New evidence demonstrates more clearly that it is possible to develop severe immediate hypersensitivity to macrogols, of which the most familiar form to most physicians is polyethylene glycol (PEG) 3350. With thousands of medications containing either PEGs or structurally similar polysorbates, Cosby A. Stone Jr., MD, MPH, and colleagues at Vanderbilt University School of Medicine sought to better understand the mechanism, cross-reactivity, and scope of PEG hypersensitivity for a study published in The Journal of Allergy and Clinical Immunology: In Practice. “The need to study this problem arose directly from encounters we had with two patients in our dedicated drug allergy clinic who had anaphylaxis after receiving injectable steroid medications and when trying to take their ‘prep’ for colonoscopies,” explains Dr. Stone. The main ingredient (PEG 3350) in the preps was also present in the steroids to which the patients reacted.
Dr. Stone and colleagues used skin testing and oral challenges with PEG and polysorbate-containing agents to determine clinical reactivity and cross-reactivity between the two allergens. Enzyme-linked immunosorbent assay and electrochemiluminescent immunoassay were used to detect anti-PEG specific IgG and IgE, respectively, using PEGylated protein or PEG alone as antigens in two cases and six PEG 3350-tolerant controls. “It was immediately clear that these patients were truly allergic when they had strongly positive skin tests to polyethylene glycol 3350 in the form of Miralax, to steroids containing the same ingredient and to steroids containing polysorbate 80,” says Dr. Stone. Plasma samples were positive for anti-PEG specific IgE and IgG antibodies only in cases, and binding increased directly proportional to the molecular weight of PEG tested.
To determine the potential scope of this allergy in the US, the study teams searched FDA adverse event reports for immediate reactions to PEG 3350 and found an average of four cases per year were reported. “We would tend to think that self-reports to the FDA might underestimate the problem, given the lack of recognition that this can be an allergy, and the wide number of medications that contain these ingredients,” notes Dr. Stone. “Having shown that allergy to PEGs and polysorbates are true allergies by the classical IgE mechanism, the most important finding for another physician to be aware of is our patients’ histories. Without an awareness of this allergy and how it would present, affected patients are potentially at risk of anaphylaxis from a wide variety of medications, in a wide number of settings. Physicians treating patients with such a history should know how to confirm a diagnosis (or refer) and how to read ingredient labels using the NIH Daily Med website to keep patients safe during their routine healthcare encounters and prescriptions.”
References
Immediate Hypersensitivity to Polyethylene Glycols and Polysorbates: More Common Than We Have Recognized
https://www.sciencedirect.com/science/article/pii/S2213219818308237
Rebecca Rice
Hi. The Pfizer/Moderna vaccine has PEG 2000 in it. I have a PEG allergy and reacted positively to the COVID vaccine — results gathered by NHS and sent to FDA /Oxford etc. I have had a subsequent allergic reaction to polysorbate 80, which then caused another reaction to cetirizine which has PEG 400 in it – thus lowering my allergic sensitivity to lower molecular weight PEG — I think my allergy kicks in around 1000. Polysorbate 80 is in J&J and AstraZeneca. We have to wait for Sanofi which has polysorbate 20 in it.
I had industrial asthma in 1989 working over seal irons that sealed a polyurethane film, I started to choke and could not work in that environment again. they finally changed that film to not have polyurethane but it was to late for me. I was having a tough time around strong perfumes and other strong fumes. I have had my pneumonia shot and been having the flu vaccine for over 20 years. And I wander if the pfizer and moderna vaccines are similar to the flu and pneumonia shots in ingredients.
Prepping for a colonoscopy, I had taken Dulcolax pills and was prescribed but had never taken Glycolax which I mixed in 1 gal. lemonade Kool Aid. Took one glass of this mix, everything OK, after about half of the next glass I felt a sensation of heat in my face. I was taking the garbage out a few moments later and walked out on the porch and down the 2 steps when all of a sudden I felt like my back was seized up. I sat down on the porch for about 10 minutes until I felt a little better, then took the garbage on out to the curb. When I went back into the house I thought it was prudent visit the bathroom to see if I had to go. While there, little red bumps started rising on my legs almost fast enough to see it happening. My eyelids felt scratchy inside and I could feel my lungs start to be irritated and I started coughing because of this. I left the bathroom after looking in the mirror and could see my face looked like I was blushing badly. A little later my wife’s sister in law who was a nurse and her brother stopped by. She saw I looked a little funny and asked what had happened. I told her and she said I needed to go to the hospital because I was having an allergic reaction to the Glycolax. I had my son take me to the hospital, where I was in the emergency room overnight. They were trying to accuse me of taking drugs, which I don’t do. After this was hashed out they gave me some benadryl and told me I could stay a little longer for observation or go ahead and have the colonoscopy that morning. The endoscopy clinic was just down the road about a mile, so I elected to go ahead and get this over with. When I arrived at the clinic and explained what had happened, the doctor came out and told me to come on back I would be the first to have the procedure. He also stated that he had prescribed Glycolax to thousands of patients and I was the first one to have an allergic reaction. The hospital nurse forgot to remove the IV from my arm from the night before, so at least I didn’t have to get stuck again at the endoscopy clinic.
