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

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 heterogenous group of disorders in which patients may be prone to anaphylaxis caused by vaccination. This study aimed t...

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Bibliographic Details
Published in:Vaccines (Basel) 2022-05, Vol.10 (5), p.718
Main Authors: Rama, Tiago Azenha, Miranda, Joana, Silva, Diana, Amaral, Luís, Castro, Eunice, Coimbra, Alice, Moreira, André, Plácido, José Luís
Format: Article
Language:English
Subjects:
Anaphylaxis
Antihistamines
Blood
Bone marrow
clonal mast cell activation syndrome
Coronaviruses
COVID-19
COVID-19 vaccines
Disorders
Drug dosages
Gastroesophageal reflux
mastocytosis
Measles
Montelukast
mRNA vaccines
Mumps
Patients
Polyethylene glycol
Rubella
Safety
Severe acute respiratory syndrome coronavirus 2
Signs and symptoms
Vaccines
Vectors (Biology)
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Summary: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 heterogenous 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: 5y to 76y). 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.
ISSN:2076-393X
2076-393X
DOI:10.3390/vaccines10050718