COVID19 SARS Vaccinations: Systemic Allergic Reactions to SARS-CoV-2 Vaccinations

Completed · Phase 2 · Has a placebo group

Conditions studied: SARS-CoV Infection, COVID-19, Allergic Reaction, Mast Cell Disorder

In brief

Background: Allergic reactions have been reported to occur after vaccination with both the Pfizer-BioNTech COVID-19 Vaccine and Moderna COVID-19 Vaccine. Allergic reactions range from mild to severe and include life- threatening anaphylactic reactions, although no deaths have been reported with either vaccine. This study is designed with two principal aims: * To estimate the proportions of systemic allergic reactions to the Pfizer-BioNTech COVID-19 Vaccine and the Moderna COVID-19 Vaccine in a High-Allergy/Mast Cell Disorder (HA/MCD) population, and * If the risk in the HA/MCD is demonstrable, to determine whether the proportions are higher in the HA/MCD in comparison to a representative population without severe allergies or mast cell disorders

Key facts

Study ID

NCT04761822

Run by

National Institute of Allergy and Infectious Diseases (NIAID)

People needed

746

Starts

2021-04-07

Expected to finish

2022-04-27

Last updated by the study team

2025-08-12

Who can join

Age: 5 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Individuals who meet all of the following criteria are eligible for enrollment as study participants:
• Both groups (e.g., High-Allergy and Mast Cell Disorder (HA/MCD) Group and Comparison Group):
• Able to understand and provide informed consent
• Male or non-pregnant female ≥12 years of age on the date of first study vaccination/placebo administration (protocol versions 1.0 - 4.0) OR male or non-pregnant female 5-17 years of age on the date of first study vaccination/placebo administration (protocol version 5.0)
• Females of childbearing potential must have a negative pregnancy test prior to the first vaccination and placebo administration, if applicable.
• -If a participant becomes pregnant after receiving a placebo dose but prior to receiving study vaccination, she will be discontinued from the study
• Females of reproductive potential° and sexually active must agree to use FDA approved methods of birth control for the duration of the study. These include hormonal contraceptives, intrauterine device, double barrier contraception (i.e., condom plus diaphragm), or male partner with documented vasectomy.
• Menopause is defined as at least 12 consecutive months without menses; if in question, a follicle stimulating hormone of ≥25 U/mL must be documented.
• Hysterectomy, bilateral oophorectomy, or bilateral tubal ligation must be documented, as applicable; if documented, women with these conditions are not required to use additional contraception.
• High-Allergy and Mast Cell Disorder (HA/MCD) Group:
• Individuals who meet at least one of the following criteria are eligible for enrollment in the HA/MCD group:
• History of a severe allergic reaction to food(s), allergen immunotherapy, insect venom(s), or latex with use of epinephrine within the last 15 years
• History of an Emergency Department visit with convincing evidence of a systemic allergic reaction (consistent with CoFAR Grade 3 or higher) to food(s), allergen immunotherapy, insect venom(s), or latex within the last 15 years
• History of documented, immediate allergic reactions to 2 or more unrelated drugs within the last 15 years
• A convincing clinical history, or a history that is accompanied by a positive skin test, of an immediate reaction to a drug, vaccine, or latex within the last 15 years
• History of physician-diagnosed idiopathic anaphylaxis requiring epinephrine or an Emergency Department visit in the last 15 years
• History of a physician-diagnosed mast cell disorder (e.g., mastocytosis, mast cell activation syndrome [MCAS], or hereditary alpha-tryptasemia). MCAS must meet consensus criteria as defined below:
• Criterion A: Typical clinical signs of severe, recurrent (episodic) systemic Mast Cell Activation are present (often in form of anaphylaxis)
• --Definition of systemic: involving at least 2 organ systems
• Criterion B: Involvement of Mast Cell (MC) is documented by biochemical studies
• -- Preferred marker: increase in serum tryptase level from the individual's baseline to plus 20% + 2 ng/ml
• Criterion C: Response of symptoms to therapy with MC-stabilizing agents, drugs directed against MC mediator production or drugs blocking mediator release or effects of MC-derived mediators
• NOTE: All 3 Mast Cell Activation Syndrome (MCAS) criteria (A + B + C) must be fulfilled to call a condition MCAS.
• Comparison Group:
• Individuals who meet all of the following criteria are eligible for enrollment in the comparison group:

