Safety of mRNA-based COVID-19 vaccination in paediatric patients with a PEG-asparaginase allergy

Nancy Broos; Leiah J. Brigitha; Annemieke Schuurhof; Heike Röckmann-Helmbach; Wim J.E. Tissing; Rob Pieters; Inge M. van der Sluis; Marike B. Stadermann

doi:10.1016/j.ejcped.2022.100002

Safety of mRNA-based COVID-19 vaccination in paediatric patients with a PEG-asparaginase allergy

Nancy Broos, Leiah J. Brigitha, Annemieke Schuurhof, Heike Röckmann-Helmbach, Wim J.E. Tissing, Rob Pieters, Inge M. van der Sluis, Marike B. Stadermann^*

^*Corresponding author for this work

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Abstract

Background: Children treated for a malignancy are at risk to develop serious illness from a COVID-19 infection. Pegylated E. coli asparaginase (PEG-asparaginase) is used in the treatment of acute lymphoblastic leukemia. Allergy to this drug is common and both asparaginase and polyethylene glycol (PEG) are identified as possible antigens. The mRNA-based vaccines against COVID-19 contain PEG as a stabilizing component. Methods: We developed a protocol to be able to safely vaccinate children with a PEG-asparaginase allergy. All patients with a history of allergy to PEG-asparaginase have been included and skin prick testing for various PEGs was performed before vaccination with the mRNA Pfizer-BioNTech COVID-19 vaccine. Results: Twelve children between six and 16 years old were vaccinated, without allergic reaction. None of them got a positive skin prick test for PEG. Ten patients had pre-existing IgG or IgM antibodies against PEG. Conclusion: Children with a PEG-asparaginase allergy can be safely vaccinated against COVID-19 with mRNA vaccines containing PEG irrespective of IgG/IgM antibodies to PEG-asparaginase. Routine skin prick testing in patients with PEG-asparaginase allergy does not seem to be of added value.

Original language	English
Article number	100002
Journal	EJC Paediatric Oncology
Volume	1
DOIs	https://doi.org/10.1016/j.ejcped.2022.100002
Publication status	Published - Jan 2023

Keywords

Allergy
Antibodies
COVID-19 vaccine
Paediatric
PEG-Asparaginase
Polyethylene glycol

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PIIS2772610X22000022Final published version, 500 KBLicence: CC BY-NC-ND

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@article{13241128ec3b424aa88857a58648de61,

title = "Safety of mRNA-based COVID-19 vaccination in paediatric patients with a PEG-asparaginase allergy",

abstract = "Background: Children treated for a malignancy are at risk to develop serious illness from a COVID-19 infection. Pegylated E. coli asparaginase (PEG-asparaginase) is used in the treatment of acute lymphoblastic leukemia. Allergy to this drug is common and both asparaginase and polyethylene glycol (PEG) are identified as possible antigens. The mRNA-based vaccines against COVID-19 contain PEG as a stabilizing component. Methods: We developed a protocol to be able to safely vaccinate children with a PEG-asparaginase allergy. All patients with a history of allergy to PEG-asparaginase have been included and skin prick testing for various PEGs was performed before vaccination with the mRNA Pfizer-BioNTech COVID-19 vaccine. Results: Twelve children between six and 16 years old were vaccinated, without allergic reaction. None of them got a positive skin prick test for PEG. Ten patients had pre-existing IgG or IgM antibodies against PEG. Conclusion: Children with a PEG-asparaginase allergy can be safely vaccinated against COVID-19 with mRNA vaccines containing PEG irrespective of IgG/IgM antibodies to PEG-asparaginase. Routine skin prick testing in patients with PEG-asparaginase allergy does not seem to be of added value.",

keywords = "Allergy, Antibodies, COVID-19 vaccine, Paediatric, PEG-Asparaginase, Polyethylene glycol",

author = "Nancy Broos and Brigitha, {Leiah J.} and Annemieke Schuurhof and Heike R{\"o}ckmann-Helmbach and Tissing, {Wim J.E.} and Rob Pieters and {van der Sluis}, {Inge M.} and Stadermann, {Marike B.}",

note = "Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2023",

month = jan,

doi = "10.1016/j.ejcped.2022.100002",

language = "English",

volume = "1",

journal = "EJC Paediatric Oncology",

issn = "2772-610X",

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T1 - Safety of mRNA-based COVID-19 vaccination in paediatric patients with a PEG-asparaginase allergy

AU - Broos, Nancy

AU - Brigitha, Leiah J.

AU - Schuurhof, Annemieke

AU - Röckmann-Helmbach, Heike

AU - Tissing, Wim J.E.

AU - Pieters, Rob

AU - van der Sluis, Inge M.

AU - Stadermann, Marike B.

PY - 2023/1

Y1 - 2023/1

N2 - Background: Children treated for a malignancy are at risk to develop serious illness from a COVID-19 infection. Pegylated E. coli asparaginase (PEG-asparaginase) is used in the treatment of acute lymphoblastic leukemia. Allergy to this drug is common and both asparaginase and polyethylene glycol (PEG) are identified as possible antigens. The mRNA-based vaccines against COVID-19 contain PEG as a stabilizing component. Methods: We developed a protocol to be able to safely vaccinate children with a PEG-asparaginase allergy. All patients with a history of allergy to PEG-asparaginase have been included and skin prick testing for various PEGs was performed before vaccination with the mRNA Pfizer-BioNTech COVID-19 vaccine. Results: Twelve children between six and 16 years old were vaccinated, without allergic reaction. None of them got a positive skin prick test for PEG. Ten patients had pre-existing IgG or IgM antibodies against PEG. Conclusion: Children with a PEG-asparaginase allergy can be safely vaccinated against COVID-19 with mRNA vaccines containing PEG irrespective of IgG/IgM antibodies to PEG-asparaginase. Routine skin prick testing in patients with PEG-asparaginase allergy does not seem to be of added value.

AB - Background: Children treated for a malignancy are at risk to develop serious illness from a COVID-19 infection. Pegylated E. coli asparaginase (PEG-asparaginase) is used in the treatment of acute lymphoblastic leukemia. Allergy to this drug is common and both asparaginase and polyethylene glycol (PEG) are identified as possible antigens. The mRNA-based vaccines against COVID-19 contain PEG as a stabilizing component. Methods: We developed a protocol to be able to safely vaccinate children with a PEG-asparaginase allergy. All patients with a history of allergy to PEG-asparaginase have been included and skin prick testing for various PEGs was performed before vaccination with the mRNA Pfizer-BioNTech COVID-19 vaccine. Results: Twelve children between six and 16 years old were vaccinated, without allergic reaction. None of them got a positive skin prick test for PEG. Ten patients had pre-existing IgG or IgM antibodies against PEG. Conclusion: Children with a PEG-asparaginase allergy can be safely vaccinated against COVID-19 with mRNA vaccines containing PEG irrespective of IgG/IgM antibodies to PEG-asparaginase. Routine skin prick testing in patients with PEG-asparaginase allergy does not seem to be of added value.

KW - Allergy

KW - Antibodies

KW - COVID-19 vaccine

KW - Paediatric

KW - PEG-Asparaginase

KW - Polyethylene glycol

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ER -

Safety of mRNA-based COVID-19 vaccination in paediatric patients with a PEG-asparaginase allergy

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