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Forsdyke DR. Cryptic late-onset myocarditis after coronavirus vaccination. FASEB J 2024; 38:e23814. [PMID: 38959046 DOI: 10.1096/fj.202302692rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 06/15/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024]
Abstract
As we enter a new era of mRNA-based therapeutics, evidence on genetic or environmental factors that might predispose to unknown off-target side effects, gains in importance. Among these factors, exercise appears likely to have influenced otherwise cryptic cases of early-onset postvaccination myocarditis. And the existence of a distinct late-onset myocarditis is now being recognized. Here, three case-history reports suggest crypticity (the author's own case), unless provoked by a preexisting cardiac morbidity (one case), or by immune checkpoint blockade to enhance anticancer autoimmunity (several cases). These reports are supported by noninvasive fluorodeoxyglucose-based cardiac scan comparisons of multiple vaccinated and unvaccinated subjects. In pre-pandemic decades, applications for funds by the leading innovator in mRNA-based therapeutics seldom gained peer-review approval. Thus, at the start of the pandemic, the meager data on such side effects could justify only emergency approval. We must do better.
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Affiliation(s)
- Donald R Forsdyke
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
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2
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Buoninfante A, Andeweg A, Genov G, Cavaleri M. Myocarditis associated with COVID-19 vaccination. NPJ Vaccines 2024; 9:122. [PMID: 38942751 PMCID: PMC11213864 DOI: 10.1038/s41541-024-00893-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 05/23/2024] [Indexed: 06/30/2024] Open
Abstract
Following the start of the COVID-19 vaccination campaign, the adverse events of myocarditis and pericarditis were linked mainly to mRNA COVID-19 vaccines by the regulatory authorities worldwide. COVID-19 vaccines have been administered to several million people and the risk of myocarditis post COVID-19 vaccination has been characterised in great detail. At the present time the research data available are scarce and there is still no clear understanding of the biological mechanism/s responsible for this disease. This manuscript provides a concise overview of the epidemiology of myocarditis and the most prominent mechanistic insights in the pathophysiology of the disease. Most importantly it underscores the needed next steps in the research agenda required to characterize the pathophysiology of this disease post-COVID-19 vaccination. Finally, it shares our perspectives and considerations for public health.
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Affiliation(s)
| | - Arno Andeweg
- Public Health Threats, European Medicines Agency, Amsterdam, The Netherlands
| | - Georgy Genov
- Pharmacovigilance Office, European Medicines Agency, Amsterdam, The Netherlands
| | - Marco Cavaleri
- Public Health Threats, European Medicines Agency, Amsterdam, The Netherlands.
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3
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Boros LG, Kyriakopoulos AM, Brogna C, Piscopo M, McCullough PA, Seneff S. Long-lasting, biochemically modified mRNA, and its frameshifted recombinant spike proteins in human tissues and circulation after COVID-19 vaccination. Pharmacol Res Perspect 2024; 12:e1218. [PMID: 38867495 PMCID: PMC11169277 DOI: 10.1002/prp2.1218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/20/2024] [Indexed: 06/14/2024] Open
Abstract
According to the CDC, both Pfizer and Moderna COVID-19 vaccines contain nucleoside-modified messenger RNA (mRNA) encoding the viral spike glycoprotein of severe acute respiratory syndrome caused by corona virus (SARS-CoV-2), administered via intramuscular injections. Despite their worldwide use, very little is known about how nucleoside modifications in mRNA sequences affect their breakdown, transcription and protein synthesis. It was hoped that resident and circulating immune cells attracted to the injection site make copies of the spike protein while the injected mRNA degrades within a few days. It was also originally estimated that recombinant spike proteins generated by mRNA vaccines would persist in the body for a few weeks. In reality, clinical studies now report that modified SARS-CoV-2 mRNA routinely persist up to a month from injection and can be detected in cardiac and skeletal muscle at sites of inflammation and fibrosis, while the recombinant spike protein may persist a little over half a year in blood. Vaccination with 1-methylΨ (pseudouridine enriched) mRNA can elicit cellular immunity to peptide antigens produced by +1 ribosomal frameshifting in major histocompatibility complex-diverse people. The translation of 1-methylΨ mRNA using liquid chromatography tandem mass spectrometry identified nine peptides derived from the mRNA +1 frame. These products impact on off-target host T cell immunity that include increased production of new B cell antigens with far reaching clinical consequences. As an example, a highly significant increase in heart muscle 18-flourodeoxyglucose uptake was detected in vaccinated patients up to half a year (180 days). This review article focuses on medical biochemistry, proteomics and deutenomics principles that explain the persisting spike phenomenon in circulation with organ-related functional damage even in asymptomatic individuals. Proline and hydroxyproline residues emerge as prominent deuterium (heavy hydrogen) binding sites in structural proteins with robust isotopic stability that resists not only enzymatic breakdown, but virtually all (non)-enzymatic cleavage mechanisms known in chemistry.
