Diagnostic accuracy of vaccine and vaccine excipient testing in the setting of allergic reactions to COVID-19 vaccines: A systematic review and meta-analysis
dc.contributor.author | Greenhawt, Matthew | |
dc.contributor.author | Shaker, Marcus | |
dc.contributor.author | Golden, David B. K. | |
dc.contributor.author | Abrams, Elissa M. | |
dc.contributor.author | Blumenthal, Kimberly G. | |
dc.contributor.author | Wolfson, Anna R. | |
dc.contributor.author | Stone, Cosby A. | |
dc.contributor.author | Krantz, Matthew S. | |
dc.contributor.author | Chu, Derek K. | |
dc.contributor.author | Dwamena, Ben A. | |
dc.date.accessioned | 2023-01-11T16:22:08Z | |
dc.date.available | 2024-02-11 11:22:06 | en |
dc.date.available | 2023-01-11T16:22:08Z | |
dc.date.issued | 2023-01 | |
dc.identifier.citation | Greenhawt, Matthew; Shaker, Marcus; Golden, David B. K.; Abrams, Elissa M.; Blumenthal, Kimberly G.; Wolfson, Anna R.; Stone, Cosby A.; Krantz, Matthew S.; Chu, Derek K.; Dwamena, Ben A. (2023). "Diagnostic accuracy of vaccine and vaccine excipient testing in the setting of allergic reactions to COVID-19 vaccines: A systematic review and meta-analysis." Allergy (1): 71-83. | |
dc.identifier.issn | 0105-4538 | |
dc.identifier.issn | 1398-9995 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/175406 | |
dc.description.abstract | For persons with immediate allergic reactions to mRNA COVID-19 vaccines, skin testing (ST) to the vaccine/excipients (polyethylene glycol[PEG] and polysorbate 80 [PS]) has been recommended, but has unknown accuracy. To assess vaccine/excipient ST accuracy in predicting all-severity immediate allergic reactions upon re-vaccination, systematic review was performed searching Medline, EMBASE, Web of Science, and the WHO global coronavirus database (inception-Oct 4, 2021) for studies addressing immediate (≤4 h post-vaccination) all-severity allergic reactions to 2nd mRNA COVID-19 vaccination in persons with 1st dose immediate allergic reactions. Cases evaluating delayed reactions, change of vaccine platform, or revaccination without vaccine/excipient ST were excluded. Meta-analysis of diagnostic testing accuracy was performed using Bayesian methods. The GRADE approach evaluated certainty of the evidence, and QUADAS-2 assessed risk of bias. Among 20 studies of mRNA COVID-19 first dose vaccine reactions, 317 individuals underwent 578 ST to any one or combination of vaccine, PEG, or PS, and were re-vaccinated with the same vaccine. Test sensitivity for either mRNA vaccine was 0.2 (95%CrI 0.01–0.52) and specificity 0.97 (95%CrI 0.9–1). PEG test sensitivity was 0.02 (95%CrI 0.00–0.07) and specificity 0.99 (95%CrI 0.96–1). PS test sensitivity was 0.03 (95%CrI 0.00–0.0.11) and specificity 0.97 (95%CrI 0.91–1). Combined for use of any of the 3 testing agents, sensitivity was 0.03 (95%CrI 0.00–0.08) and specificity was 0.98 (95%CrI 0.95–1.00). Certainty of evidence was moderate. ST has low sensitivity but high specificity in predicting all-severity repeat immediate allergic reactions to the same agent, among persons with 1st dose immediate allergic reactions to mRNA COVID-19 vaccines. mRNA COVID-19 vaccine or excipient ST has limited risk assessment utility. | |
dc.publisher | Chapman & Hall/CRC | |
dc.publisher | Wiley Periodicals, Inc. | |
dc.subject.other | test sensitivity | |
dc.subject.other | test specificity | |
dc.subject.other | mRNA COVID-19 vaccine | |
dc.subject.other | allergic reactions | |
dc.subject.other | COVID-19 | |
dc.title | Diagnostic accuracy of vaccine and vaccine excipient testing in the setting of allergic reactions to COVID-19 vaccines: A systematic review and meta-analysis | |
dc.type | Article | |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Microbiology and Immunology | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175406/1/all15571-sup-0003-supplementaryfigureE2.pdf | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175406/2/all15571-sup-0002-supplementaryfigureE1.pdf | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175406/3/all15571_am.pdf | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175406/4/all15571.pdf | |
dc.identifier.doi | 10.1111/all.15571 | |
dc.identifier.source | Allergy | |
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dc.working.doi | NO | en |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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