They note that with their company, Grifols, there is only about a 4-month lag between plasma collection and the release of a lot of IVIg. Given the fact that in a recent reply on this website it was thought that antibodies to SARS–Cov2 should be in gammaglobulin products due to the 9 month turnaround of production, (or at some point now or soon) what would be your recommendation for immune deficient patients on gammaglobulin? Under what circumstances might this product be offered?Īnswer: Romero and coworkers noted that specific anti-SARS-CoV-2 antibodies were first detected in their batches of IVIg products manufactured from plasma collected in the United States in September, 2020, with increased titers observed by October, 2020. However, her responsiveness to vaccine such as pneumococcus was nil.
She has had 3 SARS–COV2 vaccinations so she has had her booster vaccination. Question: A 63-year-old Caucasian female with CVID and postsplenectomy asked me about Evusheld which was recently released by the FDA under EUA. Work up suggests GPA/mast cell activation - consult with hematology suggests mast cell activation secondary to his autoimmune disorder (hx: Wegener's granulomatosis) or due to hypersensitive reaction) considered though bone marrow shows Normocellular (40%) bone marrow with mild nonspecific myeloid hypoplasia and no evidence of increased mast cell population.Īnswer: Individuals with mast cell activation syndrome or mastocytosis can be safely vaccinated with any of the approved COVID-19 vaccines and should be vaccinated.Ī prophylactic dose of a non-sedating antihistamine prior to vaccination may improve acute tolerability.
Our clinic has a patient who has had a persistently elevated tryptase level (generally 23-30) with several episodes of idiopathic anaphylaxis-type episodes. Early in the vaccination campaign there was conversation surrounding conditions with elevated tryptase and/or mast cell conditions being a vaccine contraindication but more recently I have not seen these recommendations persist. Question: Could you please clarify the recommendations and considerations surrounding COVID-19 vaccination for individuals with persistently elevated tryptase levels. You may search for additional questions and answers using keywords on the AAAAI Ask the Expert page.