Safety of administration of BNT162b2 mRNA (Pfizer-BioNTech) COVID-19 vaccine in youths and young adults with a history of acute lymphoblastic leukemia and allergy to PEG-asparaginase

Pediatr Blood Cancer. 2021 Nov;68(11):e29295. doi: 10.1002/pbc.29295. Epub 2021 Aug 16.


Vaccinationis a critical tool in the prevention of COVID-19 infection for individuals and for communities. The mRNA vaccines contain polyethylene glycol (PEG) as a stabilizer. Currently, in North America, only the BNT162b2 (Pfizer-BioNTech) mRNA vaccine is approved for individuals aged 12-17. Most patients treated with contemporary regimens for acute lymphoblastic leukemia receive PEG-asparaginase (PEG-ASNase) and 10%-30% will develop allergic reactions. Optimizing access and safety for vaccine administration for these patients is critical. This report describes a process developed to support COVID vaccination in a cohort of adolescents and young adults with a history of PEG-ASNase allergy.

Keywords: COVID; PEG-asparaginase; allergy; vaccine.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents / adverse effects*
  • Asparaginase / adverse effects*
  • BNT162 Vaccine
  • COVID-19 / complications
  • COVID-19 / prevention & control*
  • COVID-19 Vaccines / administration & dosage
  • COVID-19 Vaccines / adverse effects
  • COVID-19 Vaccines / therapeutic use*
  • Child
  • Drug Hypersensitivity / complications*
  • Drug Hypersensitivity / etiology
  • Humans
  • Polyethylene Glycols / adverse effects*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Young Adult


  • Antineoplastic Agents
  • COVID-19 Vaccines
  • Polyethylene Glycols
  • pegaspargase
  • Asparaginase
  • BNT162 Vaccine