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COVID-19 Vaccination Is Safe among Mast Cell Disorder Patients, under Adequate Premedication

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Resumo:Reported cases of anaphylaxis following COVID-19 vaccination raised concerns about the safety of these vaccines, namely in patients suffering from clonal mast cell (MC) disorders—a het-erogenous group of disorders in which patients may be prone to anaphylaxis caused by vaccination. This study aimed to assess the safety of COVID-19 vaccines in patients with clonal MC disorders. We performed an ambidirectional cohort study with 30 clonal MC disorder patients (n = 26 in the prospective arm and n = 4 in the retrospective arm), that were submitted to COVID-19 vaccination. Among these, 11 (37%) were males, and median age at vaccination date was 41 years (range: 5 y to 76 y). One patient had prior history of anaphylaxis following vaccination. Those in the prospective arm received a premedication protocol including H1-and H2-antihistamines and montelukast, while those in the retrospective arm did not premedicate. Overall, patients received a total of 81 doses, 73 under premedication and 8 without premedication. No MC activation symptoms were reported. COVID-19 vaccination seems to be safe in patients with clonal mast cell disorders, including those with prior anaphylaxis following vaccination. Robust premedication protocols may allow for vaccination in ambulatory settings. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Autores principais:Rama, TA
Outros Autores:Miranda, J; Silva, D; Amaral, L; Castro, E; Coimbra, A; Moreira, A; Plácido, JL
Assunto:anaphylaxis; clonal mast cell activation syndrome; COVID-19 vaccines; mastocytosis
Ano:2022
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade do Porto
Idioma:inglês
Origem:Repositório Aberto da Universidade do Porto
Descrição
Resumo:Reported cases of anaphylaxis following COVID-19 vaccination raised concerns about the safety of these vaccines, namely in patients suffering from clonal mast cell (MC) disorders—a het-erogenous group of disorders in which patients may be prone to anaphylaxis caused by vaccination. This study aimed to assess the safety of COVID-19 vaccines in patients with clonal MC disorders. We performed an ambidirectional cohort study with 30 clonal MC disorder patients (n = 26 in the prospective arm and n = 4 in the retrospective arm), that were submitted to COVID-19 vaccination. Among these, 11 (37%) were males, and median age at vaccination date was 41 years (range: 5 y to 76 y). One patient had prior history of anaphylaxis following vaccination. Those in the prospective arm received a premedication protocol including H1-and H2-antihistamines and montelukast, while those in the retrospective arm did not premedicate. Overall, patients received a total of 81 doses, 73 under premedication and 8 without premedication. No MC activation symptoms were reported. COVID-19 vaccination seems to be safe in patients with clonal mast cell disorders, including those with prior anaphylaxis following vaccination. Robust premedication protocols may allow for vaccination in ambulatory settings. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.