COVID-19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations

Marek Jutel; Maria J. Torres; Oscar Palomares; Cezmi A. Akdis; Thomas Eiwegger; Eva Untersmayr; Domingo Barber; Magdalena Zemelka-Wiacek; Anna Kosowska; Elizabeth Palmer; Stefan Vieths; Vera Mahler; Walter G. Canonica; Kari Nadeau; Mohamed H. Shamji; Ioana Agache; Mubeccel Akdis; Musa Khaitov; Alberto Alvarez-Perea; Montserrat Alvaro-Lozano; Marina Atanaskovic-Markovic; Vibeke Backer; Annick Barbaud; Sevim Bavbek; Frederic de Blay; Matteo Bonini; Sergio Bonini; Job F.M. van Boven; Knut Brockow; Mario Cazzola; Alexia Chatzipetrou; Tomas Chivato; Antonella Cianferoni; Jonathan Corren; Jean Cristoph-Caubet; Audrey Dunn-Galvin; Motohiro Ebisawa; Davide Firinu; Radoslaw Gawlik; Asli Gelincik; Stefano del Giacco; Charlotte G. Mortz; Hans Jürgen Hoffmann; Karin Hoffmann-Sommergruber; Ludger Klimek; Edward Knol; Antti Lauerma; Luis Pérez de Llano; Andrea Matucci; Rosan Meyer; André Moreira; Hideaki Morita; Sarita U. Patil; Oliver Pfaar; Florin Dan Popescu; Victoria del Pozo; Oliver J. Price; Ronald van Ree; Montserrat Fernández-Rivas; Barbara Rogala; Antonino Romano; Alexandra Santos; Ana Sediva; Isabel Skypala; Sylwia Smolinska; Milena Sokolowska; Gunter Sturm; Alessandra Vultaggio; Jolanta Walusiak-Skorupa; Margitta Worm

doi:10.1111/all.15252

COVID-19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations

Marek Jutel, Maria J. Torres, Oscar Palomares, Cezmi A. Akdis, Thomas Eiwegger, Eva Untersmayr, Domingo Barber, Magdalena Zemelka-Wiacek, Anna Kosowska, Elizabeth Palmer, Stefan Vieths, Vera Mahler, Walter G. Canonica, Kari Nadeau, Mohamed H. Shamji^*, Ioana Agache, Mubeccel Akdis, Musa Khaitov, Alberto Alvarez-Perea, Montserrat Alvaro-LozanoMarina Atanaskovic-Markovic, Vibeke Backer, Annick Barbaud, Sevim Bavbek, Frederic de Blay, Matteo Bonini, Sergio Bonini, Job F.M. van Boven, Knut Brockow, Mario Cazzola, Alexia Chatzipetrou, Tomas Chivato, Antonella Cianferoni, Jonathan Corren, Jean Cristoph-Caubet, Audrey Dunn-Galvin, Motohiro Ebisawa, Davide Firinu, Radoslaw Gawlik, Asli Gelincik, Stefano del Giacco, Charlotte G. Mortz, Hans Jürgen Hoffmann, Karin Hoffmann-Sommergruber, Ludger Klimek, Edward Knol, Antti Lauerma, Luis Pérez de Llano, Andrea Matucci, Rosan Meyer, André Moreira, Hideaki Morita, Sarita U. Patil, Oliver Pfaar, Florin Dan Popescu, Victoria del Pozo, Oliver J. Price, Ronald van Ree, Montserrat Fernández-Rivas, Barbara Rogala, Antonino Romano, Alexandra Santos, Ana Sediva, Isabel Skypala, Sylwia Smolinska, Milena Sokolowska, Gunter Sturm, Alessandra Vultaggio, Jolanta Walusiak-Skorupa, Margitta Worm

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

Immune modulation is a key therapeutic approach for allergic diseases, asthma and autoimmunity. It can be achieved in an antigen-specific manner via allergen immunotherapy (AIT) or in an endotype-driven approach using biologicals that target the major pathways of the type 2 (T2) immune response: immunoglobulin (Ig)E, interleukin (IL)-5 and IL-4/IL-13 or non-type 2 response: anti-cytokine antibodies and B-cell depletion via anti-CD20. Coronavirus disease 2019 (COVID-19) vaccination provides an excellent opportunity to tackle the global pandemics and is currently being applied in an accelerated rhythm worldwide. The vaccine exerts its effects through immune modulation, induces and amplifies the response against the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Thus, as there may be a discernible interference between these treatment modalities, recommendations on how they should be applied in sequence are expected. The European Academy of Allergy and Clinical Immunology (EAACI) assembled an expert panel under its Research and Outreach Committee (ROC). This expert panel evaluated the evidence and have formulated recommendations on the administration of COVID-19 vaccine in patients with allergic diseases and asthma receiving AIT or biologicals. The panel also formulated recommendations for COVID-19 vaccine in association with biologicals targeting the type 1 or type 3 immune response. In formulating recommendations, the panel evaluated the mechanisms of COVID-19 infection, of COVID-19 vaccine, of AIT and of biologicals and considered the data published for other anti-infectious vaccines administered concurrently with AIT or biologicals.

