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Focus on Sex and Gender: What We Need to Know in the Management of Rheumatoid Arthritis. J Pers Med 2022; 12:jpm12030499. [PMID: 35330498 PMCID: PMC8948892 DOI: 10.3390/jpm12030499] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/13/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease, affecting mostly women with a female/male ratio of 3:1. It is characterized by symmetrical polyarthritis, leading to progressive joint damage. Sex differences have been reported in terms of disease course and characteristics, influencing patients reported outcome measures (PROMs) and pain perception, ultimately leading to male–female disparities in treatment response. Notwithstanding, sex and gender discrepancies are still under-reported in clinical trials. Therefore, there is a consistent need for a precise reference of sex and gender issues in RA studies to improve treat-to-target achievement. This narrative review explores the above-mentioned aspects of RA disease, discussing the latest core principles of RA recommendations, from safety issues to early arthritis concept and management, treat-to-target and difficult-to-treat notions, up to the most recent debate on vaccination. Our final purpose is to evaluate how sex and gender can impact current management guidelines and how this issue can be integrated for effective disease control.
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Camacho Moll ME, Salinas Martínez AM, Tovar Cisneros B, García Onofre JI, Navarrete Floriano G, Bermúdez de León M. Extension and Severity of Self-Reported Side Effects of Seven COVID-19 Vaccines in Mexican Population. Front Public Health 2022; 10:834744. [PMID: 35359754 PMCID: PMC8964147 DOI: 10.3389/fpubh.2022.834744] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/07/2022] [Indexed: 01/10/2023] Open
Abstract
A few studies examined the comparative side effects of Coronavirus Disease-19 (COVID-19) vaccines. We compared the extension and severity of self-reported side effects of seven COVID-19 vaccines [BNT162b2 (Pfizer-BioNTech), ChAdOx1 (AstraZeneca), mRNA-1273 (Moderna), CoronaVac (Sinovac Life Sciences), Gam-COVID-Vac (Gamaleya's Sputnik V), Ad5-nCoV (CanSinoBIO), and Ad26.CoV2.S (Johnson & Johnson/Janssen)] in the Mexican population. We also evaluated the association of type of vaccine, sex, age, comorbidity, and history of allergies to the extent and severity of side effects. This was a cross-sectional study carried out online between August 12 and September 3, 2021 in Mexico. The first inclusion criterion was to receive a COVID-19 vaccine and the second, being at least 18 years old. The survey link was distributed via multiple social media platforms. We questioned about the type of vaccine and symptoms based on short-term side effects reported in the literature. Side effect extension was classified as local, systemic, or both. We asked about the need to take medicine, stop activities/miss work, or seek medical attention. Then, a severity index was constructed based on responses. Descriptive and stepwise multivariate logistic ordinal regression analyses were used to calculate odds ratio (OR) and 95% CI for each outcome adjusted by potential confounders. The mean age was 38.9 ± 11.0 years (n = 4,024). Prevalence of at least one side effect varied between vaccines and by a number of doses. At dose 1, ChAdOx1 was the vaccine with the highest rate of at least one side effect (85%) followed by Gam-COVID-Vac (80%). Both were associated to greater extension (adjusted OR 2.53, 95% CI 2.16, 2.96 and adjusted OR 2.41, 95% CI 1.76, 3.29, respectively) and severity of side effects (adjusted OR 4.32, 95% CI 3.73, 5.00 and adjusted OR 3.00, 95% CI 2.28, 3.94, respectively). Young age (<50 years), female sex, comorbidity, and history of allergies were associated with greater extension and severity, independent of the type of vaccine and potential confounders. At dose 2, mRNA-1273 was the vaccine with the highest rate of side effects (88%) and the only vaccine associated to greater extension (adjusted OR 2.88, 95% CI 1.59, 5.21) and severity of symptoms (adjusted OR 3.14, 95% CI 1.82, 5.43). Continuous studies are necessary to acknowledge more post-vaccine symptoms in different populations.
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Affiliation(s)
- María Elena Camacho Moll
- Department of Molecular Biology, Northeast Biomedical Research Center, Mexican Institute of Social Security, Monterrey, Mexico
- Health Sciences Division, Center for Molecular Diagnosis and Personalized Medicine, Universidad de Monterrey, Monterrey, Mexico
- *Correspondence: María Elena Camacho Moll
| | - Ana María Salinas Martínez
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Monterrey, Mexico
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey, Mexico
- Ana María Salinas Martínez
| | | | | | | | - Mario Bermúdez de León
- Department of Molecular Biology, Northeast Biomedical Research Center, Mexican Institute of Social Security, Monterrey, Mexico
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Oh TH, Woo SH, Hong S, Lee C, Lee WJ, Jeong SK. Clinical Features of Patients Presenting to the Emergency Department With Cardiovascular Adverse Reactions After COVID-19 mRNA Vaccination. J Korean Med Sci 2022; 37:e73. [PMID: 35257528 PMCID: PMC8901880 DOI: 10.3346/jkms.2022.37.e73] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/07/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Since the implementation of the nationwide coronavirus disease 2019 (COVID-19) vaccination campaign, emergency departments (EDs) have had an increasing number of patients reporting postvaccination cardiovascular adverse effects. We investigated the clinical features of patients who visited the ED for cardiovascular adverse reactions after COVID-19 mRNA vaccination. METHODS We conducted a retrospective observational study in two EDs. Patients with cardiovascular adverse reactions after COVID-19 mRNA vaccination who visited EDs between June 1, 2021, and October 15, 2021, were selected. The clinical data of these patients were collected by reviewing medical records. RESULTS Among 683 patients, 426 (62.4%) were female. The number of patients in their 20s was the highest (38.9% of males, 28.2% of females) (P < 0.001). More patients visited the ED for adverse reactions following the first vaccine dose than following the second dose (67.6% vs. 32.2%). Chief complaints were chest pain/discomfort (74.4%), dyspnea (14.3%) and palpitation (11.3%). The final diagnosis was a nonspecific cause (63.1%), and 663 (97.1%) patients were discharged from the ED. The admission rate was higher in males than in females (3.9% vs. 1.9%). Myocarditis was diagnosed in four males, who showed mild clinical progression and were discharged within 5 hospital days. CONCLUSION Most patients who visited the ED with cardiovascular adverse reactions were discharged from the ED, but some were admitted for other medical diseases as well as adverse vaccine reactions. Therefore, further surveillance and a differential diagnosis of cardiovascular adverse events after COVID-19 mRNA vaccination should be considered by emergency physicians.
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Affiliation(s)
- Tae Hoon Oh
- Department of Emergency Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Seon Hee Woo
- Department of Emergency Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Sungyoup Hong
- Department of Emergency Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Carol Lee
- Department of Emergency Medicine, David Geffen School of Medicine at UCLA, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Woon Jeong Lee
- Department of Emergency Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Si Kyoung Jeong
- Department of Emergency Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
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Watcharananan SA, Nadee C, Kongsuwattanaleart P, Sangthong N, Ngorsakun P, Vimonvattaravetee P, Phuphuakrat A, Udomsubpayakul U. Rates, types, and associated factors of acute adverse effects after the first dose of ChAdOx1 nCoV-19 vaccine administration in Thailand. IJID REGIONS 2022; 2:35-39. [PMID: 35721432 PMCID: PMC8626869 DOI: 10.1016/j.ijregi.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022]
Abstract
Acute adverse effects (AAEs) occurred in 65% of vaccinated participants Most adverse reactions were mild, including arm pain and low-grade fever AAEs were associated with younger age, female sex, anxiousness, and allergic disease
Objectives Effective vaccines are prioritized to curtail the transmission and burden of coronavirus disease 2019. Nevertheless, monitoring the safety of vaccines is crucial. As Thailand began the ChAdOx1 nCoV-19 vaccination, our study examined the acute adverse effects and associated factors after the first dose of vaccination. Methods A mobile self-report questionnaire was employed to assess the rates and types of different side-effects within 3 days of the first dose of ChAdOx1 nCoV-19 vaccine administration. The risk factors associated with these side-effects were analyzed. Results In total, 774 participants were included in the survey, with a mean (± standard deviation) age of 49.5 (± 17.2) years. The majority (57.8%) were females, and 59.1% were anxious before the vaccination. Side-effects after the vaccination were a common occurrence (65.2%), but most (42.6%) were mild. Side-effects were significantly associated (odds ratio [95% confidence interval]) with younger age (4.32 [2.26–8.23]; p < 0.001; age < 30 years vs ≥ 60 years), female sex (1.66 [1.19–2.30], p = 0.003), anxiousness (2.10 [1.06–4.13]; p = 0.033; moderate–severe anxiousness vs none), and allergic disease (2.60 [1.07–6.31]; p = 0.035). Conclusions After the ChAdOx1 nCoV-19 vaccination, most acute adverse effects were mild and often noted among participants with younger age, female sex, anxiousness, and allergic disease.
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Kalbhenn J, Gabler F, Heinrich S, Steinmann D. Subjektives Befinden und Arbeitsfähigkeit nach SARS-CoV-2-Immunisierung mit dem Vektor-Impfstoff ChAdOx1-S (AstraZeneca COVID-19–Vakzin). ZENTRALBLATT FÜR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2022; 72:51-57. [PMID: 34776649 PMCID: PMC8572530 DOI: 10.1007/s40664-021-00448-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022]
Abstract
Hintergrund Seit dem 29.01.2021 wurde der COVID-19-Impfstoff ChAdOx1‑S (Vaxzevria, AstraZeneca) durch das Paul-Ehrlich-Institut in Deutschland zugelassen. In mehreren Kampagnen wurde MitarbeiterInnen des Gesundheitssystems und Medizinstudierenden die Impfung mit diesem Vakzin auf freiwilliger Basis angeboten. Ziel der Arbeit Primärer Endpunkt der Arbeit war die Erfassung der Rate und Dauer von Arbeitsunfähigkeits(AU)-Meldungen von Arbeitnehmern in Folge der Erstimmunisierung mit ChAdOx1‑S. Sekundäre Endpunkte waren Art und Ausprägung von Nebenwirkungen sowie die selbstempfundene Verträglichkeit. Material und Methoden Anonymisierter Online-Fragebogen, einmalig ausfüllbar durch alle Geimpften nach Erhalt der ersten Dosis von ChAdOx1‑S. Die Ausprägung von Nebenwirkungen wurde über eine ordinale numerische Rating-Skala mit Werten zwischen 0 und 10 abgefragt. Weitere wesentliche Datenpunkte waren Alter, Geschlecht und Berufsgruppe. Die Arbeitsfähigkeit in den Folgetagen der Injektion wurde ebenfalls durch Selbstangabe erhoben. Ergebnisse Es wurden Daten von 1988 Befragten ausgewertet. Das mittlere Alter lag bei 37,13 (13,73) Jahren (Standardabweichung). 69,8 % der Befragten waren weiblich, 48,1 % gehörten zu therapeutischen und technischen Berufsgruppen mit Patientenkontakt, 38 % waren Studierende, 10,6 % waren dem pflegerischen und 4 % dem ärztlichen Dienst zuzuordnen. Nur 14,4 % der Befragten gaben an, die Impfung ohne Nebenwirkungen vertragen zu haben. Häufigste Nebenwirkung war Müdigkeit, gefolgt von Schmerzen an der Injektionsstelle. In absteigender Häufigkeit folgten Kopfschmerzen, Gliederschmerzen und Schüttelfrost. Nach der Impfung fühlten sich 18 % der Befragten unmittelbar wieder arbeitsfähig. 51 % aller Befragten mussten sich nach der Impfung für mindestens einen Tag arbeitsunfähig melden. Nebenwirkungen waren bei männlichen und jüngeren Befragten stärker ausgeprägt. Schlussfolgerung Die Impfung mit ChAdOx1‑S führte häufig zu Nebenwirkungen. Diese hatten bei 37 % der Befragten eine Krankmeldung zur Folge. Dennoch würden sich 89,6 % aller Befragten wieder für eine Impfung mit ChAdOx1‑S entscheiden.
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Urakawa R, Isomura ET, Matsunaga K, Kubota K, Ike M. Impact of age, sex and medical history on adverse reactions to the first and second dose of BNT162b2 mRNA COVID-19 vaccine in Japan: a cross-sectional study. BMC Infect Dis 2022; 22:179. [PMID: 35197017 PMCID: PMC8864597 DOI: 10.1186/s12879-022-07175-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/17/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Vaccines for coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being promoted worldwide. In this study, we analyzed the relationship between adverse reactions and the profile of vaccinated recipients. METHODS Vaccinated subjects who received two doses of BNT162b2 between May 17 and June 11, 2021, at Osaka University Dental Hospital were included in this study. Adverse reactions and profiles were collected by questionnaires, and the relationship between the presence of adverse reactions and the profiles of the vaccinated persons was analyzed by logistic regression analysis. The correlation between the severity of adverse reactions and age was analyzed by Spearman's rank correlation. RESULTS Logistic regression analysis showed that, for many kinds of adverse reactions, the incidence was significantly higher in females than in males and in younger than in older people. There was a very weak but significant negative correlation between age and the severity of many kinds of adverse reactions. The relationship between sex and the incidence of each adverse reaction was significant for injection site reactions and fatigue in the first vaccination, whereas significant relationships were found for fatigue, chills, fever, arthralgia, myalgia and headache in the second vaccination, all of which were clearly more likely to occur in females. CONCLUSION Adverse reactions to BNT162b2 were found to be more frequent and more intense in females and younger people in Japan, especially after the second vaccination.
