, was rapidly identified. Less than one year later, published phase 3 clinical trials underlined the effectiveness of vaccines utilizing hitherto unusual technology consisting in injection of the messenger RNA (m-RNA) of a viral protein. In the meantime, numerous clinical trials had failed to identify a maximally effective antiviral treatment, and mass vaccination came to be considered as the strategy most likely to put an end to the pandemic. The objective of this text is to address and hopefully answer the questions being put forward by healthcare professionals on the different anti-SARS-CoV-2 vaccines as regards their development, their modes of action, their effectiveness, their limits, and their utilization in different situations; we are proposing a report on both today's state of knowledge, and the 14 February 2021 recommendations of the French health authorities.
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Affiliation(s)
- M Lefebvre
- Service des maladies infectieuses et tropicales, centre de prévention des maladies infectieuses et transmissibles, centre hospitalo-universitaire Hôtel-Dieu, Inserm CIC1413, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - N Vignier
- Centre d'investigation clinique Antilles Guyane, CIC Inserm 1424, DRISP, centre hospitalier Andrée-Rosemon, Cayenne, French Guyana; Inserm, Sorbonne université, institut Pierre-Louis d'épidémiologie et de santé publique, IPLESP, 75012 Paris, France; Department of infectious disease, Groupe hospitalier Sud Ile-de-France, 77000 Melun, France
| | - B Pitard
- Université de Nantes, CNRS ERL6001, Inserm 1232, CRCINA, Nantes, France
| | - E Botelho-Nevers
- Service d'infectiologie, centre hospitalo-universitaire de Saint-Étienne, CIC 1408 Inserm, 42055 Saint-Étienne, France; Centre international de recherche en infectiologie (CIRI), Team GIMAP, université Lyon, université Jean-Monnet, université Claude-Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, 42023 Saint-Étienne, France
| | - B Wyplosz
- Service des maladies infectieuses et tropicales, Assistance publique-hôpitaux de Paris, Centre hospitalier universitaire Bicêtre, Paris, France
| | - R Cohen
- InfoVac, centre hospitalier intercommunal de Créteil, service de pédiatrie, 40, avenue de Verdun, 94000 Créteil, France
| | - O Epaulard
- Service des maladies infectieuses, centre hospitalo-universitaire Grenoble Alpes, Grenoble, France, CIC 1406 Inserm, Grenoble, France
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4
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Anaphylaktische Reaktionen nach Tollwutimpfungen mit Sensibilisierung gegenüber Gelatine. ALLERGO JOURNAL 2019. [DOI: 10.1007/s15007-019-1858-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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5
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Case series of anaphylactic reactions after rabies vaccinations with gelatin sensitization. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s40629-019-0094-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Aps LRDMM, Piantola MAF, Pereira SA, de Castro JT, Santos FADO, Ferreira LCDS. Adverse events of vaccines and the consequences of non-vaccination: a critical review. Rev Saude Publica 2018; 52:40. [PMID: 29668817 PMCID: PMC5933943 DOI: 10.11606/s1518-8787.2018052000384] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/28/2017] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To analyze the risks related to vaccines and the impacts of non-vaccination on the world population. METHODS This is a narrative review that has considered information present in the bibliographic databases NCBI-PubMed, Medline, Lilacs, and Scientific Electronic Library Online (SciELO), between November 2015 and November 2016. For the analysis of outbreaks caused by non-vaccination, we considered the work published between 2010 and 2016. RESULTS We have described the main components of the vaccines offered by the Brazilian public health system and the adverse events associated with these elements. Except for local inflammatory reactions and rare events, such as exacerbation of autoimmune diseases and allergies, no causal relationship has been demonstrated between the administration of vaccines and autism, Alzheimer's disease, or narcolepsy. On the other hand, the lack of information and the dissemination of non-scientific information have contributed to the reemergence of infectious diseases in several countries in the world and they jeopardize global plans for the eradication of these diseases. CONCLUSIONS The population should be well informed about the benefits of vaccination and health professionals should assume the role of disseminating truthful information with scientific support on the subject, as an ethical and professional commitment to society.
