Despite mounting evidence that polysorbate and polyethylene glycol (PEG) reactions did not raise the risk of coronavirus disease 2019 (COVID-19) vaccination reactions, they continued to be cited as potential risk factors for adverse reactions and a source of vaccine reluctance.  For a study, the researchers sought to look into the safety of the COVID-19 vaccination in people who had expressed responses to drugs and vaccines that contain PEG and polysorbate. Patients at a tertiary academic medical facility (cohort 1) with PEG or polysorbate reactions are recorded in their electronic medical records. Patients referred to Allergy and Immunology with reported PEG or polysorbate reactions had the safety of the COVID-19 vaccination examined (cohort 2). Following reports of symptoms (onset≤12 hours) from the first dosage of the PEG-containing messenger RNA (mRNA) COVID-19 vaccine, the safety of the vaccine was also examined (cohort 3). Of 236 (94%) of the 252 patients in cohorts 1 and 2 (n=202 and 50, respectively) received the mRNA COVID-19 vaccination (106 Pfizer and 130 Moderna), and 235 received both doses. Only 3 patients from cohort 2 experienced a minor rash after receiving the vaccine. None of the 44 individuals in cohort 3 (27 Pfizer, 17 Moderna) who experienced acute symptoms after receiving the first dose of the mRNA COVID-19 vaccination had previously reported PEG or polysorbate responses. Of the 43 of these 44 individuals who received the second dosage and 3 who experienced side effects after receiving the second dose (1 of whom required epinephrine), PEG skin testing was negative. COVID-19 vaccinations were safely administered to patients with known PEG and polysorbate sensitivities. Patients at risk for adverse reactions to the first dose or subsequent doses of the COVID-19 vaccination were not identified by PEG and polysorbate skin tests. Without identifying people at risk for COVID-19 vaccination responses, testing for PEG and polysorbate allergies might only serve to raise vaccine reluctance.

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