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Affiliation(s)
- Ryuta Urakawa
- Department of Pharmacy, Osaka University Dental Hospital, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan. .,Department of Clinical Pharmacy Research and Education, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Emiko Tanaka Isomura
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Kazuhide Matsunaga
- Second Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Kazumi Kubota
- Department of Healthcare Information Management, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Miho Ike
- Nursing Department, Osaka University Dental Hospital, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
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Khajavirad N, Salehi M, Haji Ghadery A, Khalili H, Arab Ahmadi M, Dehghan Manshadi SA, Zare Dehnavi A. Serious events following COVID-19 vaccination with ChAdOx1 nCoV-19 vaccine (Vaxzevria): A short case series from Iran. Clin Case Rep 2022; 10:e05390. [PMID: 35145690 PMCID: PMC8818285 DOI: 10.1002/ccr3.5390] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/25/2021] [Accepted: 01/07/2022] [Indexed: 11/20/2022] Open
Abstract
In 2020, the SARS‐COV‐2 disease (COVID‐19) imposed huge challenges on the health, economic, and political systems, and by the end of the year, hope had been born with the release of COVID‐19 vaccines aimed at bringing the pandemic to an end. However, the COVID‐19 vaccination programs have sparked several concerns and ongoing debates over safety issues. Here, we presented three cases of patients with serious adverse events, encephalopathy, vaccine‐induced thrombotic thrombocytopenia, and leukocytoclastic vasculitis, after receiving the ChAdOx1 nCoV‐19 vaccine. Therefore, it is critical to investigate and report the occurrence of adverse reactions following vaccination, particularly serious ones, as it contributes to the growing body of research and assists clinicians in better diagnosing and managing them.
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Affiliation(s)
- Nasim Khajavirad
- Internal Medicine Department Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran Iran
| | - Mohammadreza Salehi
- Infectious Diseases and Tropical Medicines Department Tehran University of Medical Sciences Tehran Iran
| | | | - Hossein Khalili
- Department of Clinical Pharmacy Tehran University of Medical Sciences Tehran Iran
| | - Mehran Arab Ahmadi
- Advanced Diagnostic and Interventional Radiology Research Center Tehran University of Medical Sciences Tehran Iran
| | | | - Ali Zare Dehnavi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
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Uwamino Y, Kurafuji T, Sato Y, Tomita Y, Shibata A, Tanabe A, Yatabe Y, Noguchi M, Arai T, Ohno A, Yokota H, Yamasawa W, Uno S, Nishimura T, Hasegawa N, Saya H, Wakui M, Murata M. Young age, female sex, and presence of systemic adverse reactions are associated with high post-vaccination antibody titer after two doses of BNT162b2 mRNA SARS-CoV-2 vaccination: An observational study of 646 Japanese healthcare workers and university staff. Vaccine 2022; 40:1019-1025. [PMID: 35033389 PMCID: PMC8739021 DOI: 10.1016/j.vaccine.2022.01.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/21/2021] [Accepted: 01/01/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND SARS-CoV-2 vaccination has started worldwide, including Japan. Although high rates of vaccine response and adverse reactions of BNT162b2 vaccine have been reported, knowledge about the relationship between sex differences and antibody response is limited. Furthermore, it is uncertain whether adverse reactions are associated with the vaccine response. METHODS This prospective observational study included 673 Japanese participants working in a medical school and its affiliated hospital in Tokyo, Japan (UMIN000043340). Serum samples were collected before the first dose and three weeks after the second dose of BNT162b2 vaccine, and antibody titers against the receptor-binding domain of the spike protein of SARS-CoV-2 were measured. Answers to questionnaires about background characteristics and adverse reactions were obtained at the time of sample collection, and the relationship between antibody titers was analyzed. RESULTS After excluding participants who did not complete receiving two doses of vaccination or two series of serum sample collection, 646 participants were analyzed. Although all participants became sero-positive after vaccination, antibody titers were highly variable among individuals (260.9-57,399.7A U/mL), with a median titer of 13478.0AU/mL. Mean titer was higher in females than in males and higher in young (≤45 years old) participants than in aged (>45 years old) participants. Participants who experienced adverse reactions demonstrated a higher antibody titer after vaccination than those without adverse reactions. Multivariable analysis demonstrated that young age, female sex, and adverse reactions after the second dose were independently related to higher antibody titers after the second dose. DISCUSSION A favorable antibody response was observed after two doses of BNT162b2 vaccination among mostly healthy Japanese participants, especially among female and young participants. Although further investigation is essential, our results imply that the systemic adverse reactions (i.e., fever and general fatigue) are associated with a higher antibody response that indicates the acquisition of humoral immunity.
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Affiliation(s)
- Yoshifumi Uwamino
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toshinobu Kurafuji
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yukari Tomita
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Ayako Shibata
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akiko Tanabe
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoko Yatabe
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masayo Noguchi
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tomoko Arai
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akemi Ohno
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hiromitsu Yokota
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Wakako Yamasawa
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shunsuke Uno
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tomoyasu Nishimura
- Health Center, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hideyuki Saya
- Division of Gene Regulation, Institute for Advanced Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masatoshi Wakui
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Abstract
The highly contagious and rapidly mutating COVID-19 virus is affecting individuals worldwide. A rapid and large-scale method for COVID-19 testing is needed to prevent infection. Cough testing using AI has been shown to be potentially valuable. In this paper, we propose a COVID-19 diagnostic method based on an AI cough test. We used only crowdsourced cough sound data to distinguish between the cough sound of COVID-19-positive people and that of healthy people. First, we used the COUGHVID cough database to segment only the cough sound from the original cough data. An effective audio feature set was then extracted from the segmented cough sounds. A deep learning model was trained on the extracted feature set. The COVID-19 diagnostic system constructed using this method had a sensitivity of 93% and a specificity of 94%, and achieved better results than models trained by other existing methods.
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Mohamed Hussein AAR, Ibrahim IH, Mahmoud IA, Amary M, Sayad R. To what extent AstraZeneca ChAdOx1 nCoV-19 vaccine is safe and effective? Rapid systematic review. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2022. [PMCID: PMC8795963 DOI: 10.1186/s43168-021-00109-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Until now, there are more than two hundred million confirmed cases of COVID-19 including more than seven million deaths. Clinical trials of all three vaccines authorized for use in the UK (Pfizer–BioNTech, Oxford–AstraZeneca, and Moderna) have reported high vaccine efficacy. This rapid systematic review was initiated because no systematic review had been conducted to determine the safety and efficacy of AstraZeneca ChAdOx1 nCoV-19 vaccine. Evidence acquisition: A systematic search in the following platforms: PubMed, Google Scholar, Scopus, WOS, and MEDLINE databases for all articles in the English language regarding safety and efficacy of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 was performed. Papers published up to end of June were included. Evidence synthesis: Out of 477 retrieved articles, fifteen are included. All the selected articles are concerned with evaluation of AstraZeneca ChAdOx1 nCoV-19 vaccine. Three of them discussed the effectiveness of ChAdOx1 nCoV-19 vaccine, while thirteen (one is common with the group of the effectiveness) measured the adverse effects associated with the vaccine. Because thrombosis was recorded as a serious adverse effect developed after ChAdOx1 nCoV-19 vaccination, it was emphasized in a special group to be analyzed separately. In conclusion: the main message of selected papers was that the value of ChAdOx1 nCoV-19 vaccination to provide critical protection should be considered higher compared to the significant worldwide burden of the emerging COVID-19 infection. No causal relations were found to link cases- having thrombotic adverse reactions to the vaccine.
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Halder A, Imamura H, Condon S, Boroughs K, Nilsson SC, Anderson T, Caterson ID. Pfizer/
BioNtech BNT162b2
: adverse events and insights from an Australian mass vaccination clinic for
COVID
‐19. Intern Med J 2022; 52:121-124. [DOI: 10.1111/imj.15623] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/26/2021] [Accepted: 11/07/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Aditi Halder
- Vaccination Clinic Royal Prince Alfred Hospital Sydney New South Wales Australia
- Brain and Mind Centre The University of Sydney Sydney New South Wales Australia
| | - Hanaho Imamura
- Vaccination Clinic Royal Prince Alfred Hospital Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Stewart Condon
- Vaccination Clinic Royal Prince Alfred Hospital Sydney New South Wales Australia
| | - Kelly Boroughs
- Vaccination Clinic Royal Prince Alfred Hospital Sydney New South Wales Australia
| | - Sven C. Nilsson
- Vaccination Clinic Royal Prince Alfred Hospital Sydney New South Wales Australia
| | - Teresa Anderson
- Vaccination Clinic Royal Prince Alfred Hospital Sydney New South Wales Australia
| | - Ian D. Caterson
- Vaccination Clinic Royal Prince Alfred Hospital Sydney New South Wales Australia
- Boden Collaboration, Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
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Lim SY, Kim JY, Park S, Kwon JS, Park JY, Cha HH, Suh MH, Lee HJ, Lim JS, Bae S, Jung J, Lee N, Kim K, Shum D, Jee Y, Kim SH. Correlation between Reactogenicity and Immunogenicity after the ChAdOx1 nCoV-19 and BNT162b2 mRNA Vaccination. Immune Netw 2022; 21:e41. [PMID: 35036028 PMCID: PMC8733188 DOI: 10.4110/in.2021.21.e41] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 01/15/2023] Open
Abstract
Correlation between vaccine reactogenicity and immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Thus, we investigated to determine whether the reactogenicity after coronavirus disease 2019 vaccination is associated with antibody (Ab) titers and T cell responses. This study was prospective cohort study done with 131 healthcare workers at tertiary center in Seoul, South Korea. The degrees of the local reactions after the 1st and 2nd doses of ChAdOx1 nCov-19 (ChAdOx1) vaccination were significantly associated with the S1-specific IgG Ab titers (p=0.003 and 0.01, respectively) and neutralizing Ab (p=0.04 and 0.10, respectively) in age- and sex-adjusted multivariate analysis, whereas those after the BNT162b2 vaccination did not show significant associations. T cell responses did not show significant associations with the degree of reactogenicity after the ChAdOx1 vaccination or the BNT162b2 vaccination. Thus, high degree of local reactogenicity after the ChAdOx1 vaccine may be used as an indicator of strong humoral immune responses against SARS-CoV-2.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Soonju Park
- Institut Pasteur Korea, Seongnam 13488, Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Ji Young Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Mi Hyun Suh
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hyun Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Nakyung Lee
- Institut Pasteur Korea, Seongnam 13488, Korea
| | - Kideok Kim
- Institut Pasteur Korea, Seongnam 13488, Korea
| | - David Shum
- Institut Pasteur Korea, Seongnam 13488, Korea
| | | | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
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Kian W, Zemel M, Kestenbaum EH, Rouvinov K, Alguayn W, Levitas D, Ievko A, Michlin R, Abod MA, Massalha I, Chernomordikov E, Sharb AA, Shalata W, Levison E, Roisman LC, Lavrenkov K, Peled N, Nesher L, Yakobson A. Safety of the BNT162b2 mRNA COVID-19 vaccine in oncologic patients undergoing numerous cancer treatment options: A retrospective single-center study. Medicine (Baltimore) 2022; 101:e28561. [PMID: 35029223 PMCID: PMC8758044 DOI: 10.1097/md.0000000000028561] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT The COVID-19 pandemic, caused by the SARS-CoV2 virus, has infected millions worldwide with cancer patients demonstrating a higher prevalence for severe disease and poorer outcomes. Recently, the BNT162b2 mRNA COVID-19 vaccine was released as the primary means to combat COVID-19. The currently reported incidence of local and systemic side effects was 27% in the general public. The safety of the BNT162b2 mRNA COVID-19 vaccine has not been studied in patients with an active cancer diagnosis who are either ongoing or plan to undergo oncologic therapy.This single center study reviewed the charts of 210 patients with active cancer diagnoses that received both doses of the BNT162b2 mRNA COVID-19 vaccine. The development of side effects from the vaccine, hospitalizations or exacerbations from various oncologic treatment were documented. Type of oncologic treatment (immunotherapy, chemotherapy, hormonal, biologic, radiation or mixed) was documented to identify if side effects were related to treatment type. The time at which the vaccine was administered in relation to treatment onset (on long term therapy, within 1 month of therapy or prior to therapy) was also documented to identify any relationships.Sixty five (31%) participants experienced side effects from the BNT162b2 mRNA COVID-19 vaccine, however most were mild to moderate. Treatment protocol was not linked to the development of vaccine related side effects (P = .202), nor was immunotherapy (P = .942). The timing of vaccine administered in relation to treatment onset was also not related to vaccine related side effects (P = .653). Six (2.9%) participants were hospitalized and 4 (2%) died.The incidence of side effects in cancer patients is similar to what has been reported for the general public (31% vs 27%). Therefore, we believe that the BNT162b2 mRNA COVID-19 vaccine is safe in oncologic patients undergoing numerous cancer treatments.
