COVID-19-Impfungen von Patienten mit Allergien und Typ2-entzündlichen Erkrankungen bei gleichzeitiger Antikörpertherapie (Biologika) – Ein Positionspapier der Deutschen Gesellschaft für Allergologie und Klinische Immunologie (DGAKI) u

Background: After the beginning and during the worldwide pandemic caused by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), patients with allergic and atopic diseases have felt and still feel insecure Currently, four vaccines against SARS-CoV-2 have been approved by the Paul Ehrlich Institute in Germany, and vaccination campaigns have been started nationwide In this respect, it is of utmost importance to give recommendations on possible immunological interactions and potential risks of immunomodulatory substances (monoclonal antibodies, biologicals) during concurrent vaccination with the approved vaccines Methods: This position paper provides specific recommendations on the use of immunomodulatory drugs in the context of concurrent SARS-CoV-2 vaccinations based on current literature Results: The recommendations are covering the following conditions in which biologicals are indicated and approved: i) chronic inflammatory skin diseases (atopic dermatitis, chronic spontaneous urticaria), ii) bronchial asthma, and iii) chronic rhinosinusitis with nasal polyps (CRSwNP) Patients with atopic dermatitis or chronic spontaneous urticaria are not at increased risk for allergic reactions after COVID-19 vaccination Nevertheless, vaccination may result in transient eczema exacerbation due to general immune stimulation Vaccination in patients receiving systemic therapy with biologicals can be performed Patients with severe asthma and concomitant treatment with biologicals also do not have an increased risk of allergic reaction following COVID-19 vaccination which is recommended in these patients Patients with CRSwNP are also not known to be at increased risk for allergic vaccine reactions, and continuation or initiation of a treatment with biologicals is also recommended with concurrent COVID-19 vaccination In general, COVID-19 vaccination should be given within the interval between two applications of the respective biological, that is, with a time-lag of at least 1 week after the previous or at least 1 week before the next biological treatment planned Conclusion: Biologicals for the treatment of atopic dermatitis, chronic spontaneous urticaria, bronchial asthma, and CRSwNP should be continued during the current COVID-19 vaccination campaigns However, the intervals of biological treatment may need to be slightly adjusted (DGAKI/AeDA recommendations as of March 22, 2021) © 2021 Dustri-Verlag Dr Karl Feistle