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Comment by jcims | Hacker News Reader

I wonder if they can titrate the dose a bit to limit the scale of the reaction. Or just do a reaction test to PEG before dosing.

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In the UK, according to the released documentation, recipients are monitored for allergic reactions (anaphylaxis) for several minutes after receiving the first dose and staff are trained to react quickly. Anyone with a reaction to the first dose won't be given the second.

This is correct, here in the UK everyone is observed for 15 minutes after receiving the first dose.

I read that the 15 minute observation requirement is causing various GPs to turn down the work because they don’t have that kind of time. Presumably it was never expected for all GPs to accept the work but I wonder how widespread it is and what impact it’ll have on the bigger goal.

The GP shouldn't be affected by the observation period at all. Patients just sit in a waiting area after receiving the shot. At least that's the way it worked for me with a different medication.

You typically need to sit in an area where you are under constant monitoring and can receive immediate medical intervention if symptoms of anaphylactic shock start to surface. My GP doesn’t have such a place in their office, so you sit in the room with a nurse in the hallway monitoring 2-3 rooms.

Just try coughing lightly in this scenario and watch every nurse within earshot reflexively spin their head in your direction.

This has also been confirmed for Norway, but is already standard for most vaccinations. Some minor short term reaction is common.

I’d be curious about this as well. I was on a medication previously that had a rare chance of causing Stevens-Johnson syndrome (very severe rash with other possible complications). I did some research on it, and the standard approach for the medication is to titrate patients up slowly, and if anyone has a serious reaction they back off to a lower dose and “rechallenge” with a good success rate.

Not sure if something like that is possible with the vaccine and patients who have an allergic reaction but I’d be curious to find out if a similar approach of “rechallenging” would work.

My wife had the anaphylactic reaction to doxil they mentioned in the article. I didn’t know the details but they said it was the ’carrier’ causing the reaction.

They just started titrating the dose in the future and it was fine. They still watched her like a hawk though.

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