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Affiliation(s)
- László G. Boros
- Sub‐Molecular Medical Sciences Deutenomics CoreVrije University AmsterdamAmsterdamThe Netherlands
| | | | - Carlo Brogna
- Department of ResearchCraniomed Group Facility SrlItaly
| | - Marina Piscopo
- Department of BiologyUniversity of Naples Federico IINaplesItaly
| | | | - Stephanie Seneff
- Computer Science and Artificial Intelligence LaboratoryMassachusetts Institute of TechnologyCambridgeMassachusettsUSA
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4
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Kubin PRM. Vaccine Impact Bonds: An Alternative Way of Allocating the Economic Risks of Mass Vaccination Programs. HEC Forum 2024:10.1007/s10730-024-09530-9. [PMID: 38789857 DOI: 10.1007/s10730-024-09530-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 05/26/2024]
Abstract
Vaccines can be an appropriate tool for combating pandemics. Accordingly, expectations were high when the first Covid-19 vaccines were administered. However, even though the vaccines have not met these high initial expectations, vaccine manufacturers and their investors were making large profits, while most of the associated economic risks have remained with the taxpaying public. Thus, this paper applies the concept of social impact bonds to mass vaccination programs by conceptualizing vaccine impact bonds (VIBs) as an alternative to the advance purchase agreements (APAs) for Covid-19 vaccines. Rather than rewarding vaccine manufacturers and their investors based on the quantity of doses distributed, VIBs intend to link the real-world vaccine impact to the financial returns of vaccine manufacturers and their investors. This paper indicates that VIBs can theoretically shift the economic risks of mass vaccination programs from the taxpaying public to private investors, thereby aligning commercial and public interests. However, it also identifies several major weaknesses such as the complexity of defining and evaluating the vaccine impact as well as the inherent trade-off between relieving taxpayers (through VIBs) and allowing innovation. As these substantial drawbacks outweigh the theoretical strengths of VIBs, this paper calls for further research in order to identify better alternatives to the Covid-19 vaccine contracts.
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Affiliation(s)
- Pascal René Marcel Kubin
- German University of Administrative Sciences Speyer, Freiherr-Vom-Stein-Straße 2, 67346, Speyer, Germany.
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5
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Falleti J, Orabona P, Municinò M, Castellaro G, Fusco G, Mansueto G. An Update on Myocarditis in Forensic Pathology. Diagnostics (Basel) 2024; 14:760. [PMID: 38611673 PMCID: PMC11011922 DOI: 10.3390/diagnostics14070760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
In forensic medicine, myocarditis is a complicated topic in the context of sudden death and medical malpractice. A good knowledge of the etiopathology, histopathology, and available literature are both indispensable and essential for the correct management and evaluation of the causal link. Some agents, which are rarely lethal for humans, are not necessarily related to death from myocarditis, even if an infection in other organs such as the gastrointestinal tract is documented. The diagnosis of the causes of death is often difficult and confusing. In some cases, the hypothetical diagnosis of myocarditis as the cause of death is formulated by deduction, causing error and misleading the correct temporal evaluation of pathological events. We reviewed the literature realizing that histomorphological data are scarce and often poorly documented. Only after COVID-19 have the histomorphological aspects of myocarditis been better documented. This is due to poor autopsy practice and poor accuracy in identifying the specific histotype of myocarditis with identification of the responsible agent. We believe that four points are essential for a better understanding and complete diagnosis of the disease: (1) clinical classification of myocarditis; (2) etiological classification of myocarditis; (3) pathophysiology of viral and bacterial infections with host response; and (4) histopathological diagnosis with precise identification of the histotype and pathogen. In the review we provide histological images from authoritative scientific references with the aim of providing useful information and food for thought to readers.
