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The impact of the global coronavirus disease 2019 (COVID-19) pandemic has been devastating. Safe and effective vaccines are needed to prevent the disease caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Two mRNA vaccines were approved at the end of 2020: BNT162b2 (Pfizer-BioNTech) [1] and mRNA-1273 (Moderna) [2]. During the first days of the vaccination campaign, cases of anaphylaxis were reported after administration of both vaccines in patients who had a known history of severe allergies. An alert was triggered by regulatory bodies to contraindicate their administration to allergic patients, with no clear specific indications as to the type of allergy [3,4]. Confirmed allergic reactions to vaccines are not generally attributed to the active ingredients, but rather to the excipients [5,6]. Polyethylene glycol (PEG), which is widely used due to its stabilizing properties, is an excipient of both BNT162b2 and mRNA-1273 and a known potential allergen [7]. In addition, mRNA-1273 also contains trometamol [5]. The aim of this study was to evaluate the ability of a new protocol to identify patients with previous severe allergic reactions so that they could receive the vaccines safely and to detect patients in whom vaccines should be avoided. Between January and February 2021, during the COVID-19 vaccination campaign, a specific questionnaire was administered to health care workers from a tertiary hospital in Madrid, Spain to select persons with previous severe allergic diseases. The questionnaires were sent from the Occupational Risk Prevention Department so that the vaccination could be administered in our Allergy Department. We recorded sex, age, personal history of cardiovascular or respiratory diseases, autoimmunity, immunosuppression, chronic cutaneous diseases, treatment at the time of the study, and other nonsevere allergies. 180

Safety of New mRNA Vaccines Against COVID-19 in Severely Allergic Patients