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

Jean Bousquet, Ioana Octavia Agache, Hubert Blain, Marek Jutel, Maria Teresa Ventura, Margitta Worm, Stefano Del Giacco, Athanase Bénétos, Maria Beatrice Bilò, Wienczyslawa Czarlewski

99 more authors

Amir Hamzah Abdul Latiff, Mona Al‐Ahmad, Elizabeth Angier, Isabella Annesi‐Maesano, Marina Atanasković‐Marković, Claus Bachert, Annick M. Barbaud, Anna Bedbrook, Kazi Saifuddin Bennoor, Camelia Elena Berghea, Carsten Bindslev‐Jensen, Sergio Bonini, Sinthia Z. Bosnic-Anticevich, Knut Brockow, Luisa Brussino, Paulo Augusto Moreira Camargos, Giorgio Walter Canonica, Victória Cardona, Pedro Martins, Ana Carriazo, Thomas B. Casale, Jean‐Christoph Caubet, Lorenzo Cecchi, Antonio Cherubini, George Christoff, Derek K. Chu, Álvaro Augusto Cruz, Dejan Dokic, Yehia El‐Gamal, Motohiro Ebisawa, Bernadette Eberlein, John Farrell, Montserrat Fernández‐Rivas, Wytske Johanna Fokkens, João Fonseca, Yadong Gao, G. Gavazzi, Radosław Gawlik, Asli Akkor Gelincik, Bilun Gemicioğlu, Maia Gotua, Olivier Guérin, Tari Haahtela, Karin Hoffmann‐Sommergruber, Hans Jürgen Hoffmann, Maja A. Hofmann, M Hrubiško, Maddalena Illario, Carla Irani, Zhanat Bakhitovna Ispayeva, Juan Carlos Ivancevich, Kaja Julge, Ігор Петрович Кайдашев, Musa Rakhimovich Khaitov, Edward F. Knol, Helga Kraxner, Piotr Kuna, Violeta Kvedarienė, Antti Lauerma, Lan Thi Tuyet Le, Vincent Le Moing, Michael Eliad Levin, Renaud E. Louis, Olga M. Lourenço, Vera Mahler, Finbarr C. Martin, Andrea Matucci, Branislava A. Milenkovic, Stéphanie Miot, Emma Montella, Mário Morais‐Almeida, Charlotte Gotthard Mortz, Joaquim Mullol, Leyla Seymurovna Namazova-Baranova, Hugo E. Neffen, K Nékám, Marek Niedoszytko, Mikaëla Odemyr, Robyn E. O’Hehir, Yoshitaka Okamoto, Markus W. Ollert, Óscar Palomares, Nikolaos G. Papadopoulos, Petr Panzner, Giovanni Passalacqua, Vincenzo Patella, Mirko Petrović, Oliver Pfaar, Nhan Pham‐Thi, Davor Plavec, Joaquin Sastre, Cezmi A. Akdiş, Frederico Soares Regateiro, Bernardo Sousa‐Pinto, Sanna Katriina Toppila-Salmi, Ioanna Tsiligianni, Mona Sulaiman Al-Ahmad, Eva Untersmayr, Charlotte Suppli Ulrik

2021

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DOI 10.1111/all.14838
Data confidence 85 high
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Abstract

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.