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Affiliation(s)
- Waleed Kian
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Melanie Zemel
- Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Emily H. Kestenbaum
- Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Keren Rouvinov
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Wafeek Alguayn
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dina Levitas
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Anna Ievko
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Regina Michlin
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Moataz A. Abod
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ismaell Massalha
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Elena Chernomordikov
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Adam A. Sharb
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Walid Shalata
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Esther Levison
- Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Laila C. Roisman
- The Institute of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Konstantin Lavrenkov
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Nir Peled
- The Institute of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Lior Nesher
- Infectious Disease Institute, Soroka Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Alexander Yakobson
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
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Kim MC, Park JH, Choi SH, Chung JW. Rhinovirus Incidence Rates Indicate We Are Tired of Non-pharmacological Interventions Against Coronavirus Disease 2019. J Korean Med Sci 2022; 37:e15. [PMID: 35014227 PMCID: PMC8748668 DOI: 10.3346/jkms.2022.37.e15] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/14/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of rhinovirus (RV) is inversely related to the intensity of non-pharmacological interventions (NPIs), such as universal mask wearing and physical distancing. METHODS Using RV surveillance data, changes in the effect of NPIs were investigated in South Korea during the pandemic. The time to the first visible effect of NPIs after the onset of NPIs (T1), time to the maximum effect (T2), and duration of the maximum effect (T3) were measured for each surge. For each week, the RVdiff [(RV incidence during the pandemic) - (RV incidence within 5 years before the pandemic)] was calculated, and number of weeks for RVdiff to be below zero after NPIs (time to RVdiff ≤ 0) and number of weeks RVdiff remains below zero after NPIs (duration of RVdiff ≤ 0) were measured for each surge. RESULTS During the study period, four surges of COVID-19 were reported. As the pandemic progressed, T1 and T2 increased, but T3 decreased. Additionally, the "time to RVdiff of ≤ 0" increased and "duration of RVdiff of ≤ 0" decreased. These changes became more pronounced during the third surge (mid-November 2020), before the introduction of the COVID-19 vaccine, and from the emergence of the delta variant. CONCLUSION The effect of NPIs appears slower, the duration of the effect becomes shorter, and the intensity also decreases less than a year after the onset of the pandemic owing to people's exhaustion in implementing NPIs. These findings suggest that the COVID-19 response strategy must be completely overhauled.
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Affiliation(s)
- Min-Chul Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Joung Ha Park
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Chung-Ang Medical Health Care System Hyundae Hospital, Namyangju, Korea
| | - Seong-Ho Choi
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
| | - Jin-Won Chung
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Lim S, Lee Y, Kim DW, Park WS, Yoon JH, Lee JY. Anti-SARS-CoV-2 Neutralizing Antibody Responses after Two Doses of ChAdOx1 nCoV-19 vaccine (AZD1222) in Healthcare Workers. Infect Chemother 2022; 54:140-152. [PMID: 35384425 PMCID: PMC8987172 DOI: 10.3947/ic.2022.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/01/2022] [Indexed: 01/05/2023] Open
Abstract
Background The kinetics of neutralizing antibodies against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) play an important role in evaluating vaccine efficacy and durability, herd immunity, additional vaccination, and prediction models of immune protection against coronavirus disease 2019. Materials and Methods Serum collection times were 4 and 8 weeks after 1st inoculation of AZD1222 (AstraZeneca, Cambridge, UK), and 2 and 16 weeks after 2nd inoculation with 12-week dosing intervals. Neutralizing antibody (Nab) titers were measured indirectly using commercially available R-FIND SARS-CoV-2 Neutralizing Antibody ELISA Kit (SG Medical Inc., Seoul, Korea). Possible influences of gender, age, and adverse events on neutralizing antibody titer were also investigated. Results Nab titers (median inhibition %) started to decrease shortly after reaching peaks. This decrease was more pronounced in the elderly group (≥56 years) than in the young group (≤39 years) at 8 weeks (49.5% vs. 55.4%, P = 0.021) and 16 weeks (40.6% vs. 53.9%, P = 0.006) after the 1st and 2nd inoculation. And Nab titers were inversely correlated with age in the 8-week (r = -0.2091, P = 0.0284) and the 28-week group (r = -0.2811, P = 0.0029). Seropositive conversion of Nab reached 89.1% and 100% following 1st and 2nd inoculation. This 100% seropositivity was dropped sharply to 74.5% after 16 weeks. Compared to subjects without adverse events (51.8%), median inhibition was higher in subjects with one or more systemic adverse events (74.2%, P = 0.0203) or those with one or more local and systemic adverse events (77.1%, P = 0.0003). Conclusion Nab induced by AZD1222 (AstraZeneca, UK) vaccination started to degrade shortly after the production period. Nab titers were lower in the elderly than in younger group during the degradation period. This seems to be because the degradation process of Nab is more pronounced in the elderly. This may explain why the frequency of breakthrough infections, disease severity, and mortality were higher in the elderly and may require revaccination to ensure robust immunity.
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Affiliation(s)
- Sera Lim
- Department of Infection Control, Pyeongtaek St. Mary’s Hospital, Pyeongtaek, Korea
| | - Yuil Lee
- Department of Infection Control, Pyeongtaek St. Mary’s Hospital, Pyeongtaek, Korea
| | - Dong Wan Kim
- Department of Diagnostic Laboratory Medicine, Pyeongtaek St. Mary’s Hospital, Pyeongtaek, Korea
| | - Won Sang Park
- Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Hwan Yoon
- Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Young Lee
- Department of Infection Control, Pyeongtaek St. Mary’s Hospital, Pyeongtaek, Korea
- Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Shasha D, Bareket R, Sikron FH, Gertel O, Tsamir J, Dvir D, Mossinson D, Heymann AD, Zacay G. Real-world safety data for the Pfizer BNT162b2 SARS-CoV-2 vaccine: historical cohort study. Clin Microbiol Infect 2022; 28:130-134. [PMID: 34592420 PMCID: PMC8479307 DOI: 10.1016/j.cmi.2021.09.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The Pfizer BNT162b2 vaccine showed a reassuring safety profile in clinical trials, but real-world data are scarce. Bell's palsy, herpes zoster, Guillain-Barré syndrome (GBS) and other neurological complaints in proximity to vaccination have received special public attention. We compared their rates among vaccinated and unvaccinated individuals. METHODS Individuals ≥16 years vaccinated with at least one dose of BNT162b2 were eligible for this historical cohort study in a health maintenance organization insuring 1.2 million citizens. Each vaccinee was matched to a non-vaccinated control by sex, age, population sector (general Jewish, Arab, ultra-orthodox Jewish) and comorbidities. Diagnosis of Covid-19 before or after vaccination was an exclusion criterion. The outcome was a diagnosis of Bell's palsy, GBS, herpes zoster or symptoms of numbness or tingling, coded in the visit diagnosis field using ICD-9 codes. Diagnoses of Bell's palsy and GBS were verified by individual file review. RESULTS Of 406 148 individuals vaccinated during the study period, 394 609 (97.2%) were eligible (11 539 excluded). A total of 233 159 (59.1%) were matched with unvaccinated controls. Mean follow was 43 ± 15.14 days. In vaccinated and unvaccinated individuals there were 23 versus 24 cases of Bell's palsy (RR 0.96, CI 0.54-1.70), one versus zero cases of GBS, 151 versus 141 cases of herpes zoster (RR 1.07, CI 0.85-1.35) and 605 versus 497 cases of numbness or tingling (RR 1.22, CI 1.08-1.37), respectively. DISCUSSION No association was found between vaccination, Bell's palsy, herpes zoster or GBS. Symptoms of numbness or tingling were more common among vaccinees. This study adds reassuring data regarding the safety of the BNT162b2 vaccine.
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Affiliation(s)
- David Shasha
- Meuhedet Health Maintenance Organization, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - Ronen Bareket
- Meuhedet Health Maintenance Organization, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Omer Gertel
- Meuhedet Health Maintenance Organization, Israel
| | | | - David Dvir
- Meuhedet Health Maintenance Organization, Israel
| | | | - Anthony D Heymann
- Meuhedet Health Maintenance Organization, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galia Zacay
- Meuhedet Health Maintenance Organization, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Brooks SG, De Jong AM, Abbaslou M, Sussman G. Chronic Spontaneous Urticaria Triggered by the AstraZeneca/Oxford COVID-19 Vaccine with Achieved Remission: A Case Report. ALLERGY & RHINOLOGY (PROVIDENCE, R.I.) 2022; 13:21526567211068458. [PMID: 35036040 PMCID: PMC8753064 DOI: 10.1177/21526567211068458] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
New adverse reactions to the COVID-19 vaccines are being identified as vaccination rates
increase worldwide. Recently, there have been two reports of Moderna (mRNA-1273) vaccine
induced relapse of chronic spontaneous urticaria (CSU) that was previously well
controlled. Herein, we report a case of AstraZeneca/Oxford (ChAdOx1) vaccine triggered CSU
in a patient with no history of CSU with achieved remission.
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Affiliation(s)
- Stephanie G Brooks
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Gordon Sussman Clinical Research, Inc., Toronto, Ontario, Canada
| | - Anna M De Jong
- Gordon Sussman Clinical Research, Inc., Toronto, Ontario, Canada.,University of Western Ontario, London, Ontario, Canada
| | - Mina Abbaslou
- Gordon Sussman Clinical Research, Inc., Toronto, Ontario, Canada
| | - Gordon Sussman
- Gordon Sussman Clinical Research, Inc., Toronto, Ontario, Canada.,Department of Medicine and Division of Clinical Immunology & Allergy, University of Toronto, Toronto, Ontario, Canada
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Niebel D, Wilhelmi J, De Vos L, Ziob J, Jaschke K, Bieber T, Wenzel J, Braegelmann C. Annular plaques mimicking Rowell's syndrome in the course of coronavirus disease 2019 mRNA vaccines: An overlooked phenomenon? J Dermatol 2022; 49:151-156. [PMID: 34693548 PMCID: PMC8652474 DOI: 10.1111/1346-8138.16210] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/06/2021] [Accepted: 10/12/2021] [Indexed: 01/10/2023]
Abstract
Effective vaccines for prevention of severe course and lethal outcome of coronavirus disease 2019 have been developed and approved in regulatory rolling and fast-track procedures; they are now widely distributed worldwide. Data about cutaneous side-effects of the new mRNA-type vaccines is scant, however. We herein report two similar cases of cutaneous adverse drug reactions (ADR) mimicking Rowell's syndrome that occurred after the first dose of BNT162b2 and mRNA-1273, respectively. Both patients achieved prompt clinical improvement with a short pulse of oral prednisolone and non-steroidal inflammatory drugs. We suspect this phenomenon to occur in a timeframe of 7-14 days after vaccination due to an interferon-γ-driven shift towards type I immunity in susceptible individuals. As rheumatic patients were excluded from phase III clinical trials and as most countries prioritized the elderly population to receive the vaccinations first, cutaneous ADR might become more frequent once the younger part of the population is vaccinated over the course of 2021. Atypical cutaneous ADR might be misinterpreted or overlooked by non-dermatologists. Further studies are required to determine the best suitable vaccine types for individual groups of patients.
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Affiliation(s)
- Dennis Niebel
- Department of Dermatology and AllergyUniversity Hospital BonnBonnGermany
| | - Jasmin Wilhelmi
- Department of Dermatology and AllergyUniversity Hospital BonnBonnGermany
| | - Luka De Vos
- Department of Dermatology and AllergyUniversity Hospital BonnBonnGermany
| | - Jana Ziob
- Department of Dermatology and AllergyUniversity Hospital BonnBonnGermany
| | - Kristel Jaschke
- Department of Dermatology and AllergyUniversity Hospital BonnBonnGermany
| | - Thomas Bieber
- Department of Dermatology and AllergyUniversity Hospital BonnBonnGermany
| | - Joerg Wenzel
- Department of Dermatology and AllergyUniversity Hospital BonnBonnGermany
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Local and Systemic Adverse Reactions to mRNA COVID-19 Vaccines Comparing Two Vaccine Types and Occurrence of Previous COVID-19 Infection. Vaccines (Basel) 2021; 9:vaccines9121463. [PMID: 34960209 PMCID: PMC8707814 DOI: 10.3390/vaccines9121463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/25/2021] [Accepted: 12/06/2021] [Indexed: 01/14/2023] Open
Abstract
The aim of this study was to assess adverse reactions to COVID-19 vaccines, comparing the BNT162b2 or the mRNA-1273 COVID-19 vaccines and the presence and seriousness of a previous COVID-19 infection. We conducted a cross-sectional online survey of vaccinated healthcare workers at a tertiary hospital in Barcelona (Spain). Thirty-eight percent of vaccine recipients responded to the questionnaire. We compared the prevalence of adverse reactions by vaccine type and history of COVID-19 infections. A total of 2373 respondents had received the BNT162b2 vaccine, and 506 the mRNA-1273 vaccine. The prevalence of at least one adverse reaction with doses 1 and 2 was 41% and 70%, respectively, in the BNT162b2 group, and 60% and 92% in the mRNA-1273 group (p < 0.001). The BNT162b2 group reported less prevalence of all adverse reactions. Need for medical leave was significantly more frequent among the mRNA-1273 group (12% versus 4.6% p < 0.001). Interestingly, respondents with a history of allergies or chronic illnesses did not report more adverse reactions. The frequency of adverse reactions with dose 2 was 96% (95% CI 88–100%) for those with a history of COVID-19 related hospitalization, and 86% (95% CI 83–89%) for those with mild or moderate symptomatic COVID-19, significantly higher than for participants with no history of COVID-19 infections (67%, 95% CI 65–69%). Our results could help inform vaccine recipients of the probability of their having adverse reactions to COVID-19 vaccines.