Original language	English
Pages (from-to)	2313-2336
Number of pages	24
Journal	Allergy: European Journal of Allergy and Clinical Immunology
Volume	77
Issue number	8
DOIs	https://doi.org/10.1111/all.15252
Publication status	Published - Aug 2022

Keywords

allergen
allergy
biologicals
Covid-19
immunotherapy
mRNA vaccines

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/all.15252

Cite this

Jutel, M., Torres, M. J., Palomares, O., Akdis, C. A., Eiwegger, T., Untersmayr, E., Barber, D., Zemelka-Wiacek, M., Kosowska, A., Palmer, E., Vieths, S., Mahler, V., Canonica, W. G., Nadeau, K., Shamji, M. H., Agache, I., Akdis, M., Khaitov, M., Alvarez-Perea, A., ... Worm, M. (2022). COVID-19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations. Allergy: European Journal of Allergy and Clinical Immunology, 77(8), 2313-2336. https://doi.org/10.1111/all.15252

@article{73026c67fbe04c9083fbfa7d592c76ad,

title = "COVID-19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations",

abstract = "Immune modulation is a key therapeutic approach for allergic diseases, asthma and autoimmunity. It can be achieved in an antigen-specific manner via allergen immunotherapy (AIT) or in an endotype-driven approach using biologicals that target the major pathways of the type 2 (T2) immune response: immunoglobulin (Ig)E, interleukin (IL)-5 and IL-4/IL-13 or non-type 2 response: anti-cytokine antibodies and B-cell depletion via anti-CD20. Coronavirus disease 2019 (COVID-19) vaccination provides an excellent opportunity to tackle the global pandemics and is currently being applied in an accelerated rhythm worldwide. The vaccine exerts its effects through immune modulation, induces and amplifies the response against the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Thus, as there may be a discernible interference between these treatment modalities, recommendations on how they should be applied in sequence are expected. The European Academy of Allergy and Clinical Immunology (EAACI) assembled an expert panel under its Research and Outreach Committee (ROC). This expert panel evaluated the evidence and have formulated recommendations on the administration of COVID-19 vaccine in patients with allergic diseases and asthma receiving AIT or biologicals. The panel also formulated recommendations for COVID-19 vaccine in association with biologicals targeting the type 1 or type 3 immune response. In formulating recommendations, the panel evaluated the mechanisms of COVID-19 infection, of COVID-19 vaccine, of AIT and of biologicals and considered the data published for other anti-infectious vaccines administered concurrently with AIT or biologicals.",

keywords = "allergen, allergy, biologicals, Covid-19, immunotherapy, mRNA vaccines",

author = "Marek Jutel and Torres, {Maria J.} and Oscar Palomares and Akdis, {Cezmi A.} and Thomas Eiwegger and Eva Untersmayr and Domingo Barber and Magdalena Zemelka-Wiacek and Anna Kosowska and Elizabeth Palmer and Stefan Vieths and Vera Mahler and Canonica, {Walter G.} and Kari Nadeau and Shamji, {Mohamed H.} and Ioana Agache and Mubeccel Akdis and Musa Khaitov and Alberto Alvarez-Perea and Montserrat Alvaro-Lozano and Marina Atanaskovic-Markovic and Vibeke Backer and Annick Barbaud and Sevim Bavbek and {de Blay}, Frederic and Matteo Bonini and Sergio Bonini and {van Boven}, {Job F.M.} and Knut Brockow and Mario Cazzola and Alexia Chatzipetrou and Tomas Chivato and Antonella Cianferoni and Jonathan Corren and Jean Cristoph-Caubet and Audrey Dunn-Galvin and Motohiro Ebisawa and Davide Firinu and Radoslaw Gawlik and Asli Gelincik and {del Giacco}, Stefano and Mortz, {Charlotte G.} and {J{\"u}rgen Hoffmann}, Hans and Karin Hoffmann-Sommergruber and Ludger Klimek and Edward Knol and Antti Lauerma and {de Llano}, {Luis P{\'e}rez} and Andrea Matucci and Rosan Meyer and Andr{\'e} Moreira and Hideaki Morita and Patil, {Sarita U.} and Oliver Pfaar and Popescu, {Florin Dan} and {del Pozo}, Victoria and Price, {Oliver J.} and {van Ree}, Ronald and Montserrat Fern{\'a}ndez-Rivas and Barbara Rogala and Antonino Romano and Alexandra Santos and Ana Sediva and Isabel Skypala and Sylwia Smolinska and Milena Sokolowska and Gunter Sturm and Alessandra Vultaggio and Jolanta Walusiak-Skorupa and Margitta Worm",

