Features of chronic urticaria after COVID-19 mRNA vaccine over time

Article Article scientifique Article Features of chronic urticaria after COVID-19 mRNA vaccine over time eng 2024-11-30 2024-11-30 author Schwab Johan Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. author Foglierini Mathilde 0000-0001-7538-4262 Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Biomedical Data Science Centre (BDSC) Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. author Pescosolido Eva Centro Pediatrico del Mendrisiotto, Mendrisio, Switzerland. author Pacheco Ines 0009-0005-4720-9658 Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. author Ruiz Buendia Gustavo 0000-0002-4935-1480 Centre of Vaccinology, University of Geneva, Geneva, Switzerland.,Translational Data Science Facility, AGORA Cancer Research Center, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland. 986154 author Madelon Natacha Centre of Vaccinology, University of Geneva, Geneva, Switzerland. 780405 Département de pathologie et immunologie (PATIM) author Pellaton Celine Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. author Banderet Véronique Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. author Ribi Camillo Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. author Bergmann Marcel Centro Pediatrico del Mendrisiotto, Mendrisio, Switzerland.,Faculty of Biomedical Science, Università della Svizzera Italiana (USI), Lugano, Switzerland.,Pediatric Allergy Unit, Department of Women, Children and Adolescents, University Hospitals of Geneva, Geneva, Switzerland. 773995 author Didierlaurent Arnauld 0000-0002-4736-9003 Centre of Vaccinology, University of Geneva, Geneva, Switzerland. 934659 Département de pathologie et immunologie (PATIM) Arnaud Didierlaurent author Fenwick Craig 0000-0002-9435-0110 Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. author Duperrex Olivier 0000-0002-0932-6846 Center for Primary Care and Public Health (Unisanté) and University of Lausanne, Lausanne, Switzerland. 91638 author Muller Yannick D 0000-0003-0513-7156 Division of Immunology and Allergy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland. Yannick.muller@chuv.ch.,Centre for Human Immunology Lausanne, Lausanne, Switzerland. Yannick.muller@chuv.ch. 254 10.1038/s43856-024-00656-y 39616213 2730-664X PMC11608360 https://www.nature.com/articles/s43856-024-00656-y Background: New onsets of chronic urticaria (CU) have been reported after repeated immunizations, mainly with the Moderna mRNA-1273 vaccine (Spikevax). This study aims to evaluate patients with CU after COVID-19 mRNA vaccination. The contribution of SARS-Cov2 infection, atopy and IgE against the vaccine was analyzed. Methods: We monitored the features of patients who developed CU after vaccination through two surveys conducted in 2022 and 2023. Fifty individuals with CU underwent blood tests, and their results were compared with individuals without a history of urticaria (N = 135). The presence of anti-vaccine IgE was tested in 185 individuals with basophil activation tests (BAT). We assessed anti-SARS-Cov2 humoral response, and the presence of IgEs against common respiratory allergens (Phadiatop) as a surrogate for atopy Results: Post-vaccination CU occurs after a median interval of 10 days and significantly more after the Spikevax booster, affecting middle-aged individuals (median 41, 66% females). In 2023, CU was still active in 53% of the cases. Inducible forms of CU, primarily dermographism, are reported in 54% (2022) and 61% (2023) of the cases. BAT positivity is not specific to CU, anti-nucleocapsid positivity, or atopy but is significantly associated with higher anti-spike neutralizing activities and younger age. Four CU patients tolerate an additional dose of mRNA vaccine with no disease exacerbation/recurrence. Conclusions: The spikevax booster induces anti-vaccine IgE independently of CU, the latter being not directly associated with COVID-19 infection nor atopy. The tolerance to a new booster in 4/4 patients suggests that the Spikevax vaccine indirectly triggers CU in predisposed individuals. Plain language summary : Urticaria is an itchy transient skin rash which can become in some cases recurrent and chronic. Repeated immunizations with COVID-19 mRNA vaccines can rarely lead to the development of chronic urticaria (CU), on average 10 days after vaccination. Here, we monitored people who developed CU after vaccination. One year following vaccination 53% of people still had CU. CU after vaccination was not directly associated with COVID infection, allergic predisposition or other effects of vaccination. Re-exposure to the vaccine was safe and well tolerated in four patients with vaccine-related CU suggesting an absence of a direct causality between the vaccine and CU. Therefore, managing CU post-vaccination should follow previously established guidelines as for other forms of CU. Dewey 616.07 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 137 Département de pathologie et immunologie 21F false 154 Pathogenèse et traitement des allergies alimentaires 191 1337 Laboratoire d'immunologie vaccinale humaine 1025 Communications medicine 4 1 01b54a76-bb9b-44b7-93ce-59d5c9973705 Article (Published version) Public Article_scientifique_from_europePmc.pdf 1147091 application/pdf CC BY-NC-ND-4.0 0230c766923b4f9e84c75371086177f146e29cfc09f37491195737810dfa65f0 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie

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Features of chronic urticaria after COVID-19 mRNA vaccine over time	Communications medicine			2024	11	520

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Ruiz Buendia, Gustavo