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Baek DW, Hwang S, Kim J, Lee JM, Cho HJ, Moon JH, Hwang N, Jeong JY, Lee SW, Sohn SK. Patients presenting high fever with lymphadenopathy after COVID-19 vaccination were diagnosed with hemophagocytic lymphohistiocytosis. Infect Dis (Lond) 2021; 54:303-307. [PMID: 34854350 DOI: 10.1080/23744235.2021.2010801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still continuing worldwide. Currently, two mRNA-based vaccines and two DNA vaccines using an adenovirus vector are representative vaccines. Since the SARS-CoV-2 vaccines began to be administered, a significant decrease in new infections and COVID-19-associated death has been reported. However, various adverse events from mild symptoms to death have also been described after vaccination. CASE DESCRIPTION Patients with high fever and lymphadenopathy who are diagnosed with hemophagocytic lymphohistiocytosis (HLH) after COVID-19 vaccination are very rare, and there is no standard management guideline for these patients thus far. Herein, we described two cases of HLH after the administration of an mRNA-based vaccine and adenovirus vector vaccine. DISCUSSION HLH is a life-threatening hyperinflammatory syndrome that occurs due to persistent stimulation of lymphocytes and histiocytes in various underlying conditions at all ages. Although the exact mechanisms and risk factors of COVID-19 vaccination-related HLH are still unknown, vigorous immune stimulation may trigger a huge cytokine storm, rarely resulting in HLH. It is important to note that early suspicion by clinicians can lower the mortality rate.
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Affiliation(s)
- Dong Won Baek
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Soyoon Hwang
- Department of Infectious Disease, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Juhyung Kim
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jung Min Lee
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hee Jeong Cho
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Joon-Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Narae Hwang
- Department of Laboratory Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Yun Jeong
- Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang Kyun Sohn
- Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
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Tequare MH, Abraha HE, Adhana MT, Tekle TH, Belayneh EK, Gebresilassie KB, Wolderufael AL, Ebrahim MM, Tadele BA, Berhe DF, Ashebir MM, Gebrehiwot KG, Atsbaha M, Berihu BA, Desta KG, Atsbaha MT, Mengesha RE, Tsegay MA, Sibhatu MK. Adverse events of Oxford/AstraZeneca's COVID-19 vaccine among health care workers of Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia. IJID REGIONS 2021; 1:124-129. [PMID: 35721767 PMCID: PMC8562017 DOI: 10.1016/j.ijregi.2021.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 12/28/2022]
Abstract
Background : The safety of COVID vaccines should be continuously followed. This study reports adverse events of the Oxford/AstraZeneca COVID-19 vaccine. Methods : A prospective single-cohort study design was conducted to assess adverse events following immunization and associated factors of the first dose of Oxford/AstraZeneca's COVID-19 vaccine in Ayder Comprehensive specialized hospital. A structured questionnaire was administered consecutively to 423 participants. Follow-up data were collected 72 hours after vaccination via phone. Bivariate and multivariate logistic regression models were used to find associations between adverse events and independent variables. Statistical significance was declared at P<0.05. Results : Out of 423 health care workers approached, 395 responded. At least one adverse event (95% CI: 63.58, 72.77) was reported by 270 participants. Local and systemic symptoms occurred in 46.8% (95% CI: 41.94, 51.79) and 58.48% (95% CI: 53.53, 63.26)], respectively. Muscle ache, fatigue, headache and fever were the most common local symptoms. No reports of hospitalization, disability or death. Age (adjusted odds ratio [AOR]=0.97, P=0.048), female sex (AOR=1.84, P=0.028), and comorbidity (AOR=2.28, P=0.040) were independent predictors of adverse events. Conclusion and recommendation : Adverse events following immunization are commonly reported after the first dose of the Oxford/AstraZeneca COVID-19 vaccine; age, female sex and comorbidity are independent predictors.
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72
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Im JH, Kim E, Lee E, Seo Y, Lee Y, Jang Y, Yu S, Maeng Y, Park S, Park S, Kim J, Lee JS, Baek JH. Adverse Events with the Pfizer-BioNTech COVID-19 Vaccine among Korean Healthcare Workers. Yonsei Med J 2021; 62:1162-1168. [PMID: 34816647 PMCID: PMC8612854 DOI: 10.3349/ymj.2021.62.12.1162] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 01/31/2023] Open
Abstract
The Pfizer-BioNTech COVID-19 vaccine has shown excellent clinical effectiveness; however, adverse events of the vaccine remain a concern in Korea. We surveyed adverse events in 2498 healthcare workers vaccinated with the Pfizer-BioNTech COVID-19 vaccine at a university hospital. The survey was conducted using a diary card for 7 days following each injection. The questionnaire response rate was 75.1% (1876/2498) for the first dose and 73.8% (1840/2493) for the second dose. Among local reactions, pain was the most commonly reported (84.9% after the first dose and 90.4% after the second dose). After the second dose, two people visited the emergency room due to severe local pain, but no hospitalization or skin necrosis occurred. Among systemic reactions, fatigue was most frequently reported (52.8% after the first dose and 77.0% after the second dose), followed by myalgia (49.0% and 76.1%), headache (28.7% and 59.2%), chills (16.7% and 54.0%), and arthralgia (11.4% and 39.2%). One or more critical adverse events occurred in 0.2% and 0.7% of the vaccinees. Except for urticaria, more adverse events were reported after the second dose than after the first dose. In the future, adverse events should be investigated in older adults, and a future study with a longer observation period should be conducted.
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Affiliation(s)
- Jae Hyoung Im
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Eunjung Kim
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Eunyoung Lee
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Yeongju Seo
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Yuran Lee
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Yoonkyoung Jang
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Soyeon Yu
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Yeonju Maeng
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Soyeon Park
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Seohee Park
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Jiah Kim
- Department of Health Management, Inha University Hospital, Incheon, Korea
| | - Jin-Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Ji Hyeon Baek
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
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Lee SW, Moon JY, Lee SK, Lee H, Moon S, Chung SJ, Yeo Y, Park TS, Park DW, Kim TH, Sohn JW, Yoon HJ, Kim SH. Anti-SARS-CoV-2 Spike Protein RBD Antibody Levels After Receiving a Second Dose of ChAdOx1 nCov-19 (AZD1222) Vaccine in Healthcare Workers: Lack of Association With Age, Sex, Obesity, and Adverse Reactions. Front Immunol 2021; 12:779212. [PMID: 34899739 PMCID: PMC8654782 DOI: 10.3389/fimmu.2021.779212] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/10/2021] [Indexed: 01/21/2023] Open
Abstract
Response to vaccines generally varies according to individual factors of the vaccinated subjects such as demographics and immune status. While there are various reports of factors associated with immunogenicity of mRNA COVID-19 vaccines, little is known about those of adenovirus vector vaccines. We conducted a prospective observational study to assess the relationships of antibody level with age, sex, body mass index (BMI), and adverse reactions (ARs) to an adenovirus vector vaccine, ChAdOx1 nCoV-19. Healthcare workers who planned to receive both the first and second injections of the ChAdOx1 nCoV-19 vaccine at Hanyang University Hospital, Seoul, Korea, were enrolled in the study. Seven days after each injection, participants were asked to complete an online adverse reaction survey. In addition, anti-SARS-CoV-2 spike (S) protein receptor binding domain (RBD) antibody concentration was measured 4 weeks after the second injection. All participants (n = 447, 100%) showed serologic positivity (≥ 0.8 U/mL) 4 weeks after the second injection of ChAdOx1 nCoV-19 vaccine. Furthermore, the anti-SARS-CoV-2 S protein RBD concentration was similar among groups when stratified by age, sex, BMI, or presence and severity of AR; multivariable linear regression found no associations between antibody response to the ChAdOx1 nCoV-19 vaccine and age, BMI, sex, and vaccine-induced ARs. In conclusion, age, sex, obesity, and ARs were not associated with antibody responses after two doses of ChAdOx1 nCoV-19 vaccination.
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Affiliation(s)
- Sang Won Lee
- Department of Clinical Pharmacology and Therapeutics, Hanyang University Hospital, Seoul, South Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Sun-Kyung Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
- Department of Mathematics, College of Natural Sciences, Hanyang University, Seoul, South Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - SeolHwa Moon
- College of Nursing, Hanyang University, Seoul, South Korea
| | - Sung Jun Chung
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Yoomi Yeo
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Tai Sun Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Dong Won Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Tae-Hyung Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Jang Won Sohn
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Ho Joo Yoon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Sang-Heon Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
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Miqdadi A, Herrag M. Acute Eosinophilic Pneumonia Associated With the Anti-COVID-19 Vaccine AZD1222. Cureus 2021; 13:e18959. [PMID: 34812326 PMCID: PMC8604432 DOI: 10.7759/cureus.18959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 01/12/2023] Open
Abstract
SARS-CoV-2 is an emerging virus causing the contemporary global pandemic. No cure has yet been discovered. Therefore, vaccination remains the only hope. We report the case of a 66-year-old male patient with a history of allergies. Five hours after his vaccination with the anti-COVID-19 vaccine AZD1222 (ChAdOx1 nCoV-19, AstraZeneca), he developed acute respiratory distress. The biological assessment showed hyperleukocytosis, 20% of which are eosinophils. Diagnosis of severe postvaccination acute eosinophilic pneumonia was retained given the history of allergy, lack of improvement on antibiotics, elimination of all other probable causes of eosinophilia, and improvement on corticosteroids. Such reactions of eosinophilic pneumonia have only been described twice: once following vaccination with the influenza vaccine (Vaxigrip*) and the other after vaccination with the 23-valent pneumococcal polysaccharide vaccine (Pneumovax 23*). Hypereosinophilia must be taken into consideration, feared, and prevented. Although rare and severe, post-COVID-19 vaccination acute eosinophilic pneumonia remains well manageable with corticosteroids with a good outcome. Therefore, in some poorly monitored patients with allergy or asthma, the use of another less allergenic vaccine could be considered to avoid such reactions.
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Affiliation(s)
- Amal Miqdadi
- Respiratory Medicine, Cheikh Khalifa Bin Zayed Al Nahyan Hospital, Casablanca, MAR.,Medicine, Mohammed 6 University of Health and Sciences, Casablanca, MAR
| | - Mohammed Herrag
- Respiratory Medicine, Cheikh Khalifa Bin Zayed Al Nahyan Hospital, Casablanca, MAR.,Medicine, Mohammed 6 University of Health and Sciences, Casablanca, MAR
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75
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Konu YR, Gbeasor-Komlanvi FA, Yerima M, Sadio AJ, Tchankoni MK, Zida-Compaore WIC, Nayo-Apetsianyi J, Afanvi KA, Agoro S, Salou M, Landoh DE, Nyansa AB, Boko E, Mijiyawa M, Ekouevi DK. Prevalence of severe adverse events among health professionals after receiving the first dose of the ChAdOx1 nCoV-19 coronavirus vaccine (Covishield) in Togo, March 2021. Arch Public Health 2021; 79:207. [PMID: 34819146 PMCID: PMC8611394 DOI: 10.1186/s13690-021-00741-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/14/2021] [Indexed: 12/23/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) vaccines can cause adverse events that can lead to vaccine hesitancy. This study aims at estimating the prevalence of severe adverse events (SAEs) and their associated factors among health professionals vaccinated with ChAdOx1 nCoV-19 vaccine in Togo. Methods A cross-sectional study was conducted from March 13th to 19th, 2021 in Togo among health professionals who received the first dose of the vaccine. An online self-administered questionnaire was used to collect sociodemographic and vaccination data. SAEs were defined as one resulting in hospitalization, medical consultation, or inability to work the day following the administration of the vaccine. Data analysis were performed using R© 4.0.1 software, and a 5% significance level was considered. Results A total of 1,639 health professionals (70.2% male) with a median age of 32 (interquartile range: 27-40) were enrolled. At least one adverse event was reported among 71.6% of participants (95% CI = [69.3-73.8]). The most commonly reported adverse events were injection site pain (91.0%), asthenia (74.3%), headache (68.7%), soreness (55.0%), and fever (47.5%). An increased libido was also reported in 3.0% of participants. Of the participants who experienced adverse events, 18.2% were unable to go to work the day after vaccination, 10.5% consulted a medical doctor, and 1.0% were hospitalized. The SAEs’ prevalence was 23.8% (95% CI = [21.8-25.9]). Being <30 years (AOR = 5.54; p<0.001), or 30-49 years (AOR = 3.62; p<0.001) and being female (AOR = 1.97; p<0.001) were associated with SAEs. Conclusions High prevalence of SAEs have been observed in health professionals in Togo after ChAdOx1 nCoV-19 vaccination especially in young people and females. However, these data are reassuring as they inform on COVID-19 vaccines’ SAE management. Systematic prescription of antalgics or antipyretics could be proposed to young people who get vaccinated.
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Affiliation(s)
- Yao Rodion Konu
- Public Health Department, University of Lomé, Lomé, Togo.,African Centre for Research in Epidemiology and Public Health (CARESP), Lomé, Togo
| | - Fifonsi Adjidossi Gbeasor-Komlanvi
- Public Health Department, University of Lomé, Lomé, Togo.,African Centre for Research in Epidemiology and Public Health (CARESP), Lomé, Togo
| | - Mouhoudine Yerima
- Ministry of Health and Public Hygiene, Pharmacovigilance Department, Lomé, Togo
| | - Arnold Junior Sadio
- Public Health Department, University of Lomé, Lomé, Togo.,African Centre for Research in Epidemiology and Public Health (CARESP), Lomé, Togo
| | | | | | | | - Kossivi Agbélénko Afanvi
- Public Health Department, University of Lomé, Lomé, Togo.,Ministry of Health and Public Hygiene, Lomé, Togo
| | - Sibabe Agoro
- Public Health Department, University of Lomé, Lomé, Togo.,Ministry of Health and Public Hygiene, Lomé, Togo
| | - Mounerou Salou
- Laboratory of Molecular Biology and Immunology (BIOLIM), University of Lomé, Lomé, Togo
| | | | - Atany B Nyansa
- Ministry of Health and Public Hygiene, Pharmacovigilance Department, Lomé, Togo
| | - Essohanam Boko
- Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Moustafa Mijiyawa
- Ministry of Health and Public Hygiene, Lomé, Togo.,Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Didier Koumavi Ekouevi
- Public Health Department, University of Lomé, Lomé, Togo. .,African Centre for Research in Epidemiology and Public Health (CARESP), Lomé, Togo. .,Inserm Center, Institute of Public Health and Development and University of Bordeaux, 1219, Bordeaux, France.