note = "Funding Information: Dr Jutel reports personal fees from ALK‐Abello, Allergopharma, Stallergenes, Anergis, Allergy Therapeutics, Leti and HAL during the conduct of the study; personal fees from GSK, Novartis, Teva, Takeda and Chiesi outside the submitted work. Dr Torres reports personal fees (report consultancies and speaker bureau) from Diater, Aimmune Therapeutics and Leti laboratories, grants from European Commission, MINECO and ISCIII of Spanish Government and SEAIC outside the submitted work. Dr. Palomares received research grants from Inmunotek S.L., Novartis and MINECO and fees for giving scientific lectures or participation in Advisory Boards from: Allergy Therapeutics, Amgen, AstraZeneca, Diater, GlaxoSmithKline, S.A, Inmunotek S.L, Novartis, Sanofi‐Genzyme and Stallergenes. Dr. Akdis reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine K{\"u}hne‐Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, Glakso Smith‐Kline and others from Sanofi & Regeneron. Dr. Eiwegger reports other from DBV, grants from Innovation fund Denmark, CIHR, other from Regeneron. He is the Co‐I or scientific lead in three investigator initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program Sickkids and CIHR. He serves as associate editor for Allergy. He is on the advisory board for ALK. Dr. Barber reports personal fees from ALK, AIMMUNE and grants from ALK, ALLERO THERAPEUTICS outside the submitted work. Dr. Vieths reports personal fees from Schattauer Allergologie Handbuch, Elsevier Nahrungsmittelallergien und Intoleranzen, Karger Food Allergy: Molecular Basis and Clinical Practice and non‐financial support from German Research Foundation, the European Directorate for the Quality of Medicines and Health Care, European Academy of Allergy and Clinical Immunology, the German Chemical Society (GDCh), AKM Allergiekongress, International Union of Immunological Societies, and the Spanish Society for Allergy and Clinical Immunology (SEAIC), outside the submitted work. Dr. Mahler has nothing to disclose. Disclaimer: The views expressed in this review are the personal views of the author and may not be understood or quoted as being made on behalf of or reflecting the position of the respective national competent authorities, the European Medicines Agency, or one of its committees or working parties. Dr. Nadeau reports grants from National Institute of Allergy and Infectious Diseases (NIAID), National Heart, Lung, and Blood Institute (NHLBI), National Institute of Environmental Health Sciences (NIEHS), and Food Allergy Research & Education (FARE); Director of World Allergy Organization (WAO), Advisor at Cour Pharma, co‐founder of Before Brands, Alladapt, Latitude, and IgGenix; and Nartional Scientific Committee member at Immune Tolerance Network (ITN), and National Institutes of Health (NIH) clinical research centres, outside the submitted work. In addition, Dr. Nadeau has the following patents: {\textquoteleft}Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy{\textquoteright}, (with royalties paid to Before Brands and Alladapt), {\textquoteleft}Granulocyte‐based methods for detecting and monitoring immune system disorders{\textquoteright}, (issued), {\textquoteleft}Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders,{\textquoteright} (issued), {\textquoteleft}Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation{\textquoteright}, (pending). Dr. Agache reports and Associate Editor Allergy and CTA. Dr. Alvaro Lozano reports personal fees from Allergy Therapeutics, LETI, Mead Johnson, Nestle, Uriach, Faes Pharma, Sanofi and Novartis outside the submitted work. Dr. de BLAY reports other from Novartis, other from ALK, other from Stallerg{\`e}nes, other from Regeneron, other from DBV, other from Sanofi, other from Boehringer, other from AstraZeneca, outside the submitted work. Dr. van Boven reports grants from AstraZeneca, grants and personal fees from Boehringer Ingelheim, grants and personal fees from Chiesi, personal fees from GSK, personal fees from Menarini, personal fees from Novartis, grants and personal fees from Trudell Medical, personal fees from Teva outside the submitted work and all paid to his institution. Dr. CHATZIPETROU reports personal fees from AstraZeneca outside the submitted work. Dr. Mortz reports grants from Research grant from Novartis outside the submitted work. Dr. Klimek reports grants and personal fees from Allergopharma, Sanofi LETI Pharma and MEDA/Mylan, personal fees from HAL Allergie, Cassella med and Allergy Therapeutic, grants from