Management of anaphylaxis due to COVID‐19 vaccines in the elderly

Jean Bousquet (1, 2, 3) , Ioana Agache (4) , Hubert Blain (3) , Marek Jutel (5) , Maria Teresa Ventura (6) , Margitta Worm (7) , Stefano del Giacco (8) , Athanasios Benetos (9) , Beatrice Maria Bilo (10) , Wienczyslawa Czarlewski (11) , Amir Hamzah Abdul Latiff (12) , Mona Al‐ahmad , Elizabeth Angier (13) , Isabella Annesi‐maesano (14) , Marina Atanaskovic‐markovic (15) , Claus Bachert (16) , Annick Barbaud (17, 18) , Anna Bedbrook (12) , Kazi Bennoor (19) , Elena Camelia Berghea (20) , Carsten Bindslev‐jensen (21) , Sergio Bonini (22) , Sinthia Bosnic‐anticevich (23) , Knut Brockow (24) , Luisa Brussino (25) , Paulo Camargos (26) , G. Walter Canonica (27) , Victoria Cardona (28) , Pedro Carreiro‐martins (29) , Ana Carriazo , Thomas Casale (30) , Jean‐christoph Caubet (31) , Lorenzo Cecchi (32) , Antonio Cherubini , George Christoff (33) , Derek Chu (34) , Alvaro Cruz (35) , Dejan Dokic (36) , Yehia El‐gamal† (37) , Motohiro Ebisawa (38) , Bernadette Eberlein (24) , John Farrell , Montserrat Fernandez‐rivas (39) , Wytske Fokkens (40) , Joao Fonseca (41) , Yadong Gao (42) , Gaëtan Gavazzi (43) , Radoslaw Gawlik (44) , Asli Gelincik (45) , Bilun Gemicioğlu (46) , Maia Gotua , Olivier Guérin (47) , Tari Haahtela (48) , Karin Hoffmann‐sommergruber (49) , Hans Jürgen Hoffmann (50) , Maja Hofmann (1) , Martin Hrubisko (51) , Maddalena Illario (52) , Carla Irani (53, 54) , Zhanat Ispayeva (55) , Juan Carlos Ivancevich (56) , Kaja Julge (57) , Igor Kaidashev (58) , Musa Khaitov (59) , Edward Knol (60) , Helga Kraxner (61) , Piotr Kuna (62) , Violeta Kvedariene (63) , Antti Lauerma (64) , Lan Le (65) , Vincent Le Moing (3) , Michael Levin (66) , Renaud Louis (67) , Olga Lourenco (68) , Vera Mahler , Finbarr Martin , Andrea Matucci , Branislava Milenkovic , Stéphanie Miot (3) , Emma Montella , Mario Morais‐almeida , Charlotte Mortz , Joaquim Mullol , Leyla Namazova‐baranova , Hugo Neffen , Kristof Nekam , Marek Niedoszytko , Mikaëla Odemyr , Robyn O’hehir , Yoshitaka Okamoto , Markus Ollert , Oscar Palomares , Nikolaos Papadopoulos , Petr Panzner , Giovanni Passalacqua , Vincenzo Patella , Mirko Petrovic , Oliver Pfaar , Nhân Pham‐thi , Davor Plavec , Todor Popov , Marysia Recto , Frederico Regateiro , Jacques Reynes , Regina Roller‐winsberger , Yves Rolland (69) , Antonino Romano , Carmen Rondon , Menachem Rottem , Philip Rouadi , Nathalie Salles , Boleslaw Samolinski , Alexandra Santos , Faradiba Sarquis , Joaquin Sastre , Jos M. G. A. Schols , Nicola Scichilone , Anna Sediva , Mohamed Shamji , Aziz Sheikh , Isabel Skypala , Sylwia Smolinska , Milena Sokolowska , Bernardo Sousa‐pinto , Milan Sova , Rafael Stelmach , Gunter Sturm , Charlotte Suppli Ulrik , Ana Maria Todo‐bom , Sanna Toppila‐salmi , Ioanna Tsiligianni , Maria Torres , Eva Untersmayr , Marilyn Urrutia Pereira , Arunas Valiulis , Joana Vitte (70, 71, 14) , Alessandra Vultaggio , Dana Wallace , Jolanta Walusiak‐skorupa , De‐yun Wang , Susan Waserman , Arzu Yorgancioglu , Osman Yusuf , Mario Zernotti , Mihaela Zidarn , Tomas Chivato , Cezmi Akdis , Torsten Zuberbier , Ludger Klimek