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Affiliation(s)
| | | | - Sara Araujo Pereira
- Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Microbiologia. São Paulo, SP, Brasil
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Ono A, Ito S, Sakagami S, Asada H, Saito M, Quan YS, Kamiyama F, Hirobe S, Okada N. Development of Novel Faster-Dissolving Microneedle Patches for Transcutaneous Vaccine Delivery. Pharmaceutics 2017; 9:pharmaceutics9030027. [PMID: 28771172 PMCID: PMC5620568 DOI: 10.3390/pharmaceutics9030027] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 11/30/2022] Open
Abstract
Microneedle (MN) patches are promising for transcutaneous vaccination because they enable vaccine antigens to physically penetrate the stratum corneum via low-invasive skin puncturing, and to be effectively delivered to antigen-presenting cells in the skin. In second-generation MN patches, the dissolving MNs release the loaded vaccine antigen into the skin. To shorten skin application time for clinical practice, this study aims to develop novel faster-dissolving MNs. We designed two types of MNs made from a single thickening agent, carboxymethylcellulose (CMC) or hyaluronan (HN). Both CMC-MN and HN-MN completely dissolved in rat skin after a 5-min application. In pre-clinical studies, both MNs could demonstrably increase antigen-specific IgG levels after vaccination and prolong antigen deposition compared with conventional injections, and deliver antigens into resected human dermal tissue. In clinical research, we demonstrated that both MNs could reliably and safely puncture human skin without any significant skin irritation from transepidermal water loss measurements and ICDRG (International Contact Dermatitis Research Group) evaluation results.
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Affiliation(s)
- Akihiko Ono
- Project for Vaccine and Immune Regulation, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
- Laboratory of Biotechnology and Therapeutics, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Sayami Ito
- Project for Vaccine and Immune Regulation, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
- Laboratory of Biotechnology and Therapeutics, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Shun Sakagami
- Project for Vaccine and Immune Regulation, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
- Laboratory of Biotechnology and Therapeutics, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Hideo Asada
- Department of Dermatology, Nara Medical University, 840 Shin-cho, Kashihara, Nara 634-8522, Japan.
| | - Mio Saito
- CosMED Pharmaceutical Co. Ltd., 32 Higashikujokawanishi-cho, Minami-ku, Kyoto 601-8014, Japan.
| | - Ying-Shu Quan
- CosMED Pharmaceutical Co. Ltd., 32 Higashikujokawanishi-cho, Minami-ku, Kyoto 601-8014, Japan.
| | - Fumio Kamiyama
- CosMED Pharmaceutical Co. Ltd., 32 Higashikujokawanishi-cho, Minami-ku, Kyoto 601-8014, Japan.
| | - Sachiko Hirobe
- Laboratory of Biotechnology and Therapeutics, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Naoki Okada
- Project for Vaccine and Immune Regulation, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
- Laboratory of Biotechnology and Therapeutics, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
- Laboratory of Vaccine and Immune Regulation, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Abstract
Aim To review the available literature pertaining to fatalities following vaccine administration and, in particular, cases of vaccine-related fatal anaphylaxis. Method The MEDLINE database was systematically searched up to March 2016 to identify all relevant articles pertaining to fatal cases of anaphylaxis following vaccine administration. Results Six papers pertaining to fatal anaphylaxis following vaccination were found relevant. Mast cell tryptase and total IgE concentration was assessed exclusively in one case. Laryngeal edema was not detected in any of these cases, whereas eosinophil or mast cell infiltration was observed in lymphoid organs. In one case, immunohistochemical investigations using anti-tryptase antibodies allowed pulmonary mast cells and degranulating mast cells with tryptase-positive material outside to be identified. Conclusion In any suspected IgE-mediated fatal anaphylactic cases, biochemical investigations should be systematically performed for forensic purposes. Splenic tissue should be routinely sampled for immunohistochemical investigations in all suspected anaphylaxis-related deaths and mast cell/eosinophil infiltrations should be systematically sought out in the spleen, myocardium, and coronary artery wall. The hypothesis of fatal anaphylaxis following vaccination should be formulated exclusively when circumstantial data, available medical records, laboratory investigations, and autopsy or histology findings converge in a consistent pattern. The reasonable exclusion of alternative causes of death after all postmortem investigations is also imperative in order to establish or rule out a cause-and-effect relationship between vaccine administration and any presumptive temporarily-related death.