ALK‐Abello, Stallergenes, Quintiles, ASIT biotech, Lofarma AstraZeneca, GSK, Inmunotek outside the submitted work; Membership at AeDA, DGHNO, Deutsche Akademie f{\"u}r Allergologie und klinische Immunologie, HNO‐BV, GPA, EAACI. Dr. P{\'e}rez de Llano reports grants, personal fees and non‐financial support from AstraZeneca, personal fees and non‐financial support from GSK, grants and personal fees from TEVA, personal fees and non‐financial support from Novartis, personal fees and non‐financial support from Chiesi, personal fees from Sanofi, personal fees from Menarini, grants and personal fees from Esteve, personal fees from ROVI, personal fees from MSD, personal fees from TECHDOW PHARMA, non‐financial support from FAES outside the submitted work. Dr. Pfaar reports grants and personal fees from ALK‐Abell{\'o}, Allergopharma, Stallergenes Greer, HAL Allergy Holding B.V./HAL Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, ASIT Biotech Tools S.A, Laboratorios LETI/LETI Pharma, GSK, Anergis S.A, MEDA Pharma/MYLAN and grants from Biomay, Circassia, Pohl‐Boskamp, Inmunotek S.L and personal fees from Mobile Chamber Experts (a GA2LEN Partner) Indoor Biotechnologies, personal fees from Astellas Pharma Global, EUFOREA, ROXALL Medizin, Novartis, Sanofi‐Aventis and Sanofi‐Genzyme, Med Update Europe GmbH, streamedup! GmbH, John Wiley and Sons, AS, Paul‐Martini‐Stiftung (PMS), Ingress‐Health HWM, Regeneron Pharmaceuticals Inc. outside the submitted work. Dr. Meyer reports personal fees and other from Danone/Nutricia, personal fees from Mead Johnson, other from Nestle, personal fees from Abbott, outside the submitted work. Dr. DEL POZO reports grants and personal fees from AstraZeneca, personal fees from GSK outside the submitted work. Dr. van Ree reports personal fees from HAL Allergy BV, Citeq BV, Angany Inc. and Thermo Fisher Scientific outside the submitted work. Dr. Fernandez‐Rivas reports grants from ISCIII (Spanish Government), personal fees from Aimmune, DBV, Novartis, SPRIM, grants from Aimmune, Diater, personal fees from Aimmune, ALK, Allergy Therapeutics, Diater, GSK, Thermo Fisher outside the submitted work. Dr. Santos reports grants and personal fees from Medical Research Council, grants from Asthma UK, Food Allergy Research Education, National Institute for Allergy and Infectious Diseases, non‐financial support from National Institute for Health Research, non‐financial support from Thermofisher; Buhlmann, personal fees from Thermofisher, Buhlmann, Infomed, Nutricia, Nestle, personal fees from Allergy Therapeutics, Novartis, IgGenix, Stallergenes, outside the submitted work. Dr. Sediva reports personal fees from Octapharma, Takeda and CSL Behring outside the submitted work. Dr. Sokolowska reports grants from Swiss National Science Foundation and Novartis outside the submitted work. Dr. Worm reports other from Regeneron Pharmaceuticals, other from DBV Technologies S.A, other from Stallergenes GmbH, other from HAL Allergie GmbH, other from Bencard Allergie GmbH, other from Allergopharma GmbH & Co. KG, other from ALK‐Abell{\'o} Arzneimittel GmbH, other from Mylan Germany GmbH, other from Leo Pharma GmbH, other from Sanofi‐Aventis Deutschland GmbH, other from Aimmune Therapeutics UK Limited, other from Actelion Pharmaceuticals Deutschland GmbH, other from Novartis AG, other from Biotest AG, other from AbbVie Deutschland GmbH & Co. KG, other from Lilly Deutschland GmbH, outside the submitted work. G. Sturm reports grants from ALK‐Abello, personal fees from Novartis, personal fees from Bencard, personal fees from Stallergens, personal fees from HAL, personal fees from Allergopharma, personal fees from Mylan, outside the submitted work. L. Arzt‐Gradwohl has nothing to disclose in relation to this article. JC declares grants or personal fees from AZ, Genentech/Roche, Novartis, Optinose, Sanofi, Stallergenes and TEVADr. Untersmayr, Dr Zemelka‐Wiacek, Dr Kosowska, Elizabeth Palmer, Dr Canonica, Dr Shamji, Dr Khaitov, Dr Alvarez‐Perea, Dr Atanaskovic‐Markovic, Dr Backer, Dr Barbaud, Dr M Bonini, Dr S Bonini, Dr Brockow, Dr Chivato, Dr Cianferoni, Dr Caubet, Dr DunnGalvin, Dr Ebisawa, Dr Firinu, Dr Gawlik, Dr Gelincik, Dr Hoffmann, Dr Hoffmann‐Sommergruber, Dr Knol, Dr Laurema, Dr Matucci, Dr Moreira, Dr Morita, Dr Patil, Dr Popescu, Dr Price, Dr Rogala, Dr Romano, Dr Skypala, Dr Smolinska, Dr Vultaggio, Dr Walusiak‐Skorupa, Sevim Bavbek, Mario Cazzola and Dr Del Giacco have nothing to disclose. Publisher Copyright: {\textcopyright} 2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.",