1 Humboldt University Of Berlin
2 MACVIA-LR - Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon
3 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
4 Transylvania University
5 Wrocław Medical University
6 UNIBA - Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro
7 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
8 University of Cagliari
9 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
10 UNIVPM - Università Politecnica delle Marche [Ancona]
11 Medical Consulting Czarlewski
12 Universiti Putra Malaysia
13 University of Southampton
14 IDESP - Institut Desbrest de santé publique
15 University of Belgrade [Belgrade]
16 Ghent University Hospital
17 Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon]
18 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
19 Dhaka Shishu Hospital [Bangladesh]
20 UMPCD - University of Medicine and Pharmacy “Carol Davila” Bucharest
21 OUH - Odense University Hospital
22 Italian National Research Council
23 The University of Sydney
24 TUM - Technische Universität München = Technical University of Munich
25 UNITO - Università degli studi di Torino = University of Turin
26 UFMG - Universidade Federal de Minas Gerais = Federal University of Minas Gerais [Belo Horizonte, Brazil]
27 IRCCS Research Hospital, Milan
28 Vall d'Hebron University Hospital [Barcelona]
29 Centro Hospitalar de Lisboa Central E.P.E
30 USF - University of South Florida [Tampa]
31 HUG - Geneva University Hospital
32 Azienda Usl Toscana centro [Firenze]
33 Софийски университет = Sofia University
34 McMaster University [Hamilton, Ontario]
35 State University of Bahia
36 Institute of Public Health of Republic of North Macedonia [Skopje]
37 ASU - Ain Shams University
38 Sagamihara National Hospital [Kanagawa, Japan]
39 IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
40 Amsterdam UMC - Amsterdam University Medical Center
41 Universidade do Porto = University of Porto
42 Wuhan University [China]
43 CHU Grenoble
44 Silesian University of Medicine
45 Istanbul Faculty of Medicine
46 Cerrahpasa Faculty of Medicine
47 CHU Nice - Centre Hospitalier Universitaire de Nice
48 Helsinki University Hospital [Helsinki, Finlande]
49 Medizinische Universität Wien = Medical University of Vienna
50 Aarhus University [Aarhus]
51 Oncology Institute of St Elisabeth
52 University of Naples Federico II = Università degli studi di Napoli Federico II
53 St Joseph University
54 HDF - Hôtel-Dieu de France
55 Kazakh National Medical University
56 Clinica Santa Isabel - Servicio de Alergia e ImmunologiaBuenos Aires
57 Tartu University Institute of Clinical Medicine
58 Ukrainina Medical Stomatological Academy [Poltava, Ukraine]
59 Federal Medicobiological Agency [Moscow, Russian Federation]
60 University Medical Center [Utrecht]
61 Semmelweis University [Budapest]
62 MUL - Medical University of Łódź
63 Vilnius University [Vilnius]
64 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
65 University of Medicine and Pharmacy (VIETNAM)
66 University of Cape Town
67 CHU Sart Tilman
68 UBI - University of Beira Interior [Portugal]
69 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
70 MEPHI - Microbes évolution phylogénie et infections
71 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection

Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.

Keywords: COVID -19 vaccines; Adrenaline; Anaphylaxis; Older

Domains: Life Sciences [q-bio]; Microbiology and Parasitology; Bacteriology; Life Sciences [q-bio]; Human health and pathology; Cardiology and cardiovascular system; Life Sciences [q-bio]; Human health and pathology; Emerging diseases; Life Sciences [q-bio]; Human health and pathology; Infectious diseases; Life Sciences [q-bio]; Microbiology and Parasitology; Parasitology; Life Sciences [q-bio]; Microbiology and Parasitology; Virology

Jean Bousquet, Ioana Agache, Hubert Blain, Marek Jutel, Maria Teresa Ventura, et al.. Management of anaphylaxis due to COVID‐19 vaccines in the elderly. Allergy, 2021, 76 (10), pp.2952-2964. ⟨10.1111/all.14838⟩. ⟨hal-03437014⟩