The episode I described happened about five years ago, today I went to a VA clinic for my regular 6 month visit. I had seen on the internet that persons who had an allergy to polyethylene glycol should not be vaccinated for covid. I asked if any of the 3 available vaccines could be administered to me. The nurse said she checked all three and they contained PEG so I probably should not get the shot. I will check further and see if something new develops that would let me have the vaccine. I had covid Oct. 18, 2020 for about a month so maybe I have immunity for a while, I still wear my mask and take precautions and try to be careful. Covid is something that you don’t want.
I was so happy to read this article and know I’m not crazy. I spent years trying to find out what was causing me to break out in a rash – there seemed to be no connection between what I was eating or doing to cause it. I discovered my allergy to polysorbate 80 when I went on a low calorie diet. As long as I ate fresh fish, fruits and vegetables I was fine. When I tried certain diet foods I’d break out in a rash from head to toe within 15 minutes of consuming them. The only common ingredient was polysorbate 80. I then understood the source of my “mystery rashes” that would come and go. Polysorbate 80 is in shampoos, lotions. toothpaste, vaccines, food and much more. I became more observant, and sure enough, if I had an episode of rash and itching I’d check and something I’d eaten or taken would have that ingredient. My doctor really didn’t want to believe I was allergic to it. At the time, 15 years ago, these kind of allergic reactions weren’t common. I only found out PEG was related to Polysorbate after I had a reaction to my first Pfizer vaccine – I had a terrifying episode of rapid heart rate and my heart skipping beats every 10 seconds a few hours after getting the vaccine. Since I’m allergic to P-80 now I’m wondering if there will be a vaccine for those of us allergic to both PEG and P-80. I think allergies to PEG and Polysorbate 80 are not widely recognized and are much more common than we realize in this country. My doctor seems uninterested and tells me to “check with the pharmacist” to find out if a prescription medicine or vaccine has polysorbate in it. I think the amount of these additives in our food and medicine are going to cause a great deal more health issues in the general population in the future. We need to recognize that the amount of preservatives, emulsifiers, thickeners and other unnecessary ingredients we allow in our food in this country is making people sick,
I feel this is going to be the answer to most of my allergic reactions. I have had multiple reactions and all the drs keep saying is, they don’t understand how I can be allergic to so many medications. I have been searching each drug or cream that I have had a reaction to and find a common ingredient, polysorbate. I am now wondering if my allergist can test me for this.
I am too concerned to get the Covid vaccine in fear of another reaction.
I am not a candidate for either the Pfizer or Moderna covid vaccine due to polyethylene which in a save i had a reaction. as one of the ingredients. I’m wondering if Polysorbate 80, being a spin off of PEG would be a problem for me and maybe should get tested for an
My question is what vaccine can I take , is it the Johnson &Johnson
I have the same question as you stated regarding taking the J and J vaccine. Did you ever receive an answer?
In 2007 an allergist told me that I have a pharmacogenomic response to medications. I have had an allergic reaction to every type of pain medication ever prescribed for me, resulting in very rapid heart beat and/or hives. Valium works the opposite in me. Instead of a calming effect, it produces a response like that of ingesting several cups of highly caffeinated coffee. I am allergic to many food dyes.
In January 2021 my doctor prescribed Miralax for a minor and first ever episode of rectal bleeding. First dose produced hives on my wrists, second dose produced hives on my entire forearms, third dose produced additional hives on my chest, as well as those on my forearms. When my doctor heard of the reaction, she advised against receiving the Covid 19 vaccine. I have not yet conferred with my doctor about the Johnson & Johnson vaccine, but this article confirms for me that I should not take it.
In 2009 I went into anaphylaxis immediately after getting a Benadryl/Solu-Medrol Iv And required a respiratory treatment and EpiPen to recover. I was concerned about the vaccine so my allergies tested me for PEG & polysorbate and I tested positive for both. I know I cannot take the Pfizer and Moderna vaccine, and I just read that J and J have polysorbate! I have an allergist appointment on 3/31 and wonder if people have any suggestions? Thanks
i have chronic idiopathic urticaria for 10 years. I take medications that have macrogol 400,6000, and even had the colonoscopy prep with 5330 macrogol. , No allergies. yet i had two medications of the same family which contain Polysorbate 80 : Esomprazole and Pantoprazole. They both were followed by reactions. Esomprazole had 2 -week delayed reactions that lasted for 3 weeks. 6 months later i had Pantoprazole which had an immediate reaction . The question is : Can one be allergic to Polysorabate 80 and not to Polyethylene Glycol ? If the answer is no , then it is not Polysorbate 80 that caused the allergy , it is something else. Insights on the question above will be much appreciated.