year = "2022",

month = aug,

doi = "10.1111/all.15252",

language = "English",

volume = "77",

pages = "2313--2336",

journal = "Allergy: European Journal of Allergy and Clinical Immunology",

issn = "0105-4538",

publisher = "John Wiley and sons",

number = "8",

}

Jutel, M, Torres, MJ, Palomares, O, Akdis, CA, Eiwegger, T, Untersmayr, E, Barber, D, Zemelka-Wiacek, M, Kosowska, A, Palmer, E, Vieths, S, Mahler, V, Canonica, WG, Nadeau, K, Shamji, MH, Agache, I, Akdis, M, Khaitov, M, Alvarez-Perea, A, Alvaro-Lozano, M, Atanaskovic-Markovic, M, Backer, V, Barbaud, A, Bavbek, S, de Blay, F, Bonini, M, Bonini, S, van Boven, JFM, Brockow, K, Cazzola, M, Chatzipetrou, A, Chivato, T, Cianferoni, A, Corren, J, Cristoph-Caubet, J, Dunn-Galvin, A, Ebisawa, M, Firinu, D, Gawlik, R, Gelincik, A, del Giacco, S, Mortz, CG, Jürgen Hoffmann, H, Hoffmann-Sommergruber, K, Klimek, L, Knol, E, Lauerma, A, de Llano, LP, Matucci, A, Meyer, R, Moreira, A, Morita, H, Patil, SU, Pfaar, O, Popescu, FD, del Pozo, V, Price, OJ, van Ree, R, Fernández-Rivas, M, Rogala, B, Romano, A, Santos, A, Sediva, A, Skypala, I, Smolinska, S, Sokolowska, M, Sturm, G, Vultaggio, A, Walusiak-Skorupa, J & Worm, M 2022, 'COVID-19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations', Allergy: European Journal of Allergy and Clinical Immunology, vol. 77, no. 8, pp. 2313-2336. https://doi.org/10.1111/all.15252

TY - JOUR

T1 - COVID-19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations

AU - Jutel, Marek

AU - Torres, Maria J.

AU - Palomares, Oscar

AU - Akdis, Cezmi A.

AU - Eiwegger, Thomas

AU - Untersmayr, Eva

AU - Barber, Domingo

AU - Zemelka-Wiacek, Magdalena

AU - Kosowska, Anna

AU - Palmer, Elizabeth

AU - Vieths, Stefan

AU - Mahler, Vera

AU - Canonica, Walter G.

AU - Nadeau, Kari

AU - Shamji, Mohamed H.

AU - Agache, Ioana

AU - Akdis, Mubeccel

AU - Khaitov, Musa

AU - Alvarez-Perea, Alberto

AU - Alvaro-Lozano, Montserrat

AU - Atanaskovic-Markovic, Marina

AU - Backer, Vibeke

AU - Barbaud, Annick

AU - Bavbek, Sevim

AU - de Blay, Frederic

AU - Bonini, Matteo

AU - Bonini, Sergio

AU - van Boven, Job F.M.

AU - Brockow, Knut

AU - Cazzola, Mario

AU - Chatzipetrou, Alexia

AU - Chivato, Tomas

AU - Cianferoni, Antonella

AU - Corren, Jonathan

AU - Cristoph-Caubet, Jean

AU - Dunn-Galvin, Audrey

AU - Ebisawa, Motohiro

AU - Firinu, Davide

AU - Gawlik, Radoslaw

AU - Gelincik, Asli

AU - del Giacco, Stefano

AU - Mortz, Charlotte G.

