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

Research output: Journal article (peer-reviewed)Journal article

15 Citations (Scopus)


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 languageEnglish
Pages (from-to)2313-2336
Number of pages24
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number8
Publication statusPublished - Aug 2022
Externally publishedYes


  • Allergens
  • Asthma
  • Biological Products/therapeutic use
  • COVID-19/prevention & control
  • COVID-19 Vaccines
  • Desensitization, Immunologic
  • Humans
  • Hypersensitivity
  • Immunoglobulin E
  • SARS-CoV-2
  • Vaccination


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