Covid vaccination and allergies in children

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Marie-Ange Demory
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Covid vaccination and allergies in children

Covid vaccines and allergic children: the doubts are many. Does anyone who suffers from classic seasonal allergies run any more risks? And who has had anaphylactic shock? What about asthmatics? Doubts that are particularly felt when it comes to vaccinating a child. 





Help comes from the Del Paesena Society of Pediatric Allergology and Immunology (SIAIP) which has developed recommendations for the "Management of vaccination for Covid-19 in subjects aged 12-18 with allergies, asthma, anaphylaxis and immunodeficiencies". "The idea of ​​providing a tool of this type was born on the occasion of the last SIAIP congress during which many reports were dedicated to Covid-19" - explains Gian Luigi MARSEGLIA Director of the Pediatric Clinic of the University of Pavia , Policlinico San Matteo - This is a sort of decalogue that provides useful advice first of all to doctors, but also to users on how to manage subjects with a history of allergies and which is the result of the work of a study group that we have created for this purpose ". 

The groups at risk

The premise is that vaccination is recommended in all subjects aged 12 years or older who do not have specific contraindications.   "As regards allergies, we have identified three risk bands, low, medium and high, indicated respectively in green, yellow and red and for each of them we suggest to follow certain behaviors. In the end - adds MARSEGLIA - following the suggestions of the SIAIP , the traffic light for vaccination is almost always green. And here is what the experts advise to do for the different types of patients. The indication that concerns almost all allergy sufferers is certainly reassuring: those who suffer from the classic hay fever or asthma , as long as it is well controlled by therapies, it presents a risk similar to that of non-allergic individuals and can therefore be vaccinated without any particular problem "

What should someone who has had an allergic reaction do?

The same also applies to those who have had an allergic reaction later in the past to food intake or due to an insect bite or a latex allergy, provided this did not manifest itself as anaphylaxis. "The latter is by far the most serious phenomenon among allergic reactions, with the appearance of symptoms involving the respiratory and cardiovascular system, often accompanied by skin, gastrointestinal and neurological manifestations. Who has previously had anaphylaxis for example from food, latex or insect bites - continues MARSEGLIA - should be considered at medium risk. In these cases a lot is needed caution and before carrying out the vaccination, an allergological examination is indicated to confirm the diagnosis and provide the appropriate indications ".  

Medium-risk range: what to do

  They belong to the range of also average risk for asthmatics with inadequately controlled disease - in which it is recommended first of all to correct the therapy in order to achieve the best possible control - both those who have had an extensive skin reaction after the administration of the first dose of the anti Covid-19 vaccine, and those who have had allergic reactions to drugs and vaccines. "In all patients with medium risk, the SIAIP document recommends an allergological evaluation - specifies MARSEGLIA - and in any case the administration of the vaccine in a protected environment; it is also indicated to extend the observation period after vaccination to a minimum of 60 minutes".  

High Risk: Who are the high risk children

Finally, those who have had one should be considered to be at high risk generalized reaction after administration of the first dose of the Covid-19 vaccine or to other drugs or substances containing the excipients present in the vaccine (who are believed to be responsible for the allergic reaction) and those who have tested positive skin tests for the excipients of the vaccine. "In these subjects, caution is utmost: an allergist must be consulted and the risk-benefit ratio must be carefully evaluated. In cases where vaccination is decided - concludes MARSEGLIA - this must be carried out in a hospital that guarantees immediate availability of the safeguards necessary to deal with the emergency of anaphylaxis or anaphylactic shock. It must however be said that the risk of anaphylactic reactions following vaccination against Covid-19 is very low, it is estimated about 11 cases per million doses for mRNA vaccines ".



TAG:
  • coronavirus
  • allergies children
  • vaccinations for children
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