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Affiliation(s)
- Jessica Falleti
- Patology Section, Sant’Anna e San Sebastiano Hospital, 81100 Caserta, Italy; (J.F.); (P.O.)
| | - Pasquale Orabona
- Patology Section, Sant’Anna e San Sebastiano Hospital, 81100 Caserta, Italy; (J.F.); (P.O.)
| | - Maurizio Municinò
- Forensic and Legal Medicine Center, San Giuliano Hospital, 80014 Naples, Italy;
| | - Gianluca Castellaro
- University Department of Experimental Medicine—Forensic and Legal Medicine Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Giovanna Fusco
- Experimental Zooprophylactic Institute of Southern Italy, 80055 Portici, Italy;
| | - Gelsomina Mansueto
- University Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Department of Healthcare and Public Services—Forensic and Legal Medicine Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Ammirati E, Conti N, Palazzini M, Rocchetti M, Spangaro A, Garascia A, Lupi L, Cereda A. Fulminant Myocarditis Temporally Associated with COVID-19 Vaccination. Curr Cardiol Rep 2024; 26:97-112. [PMID: 38324216 DOI: 10.1007/s11886-024-02021-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE OF REVIEW Coronavirus disease-2019 (COVID-19) vaccines have been related to rare cases of acute myocarditis, occurring between 1 in 10,000 and 1 in 100,000 individuals, approximately. Incidence of COVID-19 vaccine-associated myocarditis varies with age, sex, and type of vaccine. Although most patients with acute myocarditis temporally associated with COVID-19 vaccines have an uneventful course, a small subpopulation presents with cardiogenic shock (termed fulminant myocarditis [FM]). This review explored the prevalence, clinical presentation, management, and prognosis of COVID-19 vaccine-associated acute myocarditis, specifically focusing on FM and comparing patients with fulminant versus non-fulminant myocarditis. RECENT FINDINGS Cases of FM represent about 2-4% (0 to 7.5%) of COVID-19 vaccine-associated acute myocarditis cases, and mortality is around 1%, ranging between 0 and 4.4%. First, we identified 40 cases of FM up to February 2023 with sufficient granular data from case reports and case series of COVID-19 vaccine-associated acute myocarditis that occurred within 30 days from the last vaccine injection. This population was compared with 294 cases of non-fulminant acute myocarditis identified in the literature during a similar time. Patients with FM were older (48 vs. 27 years), had a larger proportion of women (58% vs. 9%), and mainly occurred after the first shot compared with non-fulminant cases (58% vs. 16%). The reported mortality was 27% (11 out of 40), in line with non-vaccine-associated fulminant myocarditis. These data were in agreement with 36 cases of FM from a large Korean registry. Herein, we reviewed the clinical features, imaging results, and histological findings of COVID-19 vaccine-associated fulminant myocarditis. In conclusion, COVID-19 vaccine-associated FM differs from non-fulminant forms, suggesting potential specific mechanisms in these rare and severe forms. Mortality in vaccine-associated FM remains high, in line with other forms of FM.
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Affiliation(s)
- Enrico Ammirati
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Transplant Center, Milan, Italy.
- Department of Health Sciences, University of Milano-Bicocca, Monza, Italy.
| | - Nicolina Conti
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Transplant Center, Milan, Italy
| | - Matteo Palazzini
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Transplant Center, Milan, Italy
| | - Matteo Rocchetti
- Cardiovascular Department, Association Socio Sanitary Territorial Santi Paolo e Carlo, Milan, Italy
| | - Andrea Spangaro
- Cardiovascular Department, Association Socio Sanitary Territorial Santi Paolo e Carlo, Milan, Italy
| | - Andrea Garascia
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Transplant Center, Milan, Italy
| | - Laura Lupi
- Institute of Cardiology, Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Azienda Socio-Sanitaria Territoriale (ASST), University of Brescia, Brescia, Italy
| | - Alberto Cereda
- Cardiovascular Department, Association Socio Sanitary Territorial Santi Paolo e Carlo, Milan, Italy
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Minato H, Yoshikawa A, Tsuyama S, Katayanagi K, Hachiya S, Ohta K, Myojo Y. Fatal arrythmia in a young man after COVID-19 vaccination: An autopsy report. Medicine (Baltimore) 2024; 103:e37196. [PMID: 38306524 PMCID: PMC10843519 DOI: 10.1097/md.0000000000037196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
RATIONALE The benefits of COVID-19 mRNA vaccination are claimed to be substantial; however, vaccination-related myocarditis and pericarditis have also been observed globally, particularly among young men. In most cases, the symptoms are mild and resolve on their own; however, fatal cases have rarely been described. PATIENT CONCERNS A healthy 40-year-old Japanese man suddenly experienced tachycardia and lost consciousness 2 days after vaccination. Continued resuscitation recovered the spontaneous heartbeat; however, the patient did not regain consciousness and died 9 days later. Electrocardiography after resuscitation showed marked ST-segment depression and incomplete right bundle branch block. Influenza antigen and polymerase chain reaction tests for SARS-CoV-2 were negative. DIAGNOSES Fatal arrhythmia after a second COVID-19 mRNA vaccination. INTERVENTIONS We performed an autopsy and studied the material morphologically and immunohistochemically. OUTCOMES At autopsy, several small inflammatory foci with cardiomyocytic necrosis were scattered in the right and left ventricles, with a propensity for the right side. Some inflammatory foci were located near the atrioventricular nodes and His bundles. The infiltrating cells predominantly consisted of CD68-positive histiocytes, with a small number of CD8-positive and CD4-positive T cells. In this case, myocarditis was focal and mild, as is mostly observed following COVID-19 mRNA vaccination. However, the inflammatory foci were close to the conduction system and were considered the cause of fatal arrhythmia. LESSONS Although the benefits of COVID-19 vaccination appear to outweigh the side effects, it should be noted that fatal arrhythmias may rarely occur, and caution should be taken if individuals, particularly young men, complain of any symptoms after vaccination.