You may not qualify if…

• Individuals who meet any of these criteria are not eligible for enrollment as study participants:
• Inability or unwillingness of a participant and/or parent/legal guardian to give written informed consent and/or assent, as applicable, or to comply with study protocol
• Weight less than 15 kg (33 lbs)
• Prior receipt of any doses of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) Vaccine, Moderna COVID-19 Vaccine, or any other COVID-19 vaccine
• History of a severe reaction to any component of the Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 Vaccine
• History of contact dermatitis with confirmed patch test reaction to Prevalence of polyethylene glycol (PEG)
• History of reaction to Doxil®
• Known exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and still within the quarantine window
• Symptoms consistent with acute COVID-19 infection or known COVID-19 infection (positive Polymerase chain reaction [PCR] or antigen test) and still within the quarantine window
• Have an acute illness, including body temperature greater than 100.4 degrees Fahrenheit, within 14 days of the first study vaccination/placebo administration or 3 days prior to each subsequent vaccination
• History of autoimmune or other disorders requiring systemic immune modulators
• History of acute urticaria within 28 days of randomization
• Pregnant
• Have received any vaccines within 14 days of the first study vaccination/placebo administration or plan to receive other vaccines during the study period
• Had any allergen immunotherapy administration within 24 hours prior to vaccination/placebo administration or plan to receive within 24 hours after vaccination/placebo administration
• Have received a biologic therapy within 6 months of randomization
• Use of systemic steroids for any reason within 28 days of randomization
• Use of Zileuton® within 14 days of randomization
• Use of any monoclonal antibody agent for treatment or prevention of COVID-19 within 3 months of randomization
• Coronary artery disease, peripheral or cerebral vascular disease, unstable angina, or cardiac arrhythmia, other than supraventricular tachycardia (SVT)
• Medically unstable hypertension
• Current use of beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, monoamine oxidase (MAO) inhibitors, tricyclic anti-depressants or other agents that could interfere with the treatment of anaphylaxis, in the opinion of the investigator
• Unstable asthma within 3 months of randomization or symptomatic asthma on the day of vaccination, as assessed by the site investigator
• Have past or current medical problems or findings from physical exam or laboratory testing not listed above, which in the opinion of the investigator, may pose additional risks from participation in the study or which may interfere with the ability to comply with study requirements --This includes individuals with underlying conditions or other medications that, in the opinion of the investigator, may increase risk in the event of an anaphylactic reaction or lead to complications following administration of epinephrine

Where it is running

• University of Arizona Health Sciences, College of Medicine Tucson, Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine — Tucson, Arizona, United States
• Arkansas Children's, University of Arkansas for Medical Sciences — Little Rock, Arkansas, United States
• University of California, Los Angeles Medical Center — Los Angeles, California, United States
• Stanford Medicine, Sean N. Parker Center for Allergy & Asthma Research — Stanford, California, United States
• National Jewish Health — Denver, Colorado, United States
• University Health, University of Miami Health System — Miami, Florida, United States
• University of South Florida Asthma Allergy and Immunology Clinical Research Unit — Tampa, Florida, United States
• Emory University School of Medicine, Emory Healthcare: Emory Clinic Allergy and Immunology — Atlanta, Georgia, United States
• Sinus and Allergy Center of Northwestern University — Chicago, Illinois, United States
• NorthShore University HealthSystem, Dermatology Clinical Trials Unit — Skokie, Illinois, United States
• University of Iowa Health Care — Iowa City, Iowa, United States
• Johns Hopkins Bayview Medical Center — Baltimore, Maryland, United States
• Massachusetts General Hospital — Boston, Massachusetts, United States
• Brigham and Women's Hospital — Boston, Massachusetts, United States
• University of Michigan Health — Ann Arbor, Michigan, United States
• Henry Ford Hospital and Health System — Detroit, Michigan, United States
• Saint Louis University Care Center for Specialized Medicine — St Louis, Missouri, United States
• Mount Sinai Hospital, Department of Medicine, Division of Clinical Immunology — New York, New York, United States
• Columbia University Irving Medical Center — New York, New York, United States
• Rochester Regional Health — Rochester, New York, United States
• North Carolina Translational and Clinical Sciences Institute-Clinical & Translational Research Center (CTRC) at the University of North Carolina at Chapel Hill — Chapel Hill, North Carolina, United States
• Cleveland Clinic, Allergy & Clinical Immunology — Cleveland, Ohio, United States
• Penn State Health Allergy, Milton S. Hershey Medical Center — Hershey, Pennsylvania, United States
• Vanderbilt University Medical Center — Nashville, Tennessee, United States
• University of Texas Southwestern Medical Center — Dallas, Texas, United States

Full record on ClinicalTrials.gov

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