AU - Jürgen Hoffmann, Hans

AU - Hoffmann-Sommergruber, Karin

AU - Klimek, Ludger

AU - Knol, Edward

AU - Lauerma, Antti

AU - de Llano, Luis Pérez

AU - Matucci, Andrea

AU - Meyer, Rosan

AU - Moreira, André

AU - Morita, Hideaki

AU - Patil, Sarita U.

AU - Pfaar, Oliver

AU - Popescu, Florin Dan

AU - del Pozo, Victoria

AU - Price, Oliver J.

AU - van Ree, Ronald

AU - Fernández-Rivas, Montserrat

AU - Rogala, Barbara

AU - Romano, Antonino

AU - Santos, Alexandra

AU - Sediva, Ana

AU - Skypala, Isabel

AU - Smolinska, Sylwia

AU - Sokolowska, Milena

AU - Sturm, Gunter

AU - Vultaggio, Alessandra

AU - Walusiak-Skorupa, Jolanta

AU - Worm, Margitta

N1 - Funding Information: Dr Jutel reports personal fees from ALK‐Abello, Allergopharma, Stallergenes, Anergis, Allergy Therapeutics, Leti and HAL during the conduct of the study; personal fees from GSK, Novartis, Teva, Takeda and Chiesi outside the submitted work. Dr Torres reports personal fees (report consultancies and speaker bureau) from Diater, Aimmune Therapeutics and Leti laboratories, grants from European Commission, MINECO and ISCIII of Spanish Government and SEAIC outside the submitted work. Dr. Palomares received research grants from Inmunotek S.L., Novartis and MINECO and fees for giving scientific lectures or participation in Advisory Boards from: Allergy Therapeutics, Amgen, AstraZeneca, Diater, GlaxoSmithKline, S.A, Inmunotek S.L, Novartis, Sanofi‐Genzyme and Stallergenes. Dr. Akdis reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine Kühne‐Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, Glakso Smith‐Kline and others from Sanofi & Regeneron. Dr. Eiwegger reports other from DBV, grants from Innovation fund Denmark, CIHR, other from Regeneron. He is the Co‐I or scientific lead in three investigator initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program Sickkids and CIHR. He serves as associate editor for Allergy. He is on the advisory board for ALK. Dr. Barber reports personal fees from ALK, AIMMUNE and grants from ALK, ALLERO THERAPEUTICS outside the submitted work. Dr. Vieths reports personal fees from Schattauer Allergologie Handbuch, Elsevier Nahrungsmittelallergien und Intoleranzen, Karger Food Allergy: Molecular Basis and Clinical Practice and non‐financial support from German Research Foundation, the European Directorate for the Quality of Medicines and Health Care, European Academy of Allergy and Clinical Immunology, the German Chemical Society (GDCh), AKM Allergiekongress, International Union of Immunological Societies, and the Spanish Society for Allergy and Clinical Immunology (SEAIC), outside the submitted work. Dr. Mahler has nothing to disclose. Disclaimer: The views expressed in this review are the personal views of the author and may not be understood or quoted as being made on behalf of or reflecting the position of the respective national competent authorities, the European Medicines Agency, or one of its committees or working parties. Dr. Nadeau reports grants from National Institute of Allergy and Infectious Diseases (NIAID), National Heart, Lung, and Blood Institute (NHLBI), National Institute of Environmental Health Sciences (NIEHS), and Food Allergy Research & Education (FARE); Director of World Allergy Organization (WAO), Advisor at Cour Pharma, co‐founder of Before Brands, Alladapt, Latitude, and IgGenix; and Nartional Scientific Committee member at Immune Tolerance Network (ITN), and National Institutes of Health (NIH) clinical research centres, outside the submitted work. In addition, Dr. Nadeau has the following patents: ‘Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy’, (with royalties paid to Before Brands and Alladapt), ‘Granulocyte‐based methods for detecting and monitoring immune system disorders’, (issued), ‘Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders,’ (issued), ‘Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation’, (pending). Dr. Agache reports and Associate Editor Allergy and CTA. Dr. Alvaro Lozano reports personal fees from Allergy Therapeutics, LETI, Mead Johnson, Nestle, Uriach, Faes Pharma, Sanofi and Novartis outside the submitted work. Dr. de BLAY reports other from Novartis, other from ALK, other from Stallergènes, other from Regeneron, other from DBV, other from Sanofi, other from Boehringer, other from AstraZeneca, outside the submitted work. Dr. van Boven reports grants from AstraZeneca, grants and personal fees from Boehringer Ingelheim, grants and personal fees from Chiesi, personal fees from GSK, personal fees from Menarini, personal fees from Novartis, grants and personal fees from Trudell Medical, personal fees from Teva outside the submitted work and all paid to his institution. Dr. CHATZIPETROU reports personal fees from AstraZeneca outside the submitted