Management of anaphylaxis due to COVID‐19 vaccines in the elderly
Authors: Bousquet Jean , Agache Ioana , Blain Hubert , Jutel Marek , Ventura Maria Teresa , Worm Margitta , Del Giacco Stefano , Benetos Athanasios , Bilo Beatrice Maria , Czarlewski Wienczyslawa , Abdul Latiff Amir Hamzah , Al‐Ahmad Mona , Angier Elizabeth , Annesi‐Maesano Isabella , Atanaskovic‐Markovic Marina , Bachert Claus , Barbaud Annick , Bedbrook Anna , Bennoor Kazi S. , Berghea Elena Camelia , Bindslev‐Jensen Carsten , Bonini Sergio , Bosnic‐Anticevich Sinthia , Brockow Knut , Brussino Luisa , Camargos Paulo , Canonica G. Walter , Cardona Victoria , Carreiro‐Martins Pedro , Carriazo Ana , Casale Thomas , Caubet Jean‐Christoph , Cecchi Lorenzo , Cherubini Antonio , Christoff George , Chu Derek K. , Cruz Alvaro A. , Dokic Dejan , El‐Gamal† Yehia , Ebisawa Motohiro , Eberlein Bernadette , Farrell John , Fernandez‐Rivas Montserrat , Fokkens Wytske J. , Fonseca Joao A. , Gao Yadong , Gavazzi Gaëtan , Gawlik Radoslaw , Gelincik Asli , Gemicioğlu Bilun , Gotua Maia , Guérin Olivier , Haahtela Tari , Hoffmann‐Sommergruber Karin , Hoffmann Hans Jürgen , Hofmann Maja , Hrubisko Martin , Illario Maddalena , Irani Carla , Ispayeva Zhanat , Ivancevich Juan Carlos , Julge Kaja , Kaidashev Igor , Khaitov Musa , Knol Edward , Kraxner Helga , Kuna Piotr , Kvedariene Violeta , Lauerma Antti , Le Lan T. T. , Le Moing Vincent , Levin Michael , Louis Renaud , Lourenco Olga , Mahler Vera , Martin Finbarr C. , Matucci Andrea , Milenkovic Branislava , Miot Stéphanie , Montella Emma , Morais‐Almeida Mario , Mortz Charlotte G. , Mullol Joaquim , Namazova‐Baranova Leyla , Neffen Hugo , Nekam Kristof , Niedoszytko Marek , Odemyr Mikaëla , O’Hehir Robyn E. , Okamoto Yoshitaka , Ollert Markus , Palomares Oscar , Papadopoulos Nikolaos G. , Panzner Petr , Passalacqua Giovanni , Patella Vincenzo , Petrovic Mirko , Pfaar Oliver , Pham‐Thi Nhân , Plavec Davor , Popov Todor A. , Recto Marysia T. , Regateiro Frederico S. , Reynes Jacques , Roller‐Winsberger Regina E. , Rolland Yves , Romano Antonino , Rondon Carmen , Rottem Menachem , Rouadi Philip W. , Salles Nathalie , Samolinski Boleslaw , Santos Alexandra F. , S Sarquis Faradiba , Sastre Joaquin , M. G. A. Schols Jos , Scichilone Nicola , Sediva Anna , Shamji Mohamed H. , Sheikh Aziz , Skypala Isabel , Smolinska Sylwia , Sokolowska Milena , Sousa‐Pinto Bernardo , Sova Milan , Stelmach Rafael , Sturm Gunter , Suppli Ulrik Charlotte , Todo‐Bom Ana Maria , Toppila‐Salmi Sanna , Tsiligianni Ioanna , Torres Maria , Untersmayr Eva , Urrutia Pereira Marilyn , Valiulis Arunas , Vitte Joana , Vultaggio Alessandra , Wallace Dana , Walusiak‐Skorupa Jolanta , Wang De‐Yun , Waserman Susan , Yorgancioglu Arzu , Yusuf Osman M. , Zernotti Mario , Zidarn Mihaela , Chivato Tomas , Akdis Cezmi A. , Zuberbier Torsten , Klimek Ludger 
Published: April 2021

Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID‐19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID‐19 vaccines due to high risk of death. In very rare instances, the COVID‐19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA‐EAACI‐EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID‐19 vaccines. Anaphylaxis to COVID‐19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.