Gender |
Female |
Female |
Female |
Female |
Female |
Female |
Age |
24 |
29 |
28 |
52 |
43 |
43 |
Reason of vaccination in a hospital setting |
Anaphylaxis to previous
COVID-19 (Comirnaty) vaccine |
Anaphylaxis to several food products |
first COVID-19 (Comirnaty) vaccine |
Reaction to previous COVID-19
(Comirnaty) vaccine in person with severe poorly controlled asthma and
drug-related anaphylaxis in medical history |
Reaction to previous
COVID-19 (Comirnaty) vaccine |
Anaphylaxis to several drugs (including
vaccines) |
Reaction after vaccination dose (no.) |
1 |
first Covid vaccine ever |
1 |
1 |
1 |
First Covid vaccine ever |
Symptoms (objective )before referral
|
Conjunctivitis;
hypotension (systolic BP 80mmHg while normally around 120mmHg)
|
N/A
|
Itchy red skin rash, shortness of breath, nausea and diarrhea
|
Generalized urticaria
Stridor/
decreased O2
|
Objective facial angioedema
|
N/A
|
Symptoms (subjective) before referral
|
Globus pharyngeus/sense of swollen throat; hoarseness; dyspnea; nausea;
dizziness
|
N/A
|
Globus pharyngeus/sense of swollen throat
Locoregional skin rash
|
Globus pharyngeus/sense swollen throat
|
Globus pharyngeus/
sense of swollen throatdyspnea/ dizziness
|
N/A
|
Medication for reaction, before referral
|
Antihistamines iv
Corticosteroid iv
Epinephrine im
|
N/A
|
Antihistamines iv
epinephrine im
|
Antihistamines iv
Epinephrine im
|
Antihistamines iv
Epinephrine im
|
N/A
|
Skin test performed
|
COVID-19
polysorbaat 80
PEG3500
PEG6000
|
PEG3500
Polysorbaat 80:
Trometamol
|
Covid 19
Trometamol
Polysorbaat 80
PEG3500
PEG4000
|
Not performed because of daily use of prednisone, clemastine,
montelukast, imatinib and mepolizumab
|
None
|
None
|
Skin test result positive
|
COVID-19 Pfizer SPT undiluted positive
|
PEG(SPT)
and PEG (ICT)
|
COVID-19 1:100 and1:10
PEG (ICT0
|
N/A
|
N/A
|
N/A
|
Name vaccine in the hospital |
Moderna |
Comirnaty |
Comirnaty |
Comirnaty |
Comirnaty |
Comirnaty |
Symptoms after in hospital vaccination
|
Conjunctivitis, rhinitis, hoarseness and (subjective) globus
pharyngeus
|
Local erythema, itch, tingling tongue,
nausea
malaise,
sputum, vomiting,
inspiratory
stridor (preexistent)
dyspnoe, wheezing, globus feeling
|
Shortness of breath
Itch
Local urticaria
|
(additional premedication with clemastine 2mg iv, salbutamol inh)
Local erythema, dizziness, novel wheezing for which salbutamol was
readministered. After 3rd and last incremental step
direct and quickly progressing erythema chest, arms, face, sense of doom
with tachycardia for which 1st epinephrine was
administered. 2nd dose was administered when symptoms
returned after 20 minutes AND BP to 110/65, previously 140/70
|
(sense of) swollen throat, facial erythema, chest pain, dyspnea,
tachycardia
|
(sense of) swollen throat, dyspnea, headache, nausea
|
Reason for epinephrine |
Insufficient response to clemastine i.v. and
wish to complete vaccination (was incrementally administered) |
Increase
of nausea and vomiting, despite levocetirizine, salbutamol, +
metoclopramide+ prednisolone |
Urticaria |
direct and quickly
progressing erythema chest, arms, face, sense of doom with tachycardia,
later also decrease of BP |
combination of the above |
Combination of
the above, quickly progressing despite clemastine |
Response to epinephrine |
Relief of symptoms |
yes |
No response |
Relief of symptoms |
Partial relief of symptoms |
Relief of
symptoms |
Tryptase
(reference <11.4 ug/L)
|
2.92 2.46 ug/L (after)
|
3.4 ug/L
|
6.2 ug/L
|
6.104.97 ug/L
|
2.84 ug/L
|
Not measured
|
Interpretation of symptoms
(type 1 allergy/ adverse side effect/ other )
|
CARPA or CAS-related
|
No allergic reaction, respiratory complaints in a person known with
asthma (bronchial hyperreactivity)
|
No allergic reaction,
Urticaria in person with known urticaria
|
Suspicion of type 1 allergy to PEG (because of combination with other
severe drug allergies) but this could not be tested; alternatively, IRSS
in a person with severe uncontrolled asthma and also susceptible to
contact urticaria
|
Most likely hyperventilation (arterial blood gas confirmed this) and
stress, at the index reaction combined with facial angioedema in a
person with known U/A
|
Other (stress-related)
|