work. Dr. Mortz reports grants from Research grant from Novartis outside the submitted work. Dr. Klimek reports grants and personal fees from Allergopharma, Sanofi LETI Pharma and MEDA/Mylan, personal fees from HAL Allergie, Cassella med and Allergy Therapeutic, grants from ALK‐Abello, Stallergenes, Quintiles, ASIT biotech, Lofarma AstraZeneca, GSK, Inmunotek outside the submitted work; Membership at AeDA, DGHNO, Deutsche Akademie für Allergologie und klinische Immunologie, HNO‐BV, GPA, EAACI. Dr. Pérez de Llano reports grants, personal fees and non‐financial support from AstraZeneca, personal fees and non‐financial support from GSK, grants and personal fees from TEVA, personal fees and non‐financial support from Novartis, personal fees and non‐financial support from Chiesi, personal fees from Sanofi, personal fees from Menarini, grants and personal fees from Esteve, personal fees from ROVI, personal fees from MSD, personal fees from TECHDOW PHARMA, non‐financial support from FAES outside the submitted work. Dr. Pfaar reports grants and personal fees from ALK‐Abelló, Allergopharma, Stallergenes Greer, HAL Allergy Holding B.V./HAL Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, ASIT Biotech Tools S.A, Laboratorios LETI/LETI Pharma, GSK, Anergis S.A, MEDA Pharma/MYLAN and grants from Biomay, Circassia, Pohl‐Boskamp, Inmunotek S.L and personal fees from Mobile Chamber Experts (a GA2LEN Partner) Indoor Biotechnologies, personal fees from Astellas Pharma Global, EUFOREA, ROXALL Medizin, Novartis, Sanofi‐Aventis and Sanofi‐Genzyme, Med Update Europe GmbH, streamedup! GmbH, John Wiley and Sons, AS, Paul‐Martini‐Stiftung (PMS), Ingress‐Health HWM, Regeneron Pharmaceuticals Inc. outside the submitted work. Dr. Meyer reports personal fees and other from Danone/Nutricia, personal fees from Mead Johnson, other from Nestle, personal fees from Abbott, outside the submitted work. Dr. DEL POZO reports grants and personal fees from AstraZeneca, personal fees from GSK outside the submitted work. Dr. van Ree reports personal fees from HAL Allergy BV, Citeq BV, Angany Inc. and Thermo Fisher Scientific outside the submitted work. Dr. Fernandez‐Rivas reports grants from ISCIII (Spanish Government), personal fees from Aimmune, DBV, Novartis, SPRIM, grants from Aimmune, Diater, personal fees from Aimmune, ALK, Allergy Therapeutics, Diater, GSK, Thermo Fisher outside the submitted work. Dr. Santos reports grants and personal fees from Medical Research Council, grants from Asthma UK, Food Allergy Research Education, National Institute for Allergy and Infectious Diseases, non‐financial support from National Institute for Health Research, non‐financial support from Thermofisher; Buhlmann, personal fees from Thermofisher, Buhlmann, Infomed, Nutricia, Nestle, personal fees from Allergy Therapeutics, Novartis, IgGenix, Stallergenes, outside the submitted work. Dr. Sediva reports personal fees from Octapharma, Takeda and CSL Behring outside the submitted work. Dr. Sokolowska reports grants from Swiss National Science Foundation and Novartis outside the submitted work. Dr. Worm reports other from Regeneron Pharmaceuticals, other from DBV Technologies S.A, other from Stallergenes GmbH, other from HAL Allergie GmbH, other from Bencard Allergie GmbH, other from Allergopharma GmbH & Co. KG, other from ALK‐Abelló Arzneimittel GmbH, other from Mylan Germany GmbH, other from Leo Pharma GmbH, other from Sanofi‐Aventis Deutschland GmbH, other from Aimmune Therapeutics UK Limited, other from Actelion Pharmaceuticals Deutschland GmbH, other from Novartis AG, other from Biotest AG, other from AbbVie Deutschland GmbH & Co. KG, other from Lilly Deutschland GmbH, outside the submitted work. G. Sturm reports grants from ALK‐Abello, personal fees from Novartis, personal fees from Bencard, personal fees from Stallergens, personal fees from HAL, personal fees from Allergopharma, personal fees from Mylan, outside the submitted work. L. Arzt‐Gradwohl has nothing to disclose in relation to this article. JC declares grants or personal fees from AZ, Genentech/Roche, Novartis, Optinose, Sanofi, Stallergenes and TEVADr. Untersmayr, Dr Zemelka‐Wiacek, Dr Kosowska, Elizabeth Palmer, Dr Canonica, Dr Shamji, Dr Khaitov, Dr Alvarez‐Perea, Dr Atanaskovic‐Markovic, Dr Backer, Dr Barbaud, Dr M Bonini, Dr S Bonini, Dr Brockow, Dr Chivato, Dr Cianferoni, Dr Caubet, Dr DunnGalvin, Dr Ebisawa, Dr Firinu, Dr Gawlik, Dr Gelincik, Dr Hoffmann, Dr Hoffmann‐Sommergruber, Dr Knol, Dr Laurema, Dr Matucci, Dr Moreira, Dr Morita, Dr Patil, Dr Popescu, Dr Price, Dr Rogala, Dr Romano, Dr Skypala, Dr Smolinska, Dr Vultaggio, Dr Walusiak‐Skorupa, Sevim Bavbek, Mario Cazzola and Dr Del Giacco have nothing to disclose. Publisher Copyright: © 2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