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76
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Choi YY, Kim MK, Kwon HC, Kim GH. Safety Monitoring after the BNT162b2 COVID-19 Vaccine among Adults Aged 75 Years or Older. J Korean Med Sci 2021; 36:e318. [PMID: 34811980 PMCID: PMC8608922 DOI: 10.3346/jkms.2021.36.e318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Older adults are given high priority for coronavirus disease 2019 (COVID-19) vaccination; however, little is known about the safety of vaccines. This study was conducted to examine the safety of the COVID-19 vaccine for people who were ≥ 75 years of age, specifically those who first took two doses of the vaccine at the COVID-19 central vaccination center in South Korea. METHODS Safety monitoring after the BNT162b2 vaccine was conducted in three ways for older adults who received the first dose of the vaccine at our center between April 5 and April 23, 2021. For immediate adverse reactions, every person who was vaccinated was observed for 15-30 minutes after injection at the center. For active surveillance, a telephone interview was conducted for stratified randomly sampled people after 7 days of each vaccination to enquire regarding types of adverse reactions they experienced, and its severity and duration. For passive surveillance, reported adverse event data were collected from the COVID-19 vaccine adverse event following immunization (AEFI) surveillance system-run by the Korea Disease Control and Prevention Agency (KDCA). The data were then reviewed. RESULTS In total, 2,123 older adults received at least one vaccine dose during the study period. The frequency of acute adverse reactions that developed during the observed 15-30 minutes after injection was 8.5 cases per 1,000 doses. None of the reactions was assessed as acute allergic reactions to the vaccine and no cases required special treatment or drug administration. Overall, 638 people were followed up at least once by telephone interview 7 days post vaccination. The overall response rate was 82.3%. The rates of local reactions were 50.3% after the first dose and 45.2% after the second dose, and the rates of systemic reactions were 15.2% and 26.0%, respectively. During the study period, 23 medically attended adverse events (5.4 cases per 1,000 administered doses) were reported to the KDCA AEFI surveillance system. The most common symptoms of medically attended cases were nonspecific general weakness (26%) and dizziness (26%), followed by muscle pain (22%), headache (13%), fever (13%), and skin rash or urticaria (13%). Among them, there were five serious adverse events reported, which required hospitalization, including one death. However, most of them were not related to the vaccines. CONCLUSION BNT162b2 vaccination was tolerable among adults who were ≥ 75 years of age.
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Affiliation(s)
- Youn Young Choi
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Min-Kyung Kim
- Department of Infectious Diseases, National Medical Center, Seoul, Korea
| | - Hyeok Choon Kwon
- Department of Gastroenterology and Hepatology, National Medical Center, Seoul, Korea
| | - Gunn Hee Kim
- Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.
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77
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Jeong S, Lee N, Lee SK, Cho EJ, Hyun J, Park MJ, Song W, Jung EJ, Woo H, Seo YB, Park JJ, Kim HS. Comparison of the Results of Five SARS-CoV-2 Antibody Assays before and after the First and Second ChAdOx1 nCoV-19 Vaccinations among Health Care Workers: a Prospective Multicenter Study. J Clin Microbiol 2021; 59:e0178821. [PMID: 34613799 PMCID: PMC8601234 DOI: 10.1128/jcm.01788-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/28/2021] [Indexed: 01/31/2023] Open
Abstract
Reliable results for serological positivity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody after the second dose of AstraZeneca (AZ) vaccination are important to estimate the real efficacy of vaccination. We evaluated positivity rates and changes in semiquantitative antibody titers before and after the first and second ChAdOx1 nCoV-19 vaccinations using five SARS-CoV-2 antibody assays, including two surrogate virus neutralization tests. A total of 674 serum samples were obtained from 228 participants during three blood sampling periods. A questionnaire on symptoms, severity, and adverse reaction duration was completed by participants after the second vaccination. The overall positive rates for all assays were 0.0 to 0.9% before vaccination, 66.2 to 92.5% after the first vaccination, and 98.2 to 100.0% after the second vaccination. Median antibody titers in five assays after the second dose of vaccination were increased compared to those after the first dose (106.4-fold increase for Roche total antibody, 3.6-fold for Abbott IgG, 3.6-fold for Siemens, 1.2-fold for SD Biosensor V1 neutralizing antibody, and 2.2-fold for GenScript neutralizing antibody). Adverse reactions were reduced after the second dose in 89.9% of participants compared to after the first dose. Overall, the second vaccination led to almost 100% positivity rates based on these SARS-CoV-2 antibody assays. The results should be interpreted with caution, considering the characteristics of the applied assays. Our findings could inform decisions regarding vaccination and the use of immunoassays, thus contributing to SARS-CoV-2 pandemic control.
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Affiliation(s)
- Seri Jeong
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Nuri Lee
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Su Kyung Lee
- Department of Laboratory Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Eun-Jung Cho
- Department of Laboratory Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Jungwon Hyun
- Department of Laboratory Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Min-Jeong Park
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Wonkeun Song
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Eun Ju Jung
- Division of Infectious Diseases, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Heungjeong Woo
- Division of Infectious Diseases, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Jin Ju Park
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
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Iguacel I, Maldonado AL, Ruiz-Cabello AL, Casaus M, Moreno LA, Martínez-Jarreta B. Association between COVID-19 Vaccine Side Effects and Body Mass Index in Spain. Vaccines (Basel) 2021; 9:1321. [PMID: 34835252 PMCID: PMC8623604 DOI: 10.3390/vaccines9111321] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/22/2021] [Accepted: 11/10/2021] [Indexed: 12/25/2022] Open
Abstract
COVID-19 vaccines have shown high efficacy, with most side effects being mild-moderate and more frequently reported by females and people at younger ages. Since no studies have assessed the impact that weight status could have on the reported adverse reactions, we aim to study the association between weight status and reported side effects. We included data on 2136 adults from an online survey conducted from 6 May to 9 June 2021. The questionnaire was filled in by participants over Google forms. Generalized Linear Mixed Models were used. A higher risk of presenting fever ≥38°, vomiting, diarrhea and chills was found in those with a non-overweight status compared to those overweight after adjusting for age, sex, education, medication to prevent/relieve post-vaccination effects and vaccine administered. When adjusting, most of the significant effects, in the association between side effects of the COVID-19 vaccine and weight status, did not remain significant. In conclusion, a non-overweight status was associated with a higher risk of presenting fever ≥38°, vomiting, diarrhea and chills compared to those overweight. Nevertheless, most of the reported side effects to COVID-19 vaccine were not associated with a higher risk of presenting more adverse effects, and individual differences were determined by sex and age.
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Affiliation(s)
- Isabel Iguacel
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (M.C.); (L.A.M.)
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, 50009 Zaragoza, Spain;
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, 50009 Zaragoza, Spain
| | - Aurelio Luna Maldonado
- Department of Socio-sanitary Sciences, University of Murcia, 30100 Murcia, Spain; (A.L.M.); (A.L.R.-C.)
| | - Aurelio Luna Ruiz-Cabello
- Department of Socio-sanitary Sciences, University of Murcia, 30100 Murcia, Spain; (A.L.M.); (A.L.R.-C.)
| | - Marta Casaus
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (M.C.); (L.A.M.)
| | - Luis Alberto Moreno
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (M.C.); (L.A.M.)
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, 50009 Zaragoza, Spain;
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, 50009 Zaragoza, Spain
| | - Begoña Martínez-Jarreta
- Instituto de Investigación Sanitaria Aragón, 50009 Zaragoza, Spain;
- Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
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Vassallo A, Shajahan S, Harris K, Hallam L, Hockham C, Womersley K, Woodward M, Sheel M. Sex and Gender in COVID-19 Vaccine Research: Substantial Evidence Gaps Remain. Front Glob Womens Health 2021; 2:761511. [PMID: 34816252 PMCID: PMC8593988 DOI: 10.3389/fgwh.2021.761511] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/08/2021] [Indexed: 12/22/2022] Open
Abstract
Since the start of the COVID-19 pandemic there has been a global call for sex/gender-disaggregated data to be made available, which has uncovered important findings about COVID-19 testing, incidence, severity, hospitalisations, and deaths. This mini review scopes the evidence base for efficacy, effectiveness, and safety of COVID-19 vaccines from both experimental and observational research, and asks whether (1) women and men were equally recruited and represented in vaccine research, (2) the outcomes of studies were presented or analysed by sex and/or gender, and (3) there is evidence of sex and/or gender differences in outcomes. Following a PubMed search, 41 articles were eligible for inclusion, including seven randomised controlled trials (RCTs), 11 cohort studies, eight cross-sectional surveys, eight routine surveillance studies, and seven case series. Overall, the RCTs contained equal representation of women and men; however, the observational studies contained a higher percentage of women. Of 10 studies with efficacy data, only three (30%) presented sex/gender-disaggregated results. Safety data was included in 35 studies and only 12 (34%) of these presented data by sex/gender. For those that did present disaggregated data, overall, the majority of participants reporting adverse events were women. There is a paucity of reporting and analysis of COVID-19 vaccine data by sex/gender. Research should be designed in a gender-sensitive way to present and, where possible analyse, data by sex/gender to ensure that there is a robust and specific evidence base of efficacy and safety data to assist in building public confidence and promote high vaccine coverage.
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Affiliation(s)
- Amy Vassallo
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Sultana Shajahan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Katie Harris
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Laura Hallam
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Carinna Hockham
- The George Institute for Global Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Kate Womersley
- The George Institute for Global Health, School of Public Health, Imperial College London, London, United Kingdom
- University of Edinburgh, NHS Lothian, Edinburgh, United Kingdom
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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Hwang YH, Song KH, Choi Y, Go S, Choi SJ, Jung J, Kang CK, Choe PG, Kim NJ, Park WB, Oh MD. Can reactogenicity predict immunogenicity after COVID-19 vaccination? Korean J Intern Med 2021; 36:1486-1491. [PMID: 34038996 PMCID: PMC8588964 DOI: 10.3904/kjim.2021.210] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/11/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/AIMS This study aimed to assess the association between local and systemic reactogenicity and humoral immunogenicity after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. METHODS Adverse events were prospectively evaluated using an electronic diary in 135 healthy adults who received a SARS-CoV-2 vaccine (AZD1222, AstraZeneca/Oxford, n = 42; or BNT162b2, Pfizer/BioNTech, n = 93). We semi-quantitatively measured anti-S1 immunoglobulin G (IgG) using an enzyme-linked immunosorbent assay at baseline, 3 weeks after the first dose of AZD1222 or BNT162b2, and 2 weeks after the second dose of BNT162b2. We evaluated the association between the maximum grade of local or systemic adverse events and the anti-S1 IgG optical density using multivariate linear regression with adjustment for age, sex, and use of antipyretics. RESULTS The median age of the 135 vaccinees was 30 years (36 years in the AZD1222 group and 29 years in the BNT162b2 group) and 25.9% were male (9.5% in the AZD1222 group and 33.3% in the BNT162b2 group). Local and systemic adverse events were generally comparable after the first dose of AZD1222 and the second dose of BNT162b2. The grades of local and systemic adverse events were not significantly associated with anti-S1 IgG levels in the AZD1222 or BNT162b2 group. CONCLUSION Local and systemic reactogenicity may not be associated with humoral immunogenicity after SARS-CoV-2 vaccination.
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Affiliation(s)
- Young Hoon Hwang
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Yunsang Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Suryeong Go
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Su-Jin Choi
- Laboratory of Infection & Immunity, Seoul National University Hospital Biomedical Research Institute, Seoul,
Korea
| | - Jongtak Jung
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Chang Kyung Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Pyoeng Gyun Choe
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Nam-Joong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Myoung-don Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
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81
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Kang YM, Lim J, Choe KW, Lee KD, Jo DH, Kim MJ, Kim JM, Kim KN. Reactogenicity after the first and second doses of BNT162b2 mRNA coronavirus disease vaccine: a single-center study. Clin Exp Vaccine Res 2021; 10:282-289. [PMID: 34703812 PMCID: PMC8511587 DOI: 10.7774/cevr.2021.10.3.282] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/05/2021] [Indexed: 01/31/2023] Open
Abstract
Purpose This study was conducted to determine differences in adverse events associated with the first and second doses of the BNT162b2 coronavirus disease 2019 vaccine based on the age and sex of recipients. Materials and Methods An online survey on the post-vaccination adverse events of healthcare workers was conducted from March 2021 to April 2021. The differences in the types of adverse events, including severity, onset time, and duration of symptoms, and how the adverse events were dealt with by the patient were analyzed based on the age and sex. The profiles of adverse events were compared after the first and second vaccination doses. Results Among the 131 participants who participated in the online survey out of 208 vaccine recipients, 43 and 80 recipients of the BNT162b2 vaccine experienced adverse events after the first and second dose, respectively. No sex-related differences were observed in the profiles of adverse events in vaccinated recipients. The overall frequency of adverse events did not differ based on age after the first dose. After the second dose, the frequency of adverse events, including both local and systemic reactions was significantly higher in the younger age group than in the older age group. Conclusion The BNT162b2 vaccine resulted in a higher frequency of adverse events after the second dose than after the first dose especially in the younger age group; however, no sex-related differences associated with these adverse events were observed.