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Affiliation(s)
- Cristian Palmiere
- Cristian Palmiere, CURML, Chemin de la Vulliette 4, 1000 Lausanne 25, Switzerland,
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9
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Anaphylaxis and Anaphylactoid Reactions. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Knowledge, Perceptions, and Practice of Nurses on Surveillance of Adverse Events following Childhood Immunization in Nairobi, Kenya. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3745298. [PMID: 28078288 PMCID: PMC5204106 DOI: 10.1155/2016/3745298] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/16/2016] [Indexed: 11/17/2022]
Abstract
Background. Although vaccines currently approved for routine childhood immunization are safe and effective, frequent adverse events following immunization often cause illnesses and sometimes loss of public trust in immunization programs. Nurses are essential in this surveillance system. Objective. To determine nurses' knowledge, perception, and practice towards surveillance of postimmunization adverse events within Nairobi County health centers, Kenya. Methods. This is a cross-sectional survey involving nurses (n = 274). Data were collected using self-administered questionnaires. Data analysis was performed using SPSS version 20. Differences in proportions of categorical variables were compared between groups using chi-square tests. Binary logistic regression model was used to compute independent predictors of outcome. Results. 29.2%, 32.1%, and 45.3% of the respondents had good knowledge, good practices, and good perceptions on AEFI surveillance, respectively. Respondents with diploma or degree nursing training level were 1.8 times and 2.5 times more likely to have good knowledge and good perception in AEFI surveillance, respectively. Nurses with previous AEFI training were 9.7 times and 1.8 times more likely to have good AEFI knowledge and practices, respectively. Conclusion. There is a need to train and mentor nurses on AEFI surveillance. Findings of this study will be valuable in informing policy review on childhood immunization programs.
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11
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Patwardhan M, Eckert LO, Spiegel H, Pourmalek F, Cutland C, Kochhar S, Gonik B. Maternal death: Case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2016; 34:6077-6083. [PMID: 27426627 PMCID: PMC5139803 DOI: 10.1016/j.vaccine.2016.03.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 03/15/2016] [Indexed: 11/02/2022]
Affiliation(s)
- M Patwardhan
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
| | - L O Eckert
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - H Spiegel
- Henry Jackson Foundation, Bethesda, MD, USA
| | - F Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - C Cutland
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, Department of Science and Technology National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - B Gonik
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
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Fox AT, Swan KE, Perkin M, du Toit G, Lack G. The changing pattern of measles, mumps and rubella vaccine uptake in egg-allergic children. Clin Exp Allergy 2015; 44:999-1002. [PMID: 24750550 DOI: 10.1111/cea.12325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2014] [Indexed: 11/27/2022]
Affiliation(s)
- A T Fox
- Division of Asthma, Allergy and Lung Biology, King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, and Paediatric Allergy Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
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13
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Anaphylaxis and Anaphylactoid Reactions. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_39-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McCallum AD, Duncan CJA, MacDonald R, Jones ME. A decade of vaccinating allergic travellers: a clinical audit. Travel Med Infect Dis 2011; 9:231-7. [PMID: 21999910 DOI: 10.1016/j.tmaid.2011.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 08/20/2011] [Accepted: 08/24/2011] [Indexed: 11/29/2022]
Abstract
Adverse reactions following vaccination are rare but may include potentially fatal anaphylaxis. This audit is a retrospective review of 38 patients with a history, or potential risk, of 'vaccine allergy' referred to an Infectious Diseases Unit for vaccination over a 10 year period. A total of 59 patient encounters were recorded, of which 89.8% were uneventful. Of the 6 adverse events, 3 patients had a local reaction, 1 patient developed urticaria and 1 patient had a vasovagal episode. Only 1 patient developed anaphylaxis secondary to vaccination, and she had no prior history of vaccine allergy. Of these patients 17 had a history suggesting the need for immunological investigation but only 7 had laboratory evidence of allergy. The differential diagnosis of anaphylaxis includes vasovagal reactions and non-specific mediator release and immunological work-up of such events can help avoid such patients being incorrectly labelled as allergic. The vast majority of immunisations are uncomplicated and patients with a history of allergic reactions to vaccination may be vaccinated safely in a controlled setting. Unduly conservative guidelines risk withholding vaccines providing protection against dangerous pathogens but which can be safely administered.
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Affiliation(s)
- Andrew D McCallum
- Regional Infectious Diseases Unit, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, United Kingdom.
