New research was presented at ACAAI 2021, the annual American College of Allergy, Asthma & Immunology Annual Scientific Meeting, held virtually and in New Orleans from November 4-8. The features below highlight some of the studies emerging from the conference.
COVID-19 Vaccination Safe in Most Who Fear They Had/Will Have Allergic Reaction
With evidence that some Americans fear an allergic reaction to the ingredients in any of the three currently available COVID-19 vaccines, two studies were conducted to 1) assess outcomes among patients who thought they would have an allergic reaction and 2) determine if those who believed they had an allergic response to the first dose could safely be fully vaccinated. For the first study, researchers reviewed the charts of patients with a document allergy to polyethylene glycol (PEG), an ingredient in the mRNA COVID-19 vaccines. Despite previous reaction to PEG in oral PEG preparations, all participants tolerated the full vaccine series without allergic symptoms. “Our cohort consisted primarily of patients who experienced gastrointestinal intolerance with an oral PEG preparation,” said Miguel Park, MD, co-author of the study. “This is unlikely to represent a true PEG allergy and shouldn’t delay vaccination. It’s important to recognize true vs. non-allergic reactions.” For the second study, investigators assessed patients referred to an allergy clinic after reporting adverse events following immunization with one of the mRNA COVID-19 vaccines. Among them, 65% underwent a vaccine challenge following directed testing or other assessments and experienced only mild, expected post-vaccine symptoms. Only 25% of the remaining patients with adverse symptoms following the first dose were advised by an allergist not to receive the second dose.
Most Young Adults With Asthma Unprepared for Care Transition
Data indicate that the medical needs of patients with asthma change as they age, often requiring a transition to a new practitioner. To assess the awareness of this transition among young adults with asthma, investigators surveyed patients with asthma aged 18-30. Participants were recruited from a pediatric hospital or a university, where they were either current students or staff. “Of those we surveyed, most participants did not receive sufficient transition preparation from their pediatric asthma providers, no matter who was providing their asthma care,” said lead study author Suzanne Ngo, MD. Indeed, one-half did not remember their pediatric asthma provider introducing them to the concept of transitioning care, including asthma self-management, and only 17% had received information about an adult provider to whom they should transfer their care. “Introducing concepts about self-care in terms of what will be changing in their lives and what they need to take responsibility for can help [teens heading off to college] control their asthma symptoms as they begin their journey into adulthood,” added Dr. Ngo.
High Asthma Exacerbation Rates in Latinos With COVID-19
With studies indicating that minority populations experience higher rates of COVID-19 infection when compared with non-minority populations, researches examined the cases of adult patients with COVID-19 and a history of asthma, comparing outcomes by ethnicity. The study team found, among participants, that Latinos with asthma were 4.6 times more likely to develop asthma exacerbations that non-Latino Black patients following COVID-19 infection and 2.9 times more likely than non-Latino White patients. Latinos with COVID-19 also had a longer duration of uncontrolled asthma symptoms, lasting 3.2 weeks, compared with 1.5 weeks for non-Latino Whites and 1.4 weeks for non-Latino Blacks. “Despite the differences in symptoms we found in the study participants, we didn’t see a difference in the likelihood of starting steroids for symptom relief, nor for starting asthma step-up therapy (more aggressive treatment when asthma is uncontrolled) between Latino, non-Latino White and non-Latino Black populations,” said study co-author Mahboobeh Mahdavinia, MD, PhD. “All the groups sought a similar number of asthma-related provider visits, including in clinic, the emergency departments, or via telehealth.”
Many Not Following Early Peanut Introduction Guideline
To determine adherence with the 2017 National Institute of Allergy and Infectious Diseases (NIAID) guidelines on introducing peanut products to infants to prevent peanut allergy, investigators surveyed parents/caregivers from more than 3,000 households with a child aged 7 months to 3.5 years. Among respondents, 58% said that their primary care physician discussed early peanut introduction; however, only 40% reported that they had received a recommendation to introduce peanut by 11 months. Overall, only 13% of respondents were aware of the NIAID guideline. Findings were a bit more encouraging among the parents/caregivers of the 11% of infants with eczema; 18% were aware of the NIAID guideline and 69% reported that their child’s primary care physician had discussed early peanut introduction. “Early peanut introduction should be discussed with parents/caregivers of all infants, including those at higher risk of developing peanut allergy,” notes study co-author Ruchi Gupta, MD.
Early Egg Introduction Linked With Decreased Egg Allergy
With research and guidelines supporting early introduction of peanut to help prevent peanut allergy, and data indicating egg allergy to be the second most common food allergy in the world, researchers examined infant feeding and food allergy data from birth to 6 years from more than 2,200 parent surveys to determine if the same applies to egg introduction and egg allergy. Among the surveys from the Infant Feeding Practices Study II conducted by the CDC and FDA, 1,379 participants had complete food allergy data to 6 years. Egg allergy at 1 year was reported by 0.6% of all survey respondents, and 0.8% reported egg allergy at 6 years. Those with egg allergy at ages 1 and 6 had less frequent egg consumption at ages 5, 6, 7, and 10 months. “Current evidence suggests that early introduction of egg during infancy, followed by consistent and frequent feedings, seems protective against development of egg allergy,” said senior study author and principal investigator Xiaozhong Wen, MD, PhD. “We are still investigating optimal timing of infant egg introduction and frequency of feeding.”