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Affiliation(s)
- Yu Min Kang
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Jaegyun Lim
- Department of Laboratory Medicine, Myongji Hospital, Goyang, Korea
| | - Kang-Won Choe
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Ki-Deok Lee
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Dong Ho Jo
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Moon Jung Kim
- Department of Laboratory Medicine, Myongji Hospital, Goyang, Korea
| | - Jong Min Kim
- Department of Pediatrics, Myongji Hospital, Goyang, Korea
| | - Kwang Nam Kim
- Department of Pediatrics, Myongji Hospital, Goyang, Korea
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Lee SW, Lee H, Lee SK, Moon JY, Moon S, Chung SJ, Yeo Y, Park TS, Won Park D, Kim TH, Sohn JW, Yoon HJ, Kim SH. Risk Factors for Grade 3 to Grade 4 Adverse Reactions to the ChAdOx1 nCoV-19 Vaccine (AZD1222) Against SARS-CoV-2. Front Med (Lausanne) 2021; 8:738049. [PMID: 34660644 PMCID: PMC8514770 DOI: 10.3389/fmed.2021.738049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Limited data are available regarding the rates and risk factors of severe to serious adverse reactions (ARs) to the ChAdOx1 nCoV-19 vaccine. Methods: Eligible participants were healthcare workers who received their first dose of the ChAdOx1 nCoV-19 vaccine in either of two university hospitals in Seoul, Korea. We evaluated the type and severity of ARs 7 days after the first dose of the ChAdOx1 nCoV-19 vaccine using a questionnaire survey delivered via a smartphone application link. Results: Among the 1,603 participants who completed the survey, 684 (42.7%) participants experienced any kind of grade 3 to grade 4 AR. Being young (adjusted odds ratio [OR] for age 21–30 years = 2.49, 95% confidence interval [CI] = 1.75–3.56; adjusted OR for 31–40 years = 1.78, 95% CI = 1.22–2.62; adjusted OR for 41–50 years = 1.47, 95% CI = 1.03–2.11), being female (adjusted OR = 2.16. 95% CI = 1.62–2.89), and being underweight (adjusted OR = 1.61, 95% CI = 1.02–2.55) were identified as risk factors for grade 3 to grade 4 ARs. Among comorbidities, only diabetes mellitus (adjusted OR = 2.36, 95% CI = 1.03–5.53) was identified as a risk factor. When stratified by the type of AR, being young and being female were risk factors for both local and systemic grade 3 to grade 4 ARs. Conclusions: Being young, female, or underweight and having diabetes mellitus were associated with an increased risk of developing grade 3 to grade 4 ARs after receiving the first dose of the ChAdOx1 nCoV-19 vaccine.
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Affiliation(s)
- Sang Won Lee
- Department of Clinical Pharmacology and Therapeutics, Hanyang University Hospital, Seoul, South Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Sun-Kyung Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.,Department of Mathematics, College of Natural Sciences, Hanyang University, Seoul, South Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - SeolHwa Moon
- College of Nursing, Hanyang University, Seoul, South Korea
| | - Sung Jun Chung
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Yoomi Yeo
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Tai Sun Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Dong Won Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Tae-Hyung Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Jang Won Sohn
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Ho Joo Yoon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Sang-Heon Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
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Alhumaid S, Al Mutair A, Al Alawi Z, Rabaan AA, Tirupathi R, Alomari MA, Alshakhes AS, Alshawi AM, Ahmed GY, Almusabeh HM, Alghareeb TT, Alghuwainem AA, Alsulaiman ZA, Alabdulmuhsin MA, AlBuwaidi EA, Dukhi AKB, Mufti HN, Al-Qahtani M, Dhama K, Al-Tawfiq JA, Al-Omari A. Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2021; 17:109. [PMID: 34656181 PMCID: PMC8520206 DOI: 10.1186/s13223-021-00613-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/06/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population. OBJECTIVES To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases. DESIGN A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed. METHODS Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. RESULTS Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I2 = 81%, p = < 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I2 = 99%, p = < 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I2 = 85% versus 2.8, 95% CI 0.0 to 5.7, I2 = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I2 = 99% versus 63.8, 95% CI 0.0 to 151.8, I2 = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger's tests confirmed asymmetry by producing p values < 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important. CONCLUSION The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination.
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Affiliation(s)
- Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Rashdiah Street, P. O. Box 12944, Al-Ahsa, 31982 Saudi Arabia
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa, Saudi Arabia
- College of Nursing, Princess Norah Bint Abdul Rahman University, Riyadh, Saudi Arabia
- School of Nursing, University of Wollongong, Wollongong, Australia
| | - Zainab Al Alawi
- Division of Allergy and Immunology, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur, 22610 Pakistan
| | - Raghavendra Tirupathi
- Department of Medicine Keystone Health, Penn State University School of Medicine, Hershey, PA USA
- Department of Medicine, Wellspan Chambersburg and Waynesboro (Pa.) Hospitals, Chambersburg, PA USA
| | | | - Aqeel S. Alshakhes
- Department of Psychiatry, Prince Saud Bin Jalawi Hospital, Al-Ahsa, Saudi Arabia
| | - Abeer M. Alshawi
- Department of Pharmacy, King Fahad Hofuf Hospital, Al-Ahsa, Saudi Arabia
| | | | - Hassan M. Almusabeh
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Rashdiah Street, P. O. Box 12944, Al-Ahsa, 31982 Saudi Arabia
| | - Tariq T. Alghareeb
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Rashdiah Street, P. O. Box 12944, Al-Ahsa, 31982 Saudi Arabia
| | | | | | | | - Emad A. AlBuwaidi
- Primary Care Medicine, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia
| | - Amjad K. Bu Dukhi
- Department of Pharmacy, Prince Saud Bin Jalawi Hospital, Al-Ahsa, Saudi Arabia
| | - Hani N. Mufti
- Department of Cardiac Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- Department Cardiac Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- Department of Medical Research, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Manaf Al-Qahtani
- Department of Medicine, Royal College of Surgeons in Ireland, Bahrain, Kingdom of Bahrain
- Department of Infectious Diseases, Royal Medical Services, Bahrain Defence Force Hospital, Riffa, Kingdom of Bahrain
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh 243122 India
| | - Jaffar A. Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Awad Al-Omari
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
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Yang J, Ko JH, Baek JY, Hong J, Ha S, Lee B, Huh K, Cho SY, Kang CI, Chung DR, Kim YJ, Kang ES, Peck KR. Effects of Short-Term Corticosteroid Use on Reactogenicity and Immunogenicity of the First Dose of ChAdOx1 nCoV-19 Vaccine. Front Immunol 2021; 12:744206. [PMID: 34630425 PMCID: PMC8493039 DOI: 10.3389/fimmu.2021.744206] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/07/2021] [Indexed: 12/15/2022] Open
Abstract
The effects of corticosteroid use on the reactogenicity and immunogenicity of ChAdOx1 nCoV-19 (ChAd) vaccine were evaluated. Healthcare workers (HCWs) who took low-dose corticosteroid agents around the time of the first dose of ChAd (ChAdPd group) were recruited and the reactogenicity and immunogenicity were compared with those of ChAd (ChAd group) and BNT162b2 vaccination (BNT group) of HCWs without corticosteroid exposure. The immunogenicity was measured three weeks after vaccination using quantitative anti-SARS-CoV-2 spike protein (S) antibody electrochemiluminescence immunoassay and interferon gamma (IFN-γ) release assay. A total of 67 HCWs comprising 24 ChAd, 29 BNT, and 14 ChAdPd was included. The median total corticosteroid dose of the ChAdPd group was 30 mg prednisolone equivalents (interquartile range (IQR) 20-71.3 mg). HCWs in the ChAdPd group experienced significantly milder reactogenicity (median total score 7.5, IQR 4.0-18.0) compared to those in the ChAd group (median 23.0, IQR 8.0-43.0, P=0.012) but similar to that in the BNT group (median 5.0, IQR 3.0-9.0, P=0.067). The S antibody concentration of the ChAdPd group (62.4 ± 70.0 U/mL) was higher than that of the ChAd group, though without statistical significance (3.45 ± 57.6 U/mL, P=0.192). The cellular immune response was most robust in the ChAdPd group, with significantly higher IFN-γ concentration (5.363 ± 4.276 IU/mL), compared to the ChAd (0.978 ± 1.181 IU/mL, P=0.002) and BNT (1.656 ± 1.925 IU/mL, P=0.009) groups. This finding suggest that short-term corticosteroid reduces reactogenicity of the first dose of ChAd without hindering immunogenicity.
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Affiliation(s)
- Jinyoung Yang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Yang Baek
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, South Korea
| | - Jinyeong Hong
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Soyoung Ha
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Beomki Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yae-Jean Kim
- Division of Infectious Diseases and Immunodeficiency, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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85
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Alghamdi AN, Alotaibi MI, Alqahtani AS, Al Aboud D, Abdel-Moneim AS. BNT162b2 and ChAdOx1 SARS-CoV-2 Post-vaccination Side-Effects Among Saudi Vaccinees. Front Med (Lausanne) 2021; 8:760047. [PMID: 34692740 PMCID: PMC8531069 DOI: 10.3389/fmed.2021.760047] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/13/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Vaccination against SARS-CoV-2 is important for reducing hospitalization and mortalities. Both Pfizer-BioNTech (BNT162b2) and the Oxford-AstraZeneca (ChAdOx1 nCoV-19) vaccines are used in Saudi Arabia and in many parts of the world. Post-vaccinal side effects were recorded, so we aimed to screen different complaints after vaccination among vaccinees in Saudi Arabia. Methods: An online questionnaire was designed to screen the local, systemic, and allergic post vaccination reactions for vaccinees who received either one or two doses of the BNT162b2 vaccine or one dose of the ChAdOx1 vaccine. The number and percentage were recorded for each response and analyzed using cross-tab and Chi square tests. The degree of the severity of post vaccination reactions were analyzed using Roc curve. The cofactors that may affect the severity of post-vaccinal reactions including previous COVID-19 infection, age, sex, body mass index, and comorbidities were investigated. Results: During our study, 4,170 individuals reported their responses: 2,601 received one dose of BNT162b2, of whom 456 completed the second dose, and 1,569 received a single dose of ChAdOx1. The side effects were reported in 85.6% of BNT162b2 vaccinees and 96.05% of ChAdOx1 vaccinees who voluntarily responded to a survey about post-vaccination side effects. The side effects were more severe in BNT162b2 than ChAdOx1. ChAdOx1 vaccinees reported mild, moderate, severe and critical side effects in 30.13, 28.62, 29.73, and 1.53%, respectively. In contrast, mild side effects were recorded among the majority of BNT162b2 vaccinees (63.92%) while moderate, severe, and critical side effects were 27.67, 7.68, and 0.72%, respectively. Both local and systemic side effects were recorded more frequently in ChAdOx1 in comparison to BNT162b2 vaccinees. Palpitation was among the new systemic side effects reported in the current study in high frequency. Abnormal menstrual cycle (delaying/increase hemorrhages or pain) was also reported in 0.98% (18/1846) of Pfizer-BioNTech and 0.68% (7/1028) of ChAdOx1 vaccinees, while deep vein thrombosis was only reported in a single case vaccinated with BNT162b2 vaccine. Conclusion: Both vaccines induced post-vaccinal side effects; however, ChAdOx1 induces a higher frequency of post-vaccinal systemic side effects than BNT162b2.
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86
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Saita M, Yan Y, Ito K, Sasano H, Seyama K, Naito T. Reactogenicity following two doses of the BNT162b2 mRNA COVID-19 vaccine: Real-world evidence from healthcare workers in Japan. J Infect Chemother 2021; 28:116-119. [PMID: 34580011 PMCID: PMC8443338 DOI: 10.1016/j.jiac.2021.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/11/2021] [Accepted: 09/14/2021] [Indexed: 01/19/2023]
Abstract
As the first authorized COVID-19 vaccine in Japan, the BNT162b2 mRNA COVID-19 vaccine is utilized for mass vaccination. Although efficacy has been proved, real-world evidence on reactogenicity in Japanese personnel is needed to prepare the public. Healthcare workers in a large academic hospital in Japan received two doses of the Pfizer-BioNTech vaccine from March 17 to May 19, 2021. Online questionnaires were distributed to registered recipients following each dose, from day 0 through day 8. Primary outcomes are the frequency of reactogenicity including local and systemic reactions. Length of absence from work was also analyzed. Most recipients self-reported reactogenicity after the first dose (97.3%; n = 3254; mean age [36.4]) and after the second dose (97.2%; n = 3165; mean age [36.5]). Systemic reactions following the second dose were substantially higher than the first dose, especially for fever (OR, 27.38; 95% CI, [22.00–34.06]; p < 0.001), chills (OR, 16.49; 95% CI, [13.53–20.11]; p < 0.001), joint pain (OR, 8.49; 95% CI, [7.21–9.99]; p < 0.001), fatigue (OR, 7.18; 95% CI, [6.43–8.02]; p < 0.001) and headache (OR, 5.43; 95% CI, [4.80–6.14]; p < 0.001). Reactogenicity was more commonly seen in young, female groups. 19.3% of participants took days off from work after the second dose (2.2% after the first dose), with 4.7% absent for more than two days. Although most participants reported reactogenicity, severe cases were limited. This study provides real-world evidence for the general population and organizations to prepare for BNT162b2 mRNA COVID-19 vaccination in Japan and other countries in the region.