PY - 2022/8

Y1 - 2022/8

N2 - Immune modulation is a key therapeutic approach for allergic diseases, asthma and autoimmunity. It can be achieved in an antigen-specific manner via allergen immunotherapy (AIT) or in an endotype-driven approach using biologicals that target the major pathways of the type 2 (T2) immune response: immunoglobulin (Ig)E, interleukin (IL)-5 and IL-4/IL-13 or non-type 2 response: anti-cytokine antibodies and B-cell depletion via anti-CD20. Coronavirus disease 2019 (COVID-19) vaccination provides an excellent opportunity to tackle the global pandemics and is currently being applied in an accelerated rhythm worldwide. The vaccine exerts its effects through immune modulation, induces and amplifies the response against the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Thus, as there may be a discernible interference between these treatment modalities, recommendations on how they should be applied in sequence are expected. The European Academy of Allergy and Clinical Immunology (EAACI) assembled an expert panel under its Research and Outreach Committee (ROC). This expert panel evaluated the evidence and have formulated recommendations on the administration of COVID-19 vaccine in patients with allergic diseases and asthma receiving AIT or biologicals. The panel also formulated recommendations for COVID-19 vaccine in association with biologicals targeting the type 1 or type 3 immune response. In formulating recommendations, the panel evaluated the mechanisms of COVID-19 infection, of COVID-19 vaccine, of AIT and of biologicals and considered the data published for other anti-infectious vaccines administered concurrently with AIT or biologicals.

AB - Immune modulation is a key therapeutic approach for allergic diseases, asthma and autoimmunity. It can be achieved in an antigen-specific manner via allergen immunotherapy (AIT) or in an endotype-driven approach using biologicals that target the major pathways of the type 2 (T2) immune response: immunoglobulin (Ig)E, interleukin (IL)-5 and IL-4/IL-13 or non-type 2 response: anti-cytokine antibodies and B-cell depletion via anti-CD20. Coronavirus disease 2019 (COVID-19) vaccination provides an excellent opportunity to tackle the global pandemics and is currently being applied in an accelerated rhythm worldwide. The vaccine exerts its effects through immune modulation, induces and amplifies the response against the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Thus, as there may be a discernible interference between these treatment modalities, recommendations on how they should be applied in sequence are expected. The European Academy of Allergy and Clinical Immunology (EAACI) assembled an expert panel under its Research and Outreach Committee (ROC). This expert panel evaluated the evidence and have formulated recommendations on the administration of COVID-19 vaccine in patients with allergic diseases and asthma receiving AIT or biologicals. The panel also formulated recommendations for COVID-19 vaccine in association with biologicals targeting the type 1 or type 3 immune response. In formulating recommendations, the panel evaluated the mechanisms of COVID-19 infection, of COVID-19 vaccine, of AIT and of biologicals and considered the data published for other anti-infectious vaccines administered concurrently with AIT or biologicals.

KW - allergen

KW - allergy

KW - biologicals

KW - Covid-19

KW - immunotherapy

KW - mRNA vaccines

UR - http://www.scopus.com/inward/record.url?scp=85126729643&partnerID=8YFLogxK

U2 - 10.1111/all.15252

DO - 10.1111/all.15252

M3 - Article

C2 - 35147230

AN - SCOPUS:85126729643

SN - 0105-4538

VL - 77

SP - 2313

EP - 2336

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

IS - 8

ER -

COVID-19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations

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