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Affiliation(s)
- Hiroshi Minato
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa City, Ishikawa Prefecture, Japan
| | - Akane Yoshikawa
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa City, Ishikawa Prefecture, Japan
| | - Sho Tsuyama
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa City, Ishikawa Prefecture, Japan
| | - Kazuyoshi Katayanagi
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa City, Ishikawa Prefecture, Japan
| | - Satoaki Hachiya
- Department of Emergency and Critical Care, Ishikawa Prefectural Central Hospital, Kanazawa City, Ishikawa Prefecture, Japan
| | - Keisuke Ohta
- Department of Emergency and Critical Care, Ishikawa Prefectural Central Hospital, Kanazawa City, Ishikawa Prefecture, Japan
| | - Yasuhiro Myojo
- Department of Emergency and Critical Care, Ishikawa Prefectural Central Hospital, Kanazawa City, Ishikawa Prefecture, Japan
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8
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Klement RJ, Walach H. Commentary: raised c-troponin levels as a sign of myocardial injury after COVID-19 vaccination in healthy individuals are worrying. Egypt Heart J 2024; 76:16. [PMID: 38300486 PMCID: PMC10834889 DOI: 10.1186/s43044-024-00441-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/21/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Recently, Buergin et al. (Eur J Heart Fail 25(10):1871-1881, 2023 doi:10.1002/ejhf.2978) thoroughly measured a frequency of 2.8% elevated high-sensitivity cardiac troponin T levels, a sign of myocardial damage, after mRNA-1273 (Moderna) booster vaccinations. In their discussion, they claim that before vaccinations were available, the incidence and extent of myocardial damage associated with COVID-19 infection would have been much higher. We here scrutinize this claim based on empirical data. MAIN BODY Burgin et al. have only cited papers in support of their claim which considered hospitalized COVID-19 patients. After extracting COVID-19 infection data from Germany and Switzerland and the expected frequency of elevated troponin levels after COVID-19 infection in both hospitalized and non-hospitalized individuals, we find that the extent of myocardial damage after vaccinating a considerable proportion of the general population is expected to be much higher than after natural infections. CONCLUSIONS The claim that the extent of myocardial injury after COVID-19 infection would be higher than after vaccination is not supported by empirical evidence and therefore wrong. We conclude that cross-national systematic observational studies should be conducted that allow a more precise estimation of the risk-benefit ratio of COVID-19 mRNA vaccinations.
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Affiliation(s)
- Rainer Johannes Klement
- Department of Radiation Oncology, Leopoldina Hospital, Robert-Koch-Strasse 10, 97422, Schweinfurt, Germany.
| | - Harald Walach
- Next Society Institute, Kazimieras Simonavicius University, Vilnius, Lithuania
- Change Health Science Institute, Basel, Switzerland
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9
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de Boer HH, Crawford NW, Parsons S. Commentary on: "Autopsy-based histopathological characterization of myocarditis after anti-SARS-CoV-2-vaccination" by C. Schwab et al. Clin Res Cardiol 2024; 113:353-355. [PMID: 37097464 PMCID: PMC10126533 DOI: 10.1007/s00392-023-02197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 03/31/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Hans H de Boer
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, VIC, 3006, Australia.
