Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach.

This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations.

Dust-mite avoidance measures in patients on immunotherapy.

The compliance of dust-mite (DM) allergic patients receiving immunotherapy (IT) with environmental avoidance measures has not been reported. To investigate patient practices, a questionnaire was distributed to patients receiving IT for indoor allergens. Ninety-three of 200 patients (46%) with indoor allergies completed the questionnaire.

Anaphylaxis from the influenza virus vaccine.

Background: Allergic reactions to the influenza vaccine are uncommon and usually associated with sensitivity to egg or gelatin. The aim of this study was to report the case of anaphylaxis to the influenza vaccine.

Methods: Allergy percutaneous skin testing, serum specific IgE testing and IgE immunoblotting were performed to the influenza vaccine, egg, and gelatin.

Seal and whale meat: two newly recognized food allergies.

Background: Alaska's marine mammals compose a large portion of the diet of indigenous coastal Alaskan people. Bowhead whales (Balaena mysticetus) and bearded seals (Erignathus barbatus), inhabitants of the Bering and Beaufort seas along Alaska's western and northern coasts, are 2 of the most important subsistence species, serving as major food sources to the native population.

Objective: To describe an Inupiaq boy with symptoms consistent with an IgE-mediated food allergy after ingestion of bowhead whale and bearded seal meat.

Effect of imported fire ant extract on the degradation of mountain cedar pollen allergen.

Background: Dust mite, cockroach, and mold extracts have been shown to contain proteases capable of degrading the proteins in other extracts. Loss of potency of allergens has been reported in mixtures containing cockroach and fungal extracts. Fire ant venoms consist of 90% to 95% n-alkyl and n-alkenyl piperidine alkaloids, which are not allergenic.

Intraoperative anaphylaxis to bacitracin during pacemaker change and laser lead extraction.

Background: Bacitracin is widely used in operating rooms to soak implants, irrigate compound fractures, and apply to surgical incisions. However, bacitracin is a known sensitizer and causes not only allergic contact dermatitis but also anaphylaxis.

Objective: To describe a 72-year-old woman with anaphylaxis after irrigation and packing of an infected pacemaker pocket with a bacitracin solution.

Patient knowledge of immunotherapy before and after an educational intervention: a comparison of 2 methods.

Background: Immunotherapy is an invaluable therapy for allergic asthma, allergic rhinitis, and hymenoptera hypersensitivity. It is, however, not without risks.

Objectives: To examine patient knowledge regarding immunotherapy and to determine the most effective educational method to improve their knowledge by answering the following questions: Before educational intervention, what is the current knowledge level regarding allergy vaccinations of patients receiving immunotherapy? What effect does an educational encounter have on that level of knowledge? Which educational intervention--a one-on-one session vs a handout--if either, increases patient knowledge more?

Methods: An original, self-administered patient questionnaire was distributed to all patients receiving immunotherapy.