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Affiliation(s)
- Mizue Saita
- Department of General Medicine, Juntendo University Faculty of Medicine, Japan; Department of Safety and Health Promotion, Juntendo University, Japan
| | - Yan Yan
- Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Kanami Ito
- Department of Safety and Health Promotion, Juntendo University, Japan
| | - Hiroshi Sasano
- Department of Pharmacy, Juntendo University Hospital, Japan
| | - Kuniaki Seyama
- Department of Safety and Health Promotion, Juntendo University, Japan; Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Toshio Naito
- Department of General Medicine, Juntendo University Faculty of Medicine, Japan; Department of Safety and Health Promotion, Juntendo University, Japan.
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87
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Zhu JS, Zhang MX, Chien CW, Yang WY, Shi GF, Qiu S, Tung TH, Chen HX. Sex Differences in Adverse Reactions to an Inactivated SARS-CoV-2 Vaccine Among Medical Staff in China. Front Med (Lausanne) 2021; 8:731593. [PMID: 34568389 PMCID: PMC8455952 DOI: 10.3389/fmed.2021.731593] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/16/2021] [Indexed: 12/29/2022] Open
Abstract
Objective: We investigated whether there were sex differences in adverse reactions to an inactivated SARS-CoV-2 vaccine among medical staff in China. Methods: From 24 February to 7 March 2021 an online cross-sectional survey was conducted with a self-administered COVID-19 vaccine questionnaire among medical staff in Taizhou, China. In total, 1397 interviewees (1,107 women and 290 men) participated in the survey. Results: In our study, 178 (16.1%) women and 23 (7.9%) men reported adverse reactions following their first vaccination, and 169 (15.3%) women and 35 (12.1%) men reported adverse reactions following their second vaccination. After adjusting for confounding factors, adverse reactions to other vaccines, worry about adverse reactions, knowledge of the inactivated vaccine being used in the hospital, taking the vaccine for one's family proactively and receiving an influenza vaccination were significantly related to adverse reactions to both injections in women. In contrast, in men, concerns about adverse reactions independently increased the risk of adverse reactions following either vaccination, and a history of adverse reactions to other vaccines also increased the risk of adverse reactions to both injections. Conclusions: Sex differences in the frequency of reported adverse reactions to an inactivated SARS-CoV-2 vaccine and potential factors were demonstrated in a sample of medical staff.
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Affiliation(s)
- Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Mei-Xian Zhang
- Evidence-Based Medicine Center, Public Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Wei-Ying Yang
- Department of Intensive Care Unit, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Gui-Feng Shi
- Department of Preventive Health Care, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Shulin Qiu
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus, Shenzhen, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Public Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Hai-Xiao Chen
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
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88
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Niebel D, Wenzel J, Wilsmann-Theis D, Ziob J, Wilhelmi J, Braegelmann C. Single-Center Clinico-Pathological Case Study of 19 Patients with Cutaneous Adverse Reactions Following COVID-19 Vaccines. Dermatopathology (Basel) 2021; 8:463-476. [PMID: 34698094 PMCID: PMC8544472 DOI: 10.3390/dermatopathology8040049] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 01/13/2023] Open
Abstract
(1) Background: Coronavirus disease 2019 (COVID-19) vaccines are currently employed on a population-wide scale in most countries worldwide. Data about unusual cutaneous adverse drug reactions (ADR) are scant, though. (2) Methods: We retrospectively analyzed moderate to severe vaccine-related ADR in the Department of Dermatology and Allergy of the University Hospital Bonn between May to June 2021 and analyzed related skin biopsies. (3) Results: As a specialized dermatological academic center, we encountered a total of n = 19 clinically and pathologically heterogeneous cutaneous ADR with a female predominance. Delayed cutaneous ADR occurred as late as 30 days after vaccination. The majority of ADR were mild, though a few patients required systemic treatment (antihistamines, glucocorticosteroids). (4) Conclusions: The clinico-pathological spectrum of cutaneous side effects with COVID-19 vaccines is wide; however, the benefits outweigh the risks by far. More dermatopathological studies on cutaneous ADR not limited to COVID-19 vaccines are desirable to enable a better understanding of underlying pathophysiological mechanisms.
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Affiliation(s)
- Dennis Niebel
- Department of Dermatology and Allergy, University Hospital Bonn, 53127 Bonn, Germany; (J.W.); (D.W.-T.); (J.Z.); (J.W.); (C.B.)
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89
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Neutralizing Antibodies against SARS-CoV-2, Anti-Ad5 Antibodies, and Reactogenicity in Response to Ad5-nCoV (CanSino Biologics) Vaccine in Individuals with and without Prior SARS-CoV-2. Vaccines (Basel) 2021; 9:vaccines9091047. [PMID: 34579284 PMCID: PMC8472849 DOI: 10.3390/vaccines9091047] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 12/23/2022] Open
Abstract
This is the first study outside of clinical trials (phase I–III) evaluating the ability of the Ad5-nCoV vaccine to generate neutralizing antibodies and the factors associated with optimal or suboptimal response. In a longitudinal assay, 346 people (117 with prior COVID-19 and 229 without prior COVID-19) vaccinated with Ad5-nCoV were recruited. The percentage of neutralizing antibodies against SARS-CoV-2 (Surrogate Virus Neutralization Test) and antibodies against Ad5 (ADV-Ad5 IgG ELISA) were quantified pre and post-vaccination effects. The Ad5-nCoV vaccine induces higher neutralizing antibodies percentage in individuals with prior COVID-19 than those without prior COVID-19 (median [IQR]: 98% [97–98.1] vs. 72% [54–90], respectively; p < 0.0001). Furthermore, a natural infection (before vaccination) induces more neutralizing antibodies percentage than immunized individuals without prior COVID-19 (p < 0.01). No patient had vaccine-severe adverse effects. The age, antidepressant, and immunosuppressive treatments, reactogenicity, and history of COVID-19 are associated with impaired antibody production. The anti-Ad5 antibodies increased after 21 days of post-vaccination in all groups (p < 0.01). We recommend the application of a booster dose of Ad5-nCoV, especially for those individuals without previous COVID-19 infection. Finally, the induction of anti-Ad5 antibodies after vaccination should be considered if a booster with the same vaccine is planned.
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90
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Niebel D, Novak N, Wilhelmi J, Ziob J, Wilsmann-Theis D, Bieber T, Wenzel J, Braegelmann C. Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective. Vaccines (Basel) 2021; 9:944. [PMID: 34579181 PMCID: PMC8470727 DOI: 10.3390/vaccines9090944] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19). In light of high efficacy rates and satisfactory safety profiles, some agents have already reached approval and are now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning cutaneous ADRs to different COVID-19 vaccines, and incorporated our own experiences. (3) Results: Injection site reactions are the most frequent side effects arising from all vaccine types. Moreover, delayed cutaneous ADRs may occur after several days, either as a primary manifestation or as a flare of a pre-existing inflammatory dermatosis. Cutaneous ADRs may be divided according to their cytokine profile, based on the preponderance of specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific cutaneous ADRs mimic immunogenic reactions to the natural infection with SARS-CoV-2, which is associated with an abundance of type I interferons. (4) Conclusions: Further studies are required in order to determine the best suitable vaccine type for individual groups of patients, including patients suffering from chronic inflammatory dermatoses.
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Affiliation(s)
- Dennis Niebel
- Department of Dermatology and Allergy, University Hospital Bonn, 53127 Bonn, Germany; (N.N.); (J.W.); (J.Z.); (D.W.-T.); (T.B.); (J.W.); (C.B.)
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91
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Park C, Sakong J, Jo S, Kim M, Baek K. Adverse Effects on Work and Daily Life Interference among Healthcare Workers after the First and Second ChAdOx1 and BNT162b2 COVID-19 Vaccine Doses. Vaccines (Basel) 2021; 9:vaccines9080926. [PMID: 34452051 PMCID: PMC8402749 DOI: 10.3390/vaccines9080926] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 01/31/2023] Open
Abstract
In this study, we assessed the adverse effects and the work and daily life interference associated with each dose of the ChAdOx1 and BNT162b2 COVID-19 vaccines. Questionnaires were distributed to workers after they received both doses; only those who worked the day after receiving the vaccine were included in the analysis. Overall, 368 ChAdOx1-vaccinated and 27 BNT162b2-vaccinated participants were included. Among the ChAdOx1-vaccinated participants, the incidence of adverse effects was significantly lower after the second dose than after the first dose. Among the BNT162b2-vaccinated participants, however, no differences in adverse effects or work and daily life interference were found between the doses. After the first and second dose, the numeric scale score (0–10) for interference with work was 3.9 ± 2.9 and 1.6 ± 1.9 for the ChAdOx1 and 3.2 ± 2.5 and 3.6 ± 3.0 for the BNT162b2 vaccine, respectively. A similar trend was observed for interference with daily life. Factors associated with work and daily life interference in the multivariate model were age, vaccine dose (first or second), and the interaction term of vaccine type and dose. These results could be used to inform the general population of the adverse effects associated with these vaccinations.
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Affiliation(s)
- Chulyong Park
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu 42415, Korea; (C.P.); (J.S.); (S.J.); (M.K.)
- Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University, Daegu 42415, Korea
| | - Joon Sakong
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu 42415, Korea; (C.P.); (J.S.); (S.J.); (M.K.)
- Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University, Daegu 42415, Korea
| | - Seongmin Jo
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu 42415, Korea; (C.P.); (J.S.); (S.J.); (M.K.)
| | - Minkeun Kim
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu 42415, Korea; (C.P.); (J.S.); (S.J.); (M.K.)
| | - Kiook Baek
- Department of Occupational and Environmental Medicine, Korea University Medical Center Ansan Hospital, Ansan 15355, Korea
- Correspondence:
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92
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Lim SY, Kim JY, Lee JA, Kwon JS, Park JY, Cha HH, Suh MH, Lee HJ, Kim H, Kim S, Bae S, Jung J, Kim EH, Jee Y, Kim SH. Immune responses and reactogenicity after ChAdOx1 in individuals with past SARS-CoV-2 infection and those without. J Infect 2021; 84:94-118. [PMID: 34332017 PMCID: PMC8316626 DOI: 10.1016/j.jinf.2021.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/24/2021] [Indexed: 01/31/2023]
Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Ah Lee
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Young Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Hyun Suh
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyeonju Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seungtaek Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eui Ho Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Youngmee Jee
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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93
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Wu Q, Dudley MZ, Chen X, Bai X, Dong K, Zhuang T, Salmon D, Yu H. Evaluation of the safety profile of COVID-19 vaccines: a rapid review. BMC Med 2021; 19:173. [PMID: 34315454 PMCID: PMC8315897 DOI: 10.1186/s12916-021-02059-5] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The rapid process of research and development and lack of follow-up time post-vaccination aroused great public concern about the safety profile of COVID-19 vaccine candidates. To provide comprehensive overview of the safety profile of COVID-19 vaccines by using meta-analysis technique. METHODS English-language articles and results posted on PubMed, Embase, Web of Science, PMC, official regulatory websites, and post-authorization safety surveillance data were searched through June 12, 2021. Publications disclosing safety data of COVID-19 candidate vaccines in humans were included. A meta-analysis of proportions was performed to estimate the pooled incidence and the pooled rate ratio (RR) of safety outcomes of COVID-19 vaccines using different platforms. RESULTS A total of 87 publications with safety data from clinical trials and post-authorization studies of 19 COVID-19 vaccines on 6 different platforms were included. The pooled rates of local and systemic reactions were significantly lower among inactivated vaccines (23.7%, 21.0%), protein subunit vaccines (33.0%, 22.3%), and DNA vaccines (39.5%, 29.3%), compared to RNA vaccines (89.4%, 83.3%), non-replicating vector vaccines (55.9%, 66.3%), and virus-like particle vaccines (100.0%, 78.9%). Solicited injection-site pain was the most common local reactions, and fatigue and headache were the most common systemic reactions. The frequency of vaccine-related serious adverse events was low (< 0.1%) and balanced between treatment groups. Vaccine platforms and age groups of vaccine recipients accounted for much of the heterogeneity in safety profiles between COVID-19 vaccines. Reporting rates of adverse events from post-authorization observational studies were similar to results from clinical trials. Crude reporting rates of adverse events from post-authorization safety monitoring (passive surveillance) were lower than in clinical trials and varied between countries. CONCLUSIONS Available evidence indicates that eligible COVID-19 vaccines have an acceptable short-term safety profile. Additional studies and long-term population-level surveillance are strongly encouraged to further define the safety profile of COVID-19 vaccines.
