Anaphylaxis: Revision of the Brighton collaboration case definition. Issue 15 (6th April 2023)

• Record Type: Journal Article
• Authors: Gold, Michael S.; Amarasinghe, Ananda; Greenhawt, Matthew; Kelso, John M.; Kochhar, Sonali; Yu-Hor Thong, Bernard; Top, Karina A.; Turner, Paul J.; Worm, Margitta; Law, Barbara
• Is Part Of: Vaccine. Volume 41:Issue 15(2023)
• Page Start: 2605
• Page End: 2614
• Publication Date: 2023-04-06
• Subjects: Anaphylaxis -- Adverse event following immunization -- COVID-19 immunization -- Guidelines -- Case definition -- Vaccine safety; AEFI adverse events following immunization -- BC Brighton Collaboration -- COVID-19 coronavirus disease -- CARPA complement activation related pseudo allergy -- CDC Centres for Disease Control -- FAAN Food Allergy Anaphylaxis Network -- FcεRI Fc epsilon receptor I -- IgE immunoglobulin E -- ILO inducible laryngeal obstruction -- LOC level of certainty -- MCT mast cell tryptase -- mRNA messenger ribonucleic acid -- MRGPRX2 Mas-related G protein-coupled receptor X2 -- NIAID National Institute of Allergy and Infectious Disease -- VCD vocal cord dysfunction -- WAO World Allergy Organization -- WG working group; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2022.11.027
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: The Brighton Collaboration (BC) has formulated a number of case definitions which have primarily been applied to adverse events of special interest in the context of vaccine safety surveillance. This is a revision of the 2007 BC case definition for anaphylaxis. Recently, the BC definition has been widely used for evaluating reports of suspected anaphylaxis following COVID-19 vaccination. This has led to debate about the performance of the BC definition in comparison with those from the US National Institute of Allergy and Infectious Disease/Food Allergy Anaphylaxis Network (NIAID/FAAN) and the World Allergy Organization (WAO). BC convened an expert working group to revise the case definition based on their usual process of literature review and expert consensus. This manuscript presents the outcome of this process and proposes a revised case definition for anaphylaxis. Major and minor criteria have been re-evaluated with an emphasis on the reporting of observable clinical signs, rather than subjective symptoms, and a clearer approach to the ascertainment of levels of certainty is provided. The BC case definition has also been aligned with other contemporary and international case definitions for anaphylaxis.