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, VIC, 3006, Australia.
| | - Nigel W Crawford
- SAEFVIC, Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Immunisation Services, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sarah Parsons
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, VIC, 3006, Australia
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, VIC, 3006, Australia
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10
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Schirmacher P, Longerich T, Schwab C. Letter to the Editors: "Autopsy-based histopathological characterization of myocarditis after anti-SARS-CoV-2-vaccination" by C. Schwab et al. Clin Res Cardiol 2024; 113:356-357. [PMID: 37097462 PMCID: PMC10126539 DOI: 10.1007/s00392-023-02198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Peter Schirmacher
- Universitätsklinikum Heidelberg Pathologisches Institut, Heidelberg, Germany.
| | - Thomas Longerich
- Universitätsklinikum Heidelberg Pathologisches Institut, Heidelberg, Germany
| | - Constantin Schwab
- Universitätsklinikum Heidelberg Pathologisches Institut, Heidelberg, Germany
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Mead MN, Seneff S, Wolfinger R, Rose J, Denhaerynck K, Kirsch S, McCullough PA. COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign. Cureus 2024; 16:e52876. [PMID: 38274635 PMCID: PMC10810638 DOI: 10.7759/cureus.52876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 01/27/2024] Open
Abstract
Our understanding of COVID-19 vaccinations and their impact on health and mortality has evolved substantially since the first vaccine rollouts. Published reports from the original randomized phase 3 trials concluded that the COVID-19 mRNA vaccines could greatly reduce COVID-19 symptoms. In the interim, problems with the methods, execution, and reporting of these pivotal trials have emerged. Re-analysis of the Pfizer trial data identified statistically significant increases in serious adverse events (SAEs) in the vaccine group. Numerous SAEs were identified following the Emergency Use Authorization (EUA), including death, cancer, cardiac events, and various autoimmune, hematological, reproductive, and neurological disorders. Furthermore, these products never underwent adequate safety and toxicological testing in accordance with previously established scientific standards. Among the other major topics addressed in this narrative review are the published analyses of serious harms to humans, quality control issues and process-related impurities, mechanisms underlying adverse events (AEs), the immunologic basis for vaccine inefficacy, and concerning mortality trends based on the registrational trial data. The risk-benefit imbalance substantiated by the evidence to date contraindicates further booster injections and suggests that, at a minimum, the mRNA injections should be removed from the childhood immunization program until proper safety and toxicological studies are conducted. Federal agency approval of the COVID-19 mRNA vaccines on a blanket-coverage population-wide basis had no support from an honest assessment of all relevant registrational data and commensurate consideration of risks versus benefits. Given the extensive, well-documented SAEs and unacceptably high harm-to-reward ratio, we urge governments to endorse a global moratorium on the modified mRNA products until all relevant questions pertaining to causality, residual DNA, and aberrant protein production are answered.
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Affiliation(s)
- M Nathaniel Mead
- Biology and Nutritional Epidemiology, Independent Research, Copper Hill, USA
| | - Stephanie Seneff
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, USA
| | - Russ Wolfinger
- Biostatistics and Epidemiology, Independent Research, Research Triangle Park, USA
| | - Jessica Rose
- Immunology and Public Health Research, Independent Research, Ottawa, CAN
| | - Kris Denhaerynck
- Epidemiology and Biostatistics, Independent Research, Basel, CHE
| | - Steve Kirsch
- Data Science, Independent Research, Los Angeles, USA
| | - Peter A McCullough
- Cardiology, Epidemiology, and Public Health, McCullough Foundation, Dallas, USA
- Cardiology, Epidemiology, and Public Health, Truth for Health Foundation, Tucson, USA
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12
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Rhodes P, Parry P. Gene-based COVID-19 vaccines: Australian perspectives in a corporate and global context. Pathol Res Pract 2024; 253:155030. [PMID: 38101158 DOI: 10.1016/j.prp.2023.155030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
Pandemic management requires societal coordination, global orchestration, respect for human rights and defence of ethical principles. Yet some approaches to the COVID-19 pandemic, driven by socioeconomic, corporate, and political interests, have undermined key pillars of ethical medical science. We explore significant mistakes that may have occurred in recent pandemic control, in order to better navigate the future. Within corporate and geopolitical infrastructure, we review the COVID-19 pandemic and novel mRNA and viral-vector DNA COVID-19 vaccines, deployed by wealthy western countries. The pandemic, together with rollouts of unconventional, gene-based vaccine technology, has provided experimental opportunity to engineer social control of entire populations. The haste and scale of development, production, and distribution of these new pharmaceuticals is unprecedented in history. Key phase III clinical trials for these products are yet to be fully completed, despite administration to billions of people. Mass vaccination of workforces has been mandated, and vaccine mandates correlate with excess mortality. Many independent data sets concur - we have experienced a pandemic of viral illness, followed by a pandemic of vaccine injury. For Australia, matters have operated the other way around. Vaccination followed later by the main viral wave. Australian excess mortality data correlates with this. Neither risk nor cost can justify these products for the vast majority of people. Lack of efficacy against infection and transmission, and the equivalent benefits of natural immunity, obviate mandatory therapeutics. With the many gene-based pharmaceuticals planned, a new era of pathology lies ahead. We should pause, reflect, and reaffirm essential freedoms, welcome the end of the COVID-19 pandemic, embrace natural immunity, and lift all mandated medical therapy.