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Affiliation(s)
- Qianhui Wu
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Matthew Z Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Xinghui Chen
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Xufang Bai
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Kaige Dong
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Tingyu Zhuang
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Daniel Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Hongjie Yu
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
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94
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Novak N, Tordesillas L, Cabanillas B. Adverse rare events to vaccines for COVID-19: From hypersensitivity reactions to thrombosis and thrombocytopenia. Int Rev Immunol 2021; 41:438-447. [PMID: 34251972 PMCID: PMC8290371 DOI: 10.1080/08830185.2021.1939696] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/14/2021] [Accepted: 05/29/2021] [Indexed: 01/18/2023]
Abstract
Vaccines for the prevention of coronavirus disease 2019 (COVID-19) started to be developed since the initiation of the COVID-19 pandemic. Up to now, four vaccines have been authorized by international agencies such as European Medicines Agency (EMA). Two are DNA vaccines (ChAdOx1 nCov-19 and Ad26.COV2.S) and two mRNA vaccines (BNT162b2 and mRNA-1273). The administration of the vaccines has been associated with a strong decrease in the infections by SARS-CoV-2 and deaths associated with it. However, in parallel to these results, some rare adverse events have also been described. In that sense, events of thrombosis, thrombocytopenia, and hemorrhage have been described in close temporal proximity to the administration of the DNA vaccines ChAdOx1 nCov-19 and Ad26.COV2.S, but also mRNA vaccines. Recent scientific reports have been released with updated information on the possible association of thrombotic thrombocytopenia and COVID-19 vaccines. On the other hand, since the initiation of the vaccination campaigns, adverse hypersensitivity reactions have been described after mRNA and DNA vaccines administration for COVID-19. Although globally these adverse events are rare, a high proportion of the world population will be exposed to these vaccines. For that reason, their safety and tolerance should be carefully considered. In this review, we provide an updated review of the last scientific findings that can explain the rare side effects that the vaccines for COVID-19 can produce.
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Affiliation(s)
- Natalija Novak
- Department of Dermatology and Allergy, University Hospital, Bonn, Germany
| | - Leticia Tordesillas
- Department of Tumor Biology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Beatriz Cabanillas
- Department of Allergy, Research Institute Hospital 12 de Octubre, Madrid, Spain
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95
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Park MJ, Choi YJ, Choi S. Emergency Department Utilization by In-hospital Healthcare Workers after COVID-19 Vaccination. J Korean Med Sci 2021; 36:e196. [PMID: 34254475 PMCID: PMC8275460 DOI: 10.3346/jkms.2021.36.e196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 06/28/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND This is an observational study to analyze an emergency department (ED) utilization pattern of coronavirus disease 2019 (COVID-19) vaccinated in-hospital healthcare workers (HCWs). METHODS We included 4,703 HCWs who were administered the first dose of the COVID-19 vaccine between March 4 and April 2, 2021, in a tertiary hospital in Korea where fast-track and post-vaccination cohort zone (PVCZ) were introduced in ED. We analyzed data of participants' age, sex, occupation, date and type of vaccination, and their clinical information using SPSS v25.0. RESULTS The sample comprised HCWs, who received either the ChAdOx1 (n = 4,458) or the BNT162B2 (n = 245) vaccines; most participants were female (73.5%), and 81.1% were under 50 years old. Further, 153 (3.3%) visited the ED and reported experiencing fever (66.9%) and myalgia (56.1%). Additionally, 91 (59.5%) of them were in their 20s, and 106 (67.5%) were assigned to the PVCZ. Lastly, 107 (68.2%) of the patients received parenteral management. No patient required hospitalization. CONCLUSION In conclusion, vaccinated HCWs who visited the ED with adverse events had a high incidence of fever and a low likelihood of developing serious illnesses. As the COVID-19 vaccination program for Korean citizens continues to expand, strategies to minimize unnecessary ED overcrowding should be put into effect.
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Affiliation(s)
- Min Ji Park
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Yoo Jin Choi
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.
| | - Sangchun Choi
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
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96
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Park JY, Choi SH, Chung JW, Hwang MH, Kim MC. Systemic Adverse Events and Use of Antipyretics Predict the Neutralizing Antibody Positivity Early after the First Dose of ChAdOx1 Coronavirus Disease Vaccine. J Clin Med 2021; 10:jcm10132844. [PMID: 34199053 PMCID: PMC8268750 DOI: 10.3390/jcm10132844] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 01/31/2023] Open
Abstract
Vaccination is considered crucial for the eradication of the coronavirus disease (COVID-19). In our medical center in Korea, most health care workers (HCWs) were vaccinated with the ChAdOx1 COVID-19 vaccine. After vaccination, many HCWs complained of adverse events (AEs). However, it remains unclear whether the production of neutralizing antibodies (NAb) was affected. Therefore, here, we aimed to evaluate AEs and early NAb production in relatively healthy Asians who received the ChAdOx1 vaccine and determine the effect of AEs and antipyretics on early NAb production against COVID-19. Of the 182 Korean HCWs who received the first dose of ChAdOx1 vaccine, 172 (94.5%) experienced ≥1 adverse events and 148 (81.3%) tested positive for NAb 33–40 days after the vaccination. NAb-positive vaccine recipients reported systemic AEs and consumed acetaminophen more frequently than NAb-negative recipients. We identified an association between antibody response and COVID-19 vaccine-related AEs. In conclusion, most ChAdOx1 vaccine recipients reported AEs in our medical center.
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Affiliation(s)
- Ji Young Park
- Department of Pediatrics, Chung-Ang University Hospital, Seoul 06973, Korea;
| | - Seong-Ho Choi
- Department of Internal Medicine, Division of Infectious Diseases, Chung-Ang University Hospital, Seoul 06973, Korea; (S.-H.C.); (M.-H.H.); (M.-C.K.)
| | - Jin-Won Chung
- Department of Internal Medicine, Division of Infectious Diseases, Chung-Ang University Hospital, Seoul 06973, Korea; (S.-H.C.); (M.-H.H.); (M.-C.K.)
- Correspondence: ; Tel.: +82-2-6299-1420
| | - Min-Hyung Hwang
- Department of Internal Medicine, Division of Infectious Diseases, Chung-Ang University Hospital, Seoul 06973, Korea; (S.-H.C.); (M.-H.H.); (M.-C.K.)
| | - Min-Chul Kim
- Department of Internal Medicine, Division of Infectious Diseases, Chung-Ang University Hospital, Seoul 06973, Korea; (S.-H.C.); (M.-H.H.); (M.-C.K.)
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97
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Kim T, Park SY, Yu S, Park JW, Lee E, Jeon MH, Kim TH, Choo EJ. Impacts of Side Effects to BNT162b2 and the First Dose of ChAdOx1 Anti-SARS-CoV-2 Vaccination on Work Productivity, the Need for Medical Attention, and Vaccine Acceptance: A Multicenter Survey on Healthcare Workers in Referral Teaching Hospitals in the Republic of Korea. Vaccines (Basel) 2021; 9:648. [PMID: 34198562 PMCID: PMC8232011 DOI: 10.3390/vaccines9060648] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 12/20/2022] Open
Abstract
To establish a successful anti-SARS-CoV-2 vaccination strategy, it is necessary to take possible tradeoffs into account. We conducted a survey on vaccinated healthcare workers (HCWs) inthree referral teaching hospitals in the Republic of Korea. We investigated the frequency of vaccination side effects (SEs), the impact on their work productivity, the need for medical attention, and vaccine acceptance. Three groups of HCWs were surveyed: 1406 who had received the first dose of BNT162b2 (BNT162b2#1), 1168 who had received the second dose of BNT162b2 (BNT162b2#2), and 1679 who had received the first dose of ChAdOx1 (ChAdOx1#1). More SEs and impact on work productivity were reported in ChAdOx1#1 than in the other two groups. However, among individuals aged ≥40 years, no significant difference of absence from work was found between ChAdOx1#1 and BN162b2#2 (4.4%, 31/699 vs. 3.0%, 12/405; p = 0.26), and none were hospitalized. Older HCWs in ChAdOx1#1 showed intention to receive the second dose of the vaccine. Although the incidence of SEs and their impacts were greater after the first dose of ChAdOx1 than BNT162b2 in young people, significant impact of SEs seemed to be rare in individuals aged ≥40 years, regardless of the vaccine they received.
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Affiliation(s)
- Tark Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, Korea;
| | - Se Yoon Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea; (S.Y.P.); (E.L.); (T.H.K.)
| | - Shinae Yu
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan 31151, Korea; (S.Y.); (J.W.P.); (M.H.J.)
| | - Jung Wan Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan 31151, Korea; (S.Y.); (J.W.P.); (M.H.J.)
| | - Eunjung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea; (S.Y.P.); (E.L.); (T.H.K.)
| | - Min Hyok Jeon
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan 31151, Korea; (S.Y.); (J.W.P.); (M.H.J.)
| | - Tae Hyong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea; (S.Y.P.); (E.L.); (T.H.K.)
| | - Eun Ju Choo
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, Korea;
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Flacco ME, Soldato G, Acuti Martellucci C, Carota R, Di Luzio R, Caponetti A, Manzoli L. Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province. Vaccines (Basel) 2021; 9:628. [PMID: 34200538 PMCID: PMC8227269 DOI: 10.3390/vaccines9060628] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/14/2022] Open
Abstract
This retrospective cohort study compared the rates of virologically-confirmed SARS-CoV-2 infections, symptomatic or lethal COVID-19 among the residents of the Italian province of Pescara who received one or two doses of COVID-19 vaccines, versus the unvaccinated. The official data of the National Health System were used, and a total of 69,539 vaccinated adults were compared with 175,687 unvaccinated. Among the subjects who received at least one vaccine dose, 85 infections (0.12%), 18 severe and 3 lethal COVID-19 cases were recorded after an average follow-up of 38 days. Among the unvaccinated, the numbers were 6948 (4.00%), 933 (0.53%) and 241 (0.14%), respectively. The serious adverse event reports-yet unconfirmed-were 24 out of 102,394 administered doses. In a Cox model, adjusting for age, gender, and selected comorbidities, the effectiveness of either BNT162b2, ChAdOx1 nCoV-19 or mRNA-1273 vaccines was higher than 95% in preventing infections (mostly due to B.1.1.7 variant), symptomatic or lethal COVID-19. No differences were observed across genders, and among the 691 subjects who received the second dose of vaccine later than the recommended date. Although preliminary, these findings support current immunization policies and may help reducing vaccine hesitancy.
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Affiliation(s)
- Maria Elena Flacco
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.E.F.); (C.A.M.)
| | - Graziella Soldato
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (R.C.); (R.D.L.); (A.C.)
| | | | - Roberto Carota
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (R.C.); (R.D.L.); (A.C.)
| | - Rossano Di Luzio
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (R.C.); (R.D.L.); (A.C.)
| | - Antonio Caponetti
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (R.C.); (R.D.L.); (A.C.)
| | - Lamberto Manzoli
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.E.F.); (C.A.M.)
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Lee YW, Lim SY, Lee JH, Lim JS, Kim M, Kwon S, Joo J, Kwak SH, Kim EO, Jung J, Kwon HS, Kim TB, Kim SH, Bae S. Adverse Reactions of the Second Dose of the BNT162b2 mRNA COVID-19 Vaccine in Healthcare Workers in Korea. J Korean Med Sci 2021; 36:e153. [PMID: 34060261 PMCID: PMC8167406 DOI: 10.3346/jkms.2021.36.e153] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/11/2021] [Indexed: 01/14/2023] Open
Abstract
We conducted a prospective, mobile-based survey on the self-reported adverse reactions in healthcare workers (HCWs) who received both doses of the BNT162b2 mRNA vaccine. Of the 342 HCWs who completed the two-dose vaccination, 265 (77.5%) responded to the survey at least once. Overall, the rates of adverse reactions were higher after the second dose compared with the first dose (89.1% vs. 80.1%, P = 0.006). The most common systemic reactions were muscle ache (69.1%), fatigue (65.7%), headache (48.7%), chills (44.2%), and fever (32.1%), and were notably more common after the second dose vaccine as well. We also noted a sex difference in which the frequency of adverse reactions after the second dose of the vaccine was significantly higher in females, which was not observed after the first dose. The rates of adverse reactions were lower in older age groups, and the rates and severities of the adverse reactions decreased during the 3-day period following vaccination.
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Affiliation(s)
- Yun Woo Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Miseo Kim
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seonhee Kwon
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiyeon Joo
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Hee Kwak
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Ok Kim
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Comparisons of Motivation to Receive COVID-19 Vaccination and Related Factors between Frontline Physicians and Nurses and the Public in Taiwan: Applying the Extended Protection Motivation Theory. Vaccines (Basel) 2021; 9:vaccines9050528. [PMID: 34065222 PMCID: PMC8160641 DOI: 10.3390/vaccines9050528] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 01/28/2023] Open
Abstract
This study aimed to compare the differences in motivation to receive a COVID-19 vaccination between frontline physicians and nurses and the Taiwanese public. The associations of threat and coping appraisals, as described in Protection Motivation Theory (PMT), with motivation to receive COVID-19 vaccination were compared between these groups, too. We recruited 279 frontline physicians and nurses and 768 members of the public by a Facebook advertisement. Participants’ motivation to receive COVID-19 vaccination, perceived severity of and vulnerability to COVID-19, self-efficacy and response efficacy of COVID-19 vaccination, response cost of COVID-19 vaccination, and knowledge about the mechanism of COVID-19 vaccination in light of PMT were determined. The results demonstrated that frontline health workers had higher motivation to receive COVID-19 vaccination than the public. Response efficacy and knowledge of COVID-19 vaccination were positively associated with motivation to receive COVID-19 vaccination in both frontline health workers and the public, whereas perceived vulnerability, perceived severity, and response cost of COVID-19 vaccination were positively associated with motivation in the public but not in frontline physicians and nurses. The factors related to motivation to receive COVID-19 vaccination should be considered when designing programs to increase motivation to receive COVID-19 vaccination among frontline health workers and the public.
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