I have an allergy to PEG, documented with repeated heart rhythm problems upon ingesting certain supplements or prepping for colonoscopy’s. This was also documented with a blood test. It took me decades to put it all together.
I am not a candidate for either the Pfizer or Moderna covid vaccine due to PEG as one of the ingredients. I’m wondering if Polysorbate 80, being a spin off of PEG would be a problem for me and maybe should get tested for an reaction to it.
I’m allergic to PEG had three live threatening reactions.
My question is what vaccine can I take I’m 74?
I actually had no idea I was allergic to PEG and Polysorbate. I actually have an allergy to the TB test but noone ever told me what was in it that i was allergic to. I was asked at work if I wanted to get the covid test and said yes after researching and realized there were no ingredients that were the same between the TB test and the Covid test. My first dose was terrible and i really didnt pay attention to much to the symptoms because everyone kept saying oh it couldn’t affect you that quickly. The second dose was when i realized i had an allergy. About 2 hours after the vaccine my eyes and lips started swelling, my heart was racing, i was flushed, i had difficulty swallowing and was short of breath. I was very lucky being in the medical field and knowing what to look for i immediately took benadryl and called my doctor. Luckily i was able to control my symptoms at home, but i was terrified. Noone really knew what to do. After researching the allergy my whole life made sense. Doctors always told me I was lactose intolerant. I had a reaction to eyelash glue, every medication I’ve ever had a reaction too had these ingredients. It’s a shame this is such an underdiagnosed allergy.
I recently came across the importance of recognizing polysorbate allergy.
I perform clinical research. A potential participant had, in the past, a instant total body rash after and intra-articular injection of Depo medrol and benzocaine. I was curious to see if she may be allergic to the incipient (exclusionary of course) and was concerned there might be the same incipient in the Investigational product. Sure enough, both medications had polysorbate 80 in them.
Fortunately, the patient had been treated with Dupixent, a biological eczema drug. She was getting that every two weeks and tolerating it fine. It had polysorbate 80 in it, so I could be confident she did not have a polysorbate allergy.
She was looking forward to participating in the research very much and this allowed her to participate.
I’m independently researching the ingredients in the new Covid19 vaccine and was happy to come across this article from 2019. The ingredient in the new vaxx that sticks out to me (besides the obvious mRNA spike protein) is the polyethylene glycol. With several people having anaphylactic reactions to this new vaccine, I’m wondering if it can be from PEG?
I’ve been diagnosed with allergy to polysorbate 80. I want a covid vaccine. Mr dr told me getting covid will be worse than a reaction to the vaccine. Advice for me ? I’ve had reactions to 2 shots with polysorbate 80.
So it is my problem as well. What do we do? I was looking the internet trying to find out if there was any reason to see an allergist. Can they treat someone with this allergy? My doctor suggested I try to find someone to help me, as they would have to search the internet to.
I have a PEG anaphylactic response, tested positive to 3350 at John’s Hopkins. I have, over the years, made this issue known to the FDA, the NIH, Congress, and of course all of my treating physicians. My research indicates a growing percentage of the population has antibodies to PEG. It is a very big problem because of PEG’s ubiquity. Hospitals are not prepared to treat patients with such allergies. I needed surgery due to a snapped quadriceps tendon. I very nearly could not find a hospital to conduct it because if my allergy. As some e cigarettes use PEG as a fluid emulsifier, I have to very careful in public to avoid vapor’s. My doctor will only say, I want to prescribe you this, but you check it for PEG. As it is considered biologically inert/inactive, drug makers in many cases are not required to label it. Now I find out that one of the top contenders for a SARS Cov2 vaccine uses pegylated lipid nanoparticles to deliver the mRNA to cause cells to produce the spike protein antigen. The use of PEG in the field of medicine and pharmacology is both widespread and bug business. This is a huge problem for me, and a growing problem for our entire population.
Mr. Harold, it seems that your prediction in May about the “use of PEG in the field of medicine…is a huge problem for me and a growing problem for our entire population” was a correct analysis. If world governments had listened to you, then perhaps they could’ve saved those people a traumatic scare and an epipen injection who have now had anaphylactic reactions to the recently approved SARS CoV2 vaccine. The world may be more apt to listen now.