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Tavares F, Delaigle A, Slavin D, Bauchau V, Fries L, Seifert H. Anaphylaxis following H1N1 pandemic vaccines: Safety data in perspective. Vaccine 2011; 29:6402-7. [DOI: 10.1016/j.vaccine.2011.04.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 04/05/2011] [Accepted: 04/08/2011] [Indexed: 12/16/2022]
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Corbett HJ, Fernando GJP, Chen X, Frazer IH, Kendall MAF. Skin vaccination against cervical cancer associated human papillomavirus with a novel micro-projection array in a mouse model. PLoS One 2010; 5:e13460. [PMID: 20976136 PMCID: PMC2956639 DOI: 10.1371/journal.pone.0013460] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 08/16/2010] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Better delivery systems are needed for routinely used vaccines, to improve vaccine uptake. Many vaccines contain alum or alum based adjuvants. Here we investigate a novel dry-coated densely-packed micro-projection array skin patch (Nanopatch™) as an alternate delivery system to intramuscular injection for delivering an alum adjuvanted human papillomavirus (HPV) vaccine (Gardasil®) commonly used as a prophylactic vaccine against cervical cancer. METHODOLOGY/PRINCIPAL FINDINGS Micro-projection arrays dry-coated with vaccine material (Gardasil®) delivered to C57BL/6 mouse ear skin released vaccine within 5 minutes. To assess vaccine immunogenicity, doses of corresponding to HPV-16 component of the vaccine between 0.43 ± 0.084 ng and 300 ± 120 ng (mean ± SD) were administered to mice at day 0 and day 14. A dose of 55 ± 6.0 ng delivered intracutaneously by micro-projection array was sufficient to produce a maximal virus neutralizing serum antibody response at day 28 post vaccination. Neutralizing antibody titres were sustained out to 16 weeks post vaccination, and, for comparable doses of vaccine, somewhat higher titres were observed with intracutaneous patch delivery than with intramuscular delivery with the needle and syringe at this time point. CONCLUSIONS/SIGNIFICANCE Use of dry micro-projection arrays (Nanopatch™) has the potential to overcome the need for a vaccine cold chain for common vaccines currently delivered by needle and syringe, and to reduce risk of needle-stick injury and vaccine avoidance due to the fear of the needle especially among children.
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Affiliation(s)
- Holly J. Corbett
- Delivery of Drugs and Genes Group (D2G2), Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Queensland, Australia
| | - Germain J. P. Fernando
- Delivery of Drugs and Genes Group (D2G2), Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Queensland, Australia
| | - Xianfeng Chen
- Delivery of Drugs and Genes Group (D2G2), Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Queensland, Australia
| | - Ian H. Frazer
- Diamantina Institute, Princess Alexandra Hospital, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Mark A. F. Kendall
- Delivery of Drugs and Genes Group (D2G2), Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Queensland, Australia
- Diamantina Institute, Princess Alexandra Hospital, The University of Queensland, Woolloongabba, Queensland, Australia
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Raphael AP, Prow TW, Crichton ML, Chen X, Fernando GJP, Kendall MAF. Targeted, needle-free vaccinations in skin using multilayered, densely-packed dissolving microprojection arrays. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2010; 6:1785-1793. [PMID: 20665628 DOI: 10.1002/smll.201000326] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Targeting of vaccines to abundant immune cell populations within our outer thin skin layers using miniaturized devices-much thinner than a needle and syringe, could improve the efficacy of vaccines (and other immunotherapies). To meet this goal, a densely packed dissolving microprojection array (dissolving Nanopatch) is designed, achieving functional miniaturization by 1) formulating small microneedles (two orders of magnitude smaller than a standard needle and syringe) and 2) multiple layering of the payload within microprojections with tight tolerances (of the order of a micrometer). The formulation method is suitable to many vaccines because it is without harsh or complex chemical processes, and it is performed at low temperatures and at a neutral pH. When the formulated dNPs are applied to skin, consistent and robust penetration is achieved, rapidly targeting the skin strata of interest (<5 min; significantly faster than larger dissolving microneedles that have been previously reported). Resultant diffusion is significantly enhanced within the dermis compared with the epidermis. Using two different antigens (ovalbumin and a commercial trivalent influenza vaccine [Fluvax2008]), the administration of these dissolving patches generate robust systemic immune responses in a mouse model. To the authors' knowledge, this is the first report of successful vaccination with any form of dissolving microneedles. The patches made by this method therefore have the potential for pain-free, needle-free, and effective vaccination in humans.
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Affiliation(s)
- Anthony P Raphael
- The University of Queensland Australian Institute for Bioengineering and Nanotechnology (AIBN) Brisbane, QLD 4072, Australia
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Moore GE, HogenEsch H. Adverse Vaccinal Events in Dogs and Cats. Vet Clin North Am Small Anim Pract 2010; 40:393-407. [DOI: 10.1016/j.cvsm.2010.02.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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19
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Oakes JL, Piller KJ, Bost KL. An antibody response to cholera toxin, but not soy proteins, following oral administration of adjuvanted soybean formulations. FOOD AGR IMMUNOL 2009. [DOI: 10.1080/09540100903242473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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20
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2007. [DOI: 10.1002/pds.1375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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