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