COVID-19 Vaccine Allergy Safety Track (VAS-Track) pathway: real-world outcomes on vaccination rates and antibody protection.

IF 2.3 4区 医学 Q3 ALLERGY Asian Pacific journal of allergy and immunology Pub Date : 2024-12-01 DOI:10.12932/AP-110722-1410
Valerie Chiang, Kelvin Kai Wang To, Ivan Fan Ngai Hung, Chinmoy Saha, Jackie Sh Yim, Jane Chi Yan Wong, Elaine Yl Au, Tik Suet Chan, Andy Ka Chun Kan, Yuh Dong Hong, Jiaxi Ye, Carmen S Ng, Carmen Tk Ho, Chak Sing Lau, Tommy Ty Lam, Esther Wy Chan, Jianchao Quan, Philip Hei Li
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引用次数: 0

Abstract

Background: Misdiagnosed vaccine-related "allergies" lead to unnecessary vaccine deferrals and incomplete vaccinations, leaving patients unprotected against COVID-19. To overcome limitations and queues for Allergist assessment, the "VAS-Track" pathway was developed to evaluate patients via a multi-disciplinary triage model including nurses, non-specialists, and Allergists.

Objective: We assessed the effectiveness and safety of VAS-Track and evaluate its real-world impact in terms of vaccination rates and COVID-19 protection.

Methods: Patients referred to VAS-Track between September 2021 and March 2022 were recruited. Subgroup analysis was performed with prospective pre- and post-clinic antibody levels.

Results: Nurse-assisted screening identified 10,412 (76%) referrals as inappropriate. 369 patients were assessed by VAS-Track. Overall, 100% of patients were recommended to complete vaccination and 332 (90%) completed their primary series. No patients reported any significant allergic reactions following subsequent vaccination. Vaccination completion rates between patients seen by non-specialists and additional Allergist review were similar (90% vs. 89%, p = 0.617). Vaccination rates were higher among patients with prior history of immediate-type reactions (odds ratio: 2.43, p = 0.025). Subgroup analysis revealed that only 20% (56/284) of patients had seropositive COVID-19 neutralizing antibody levels (≥ 15 AU/mL) prior to VAS-Track, which increased to 92% after vaccine completion (pre-clinic antibody level 6.0 ± 13.5 AU/mL vs. post-clinic antibody level 778.8 ± 337.4 AU/mL, p > 0.001).

Conclusions: A multi-disciplinary allergy team was able to streamline our COVID-19 VAS services, enabling almost all patients to complete their primary series, significantly boosting antibody levels and real-world COVID-19 protection. We propose similar multidisciplinary models to be further utilized, especially in the settings with limited allergy services.

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COVID-19 疫苗过敏安全跟踪(VAS-Track)途径:疫苗接种率和抗体保护的实际效果。
背景:被误诊为与疫苗相关的 "过敏 "会导致不必要的疫苗延期接种或接种不完全,从而使患者无法预防 COVID-19。为了克服过敏症专家评估的局限性和排队问题,我们开发了 "VAS-Track "路径,通过包括护士、非专科医生和过敏症专家在内的多学科分流模式对患者进行评估:我们评估了 VAS-Track 的有效性和安全性,并从疫苗接种率和 COVID-19 保护方面评估了其实际影响:招募了 2021 年 9 月至 2022 年 3 月期间转诊至 VAS-Track 的患者。方法:招募 2021 年 9 月至 2022 年 3 月期间转诊的 VAS-Track 患者,并根据门诊前和门诊后的抗体水平进行分组分析:护士辅助筛查确定了 10,412 名(76%)转诊患者不合适。369 名患者接受了 VAS-Track 评估。总体而言,100% 的患者被建议完成疫苗接种,其中 332 人(90%)完成了初级系列接种。没有患者报告接种疫苗后出现任何明显的过敏反应。由非专科医生诊治的患者与经过过敏专科医生复查的患者的疫苗接种完成率相似(90% 对 89%,P = 0.617)。有即刻型反应病史的患者接种率更高(几率比:2.43,p = 0.025)。亚组分析显示,在进行 VAS-Track 前,只有 20% 的患者(56/284)血清中 COVID-19 中和抗体水平呈阳性(≥ 15 AU/mL),而在完成疫苗接种后,这一比例上升至 92%(临床前抗体水平为 6.0 ± 13.5 AU/mL vs. 临床后抗体水平为 778.8 ± 337.4 AU/mL,p > 0.001):多学科过敏团队能够简化我们的 COVID-19 VAS 服务,使几乎所有患者都能完成初治系列,显著提高抗体水平和实际 COVID-19 保护能力。我们建议进一步利用类似的多学科模式,尤其是在过敏服务有限的环境中。
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来源期刊
CiteScore
12.80
自引率
0.00%
发文量
74
审稿时长
>12 weeks
期刊介绍: The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747 APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume. APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand. The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.
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