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Affiliation(s)
- Peter Rhodes
- Independent Researcher, Gonville & Caius College, University of Cambridge, UK, (alma mater), Consultant Specialist Anaesthesia and Intensive Care Medicine, Brisbane, Queensland, Australia
| | - Peter Parry
- Children's Health Research Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
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13
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Roest Korsgaard S. Were athletes at increased risk of sudden cardiac death and survived sudden cardiac arrest in 2021? Scand J Immunol 2023; 98:e13334. [PMID: 38441380 DOI: 10.1111/sji.13334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 03/07/2024]
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14
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Polykretis P, Donzelli A, Lindsay JC, Wiseman D, Kyriakopoulos AM, Mörz M, Bellavite P, Fukushima M, Seneff S, McCullough PA. Autoimmune inflammatory reactions triggered by the COVID-19 genetic vaccines in terminally differentiated tissues. Autoimmunity 2023; 56:2259123. [PMID: 37710966 DOI: 10.1080/08916934.2023.2259123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/05/2023] [Accepted: 09/10/2023] [Indexed: 09/16/2023]
Abstract
As a result of the spread of SARS-CoV-2, a global pandemic was declared. Indiscriminate COVID-19 vaccination has been extended to include age groups and naturally immune people with minimal danger of suffering serious complications due to COVID-19. Solid immuno-histopathological evidence demonstrates that the COVID-19 genetic vaccines can display a wide distribution within the body, affecting tissues that are terminally differentiated and far away from the injection site. These include the heart and brain, which may incur in situ production of spike protein eliciting a strong autoimmunological inflammatory response. Due to the fact that every human cell which synthesises non-self antigens, inevitably becomes the target of the immune system, and since the human body is not a strictly compartmentalised system, accurate pharmacokinetic and pharmacodynamic studies are needed in order to determine precisely which tissues can be harmed. Therefore, our article aims to draw the attention of the scientific and regulatory communities to the critical need for biodistribution studies for the genetic vaccines against COVID-19, as well as for rational harm-benefit assessments by age group.
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Affiliation(s)
- Panagis Polykretis
- "Allineare Sanità e Salute" Foundation, Milano, Italy
- Independent Medical Scientific Commission (CMSi), Milano, Italy
| | - Alberto Donzelli
- "Allineare Sanità e Salute" Foundation, Milano, Italy
- Independent Medical Scientific Commission (CMSi), Milano, Italy
| | - Janci C Lindsay
- Toxicology & Molecular Biology, Toxicology Support Services, LLC, Sealy, TX, USA
| | | | | | | | | | | | - Stephanie Seneff
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA, USA
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15
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Broberg MC, Mazer MB, Cheifetz IM. Cardiovascular effects of COVID-19 in children. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:533-541. [PMID: 38920204 DOI: 10.47102/annals-acadmedsg.202386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction Although severe acute respiratory failure is the primary cause of morbidity and mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, this viral infection leads to cardiovascular disease in some individuals. Cardiac effects of the virus include myocarditis, pericarditis, arrhythmias, coronary aneurysms and cardiomyopathy, and can result in cardiogenic shock and multisystem organ failure. Method This review summarises cardiac manifesta-tions of SARS-CoV-2 in the paediatric population. We performed a scoping review of cardiovascular disease associated with acute coronavirus disease 2019 (COVID-19) infection, multisystem inflammatory syndrome in children (MIS-C), and mRNA COVID-19 vaccines. Also examined are special considerations for paediatric athletes and return to play following COVID-19 infection. Results Children presenting with acute COVID-19 should be screened for cardiac dysfunction and a thorough history should be obtained. Further cardiovascular evaluation should be considered following any signs/symptoms of arrhythmias, low cardiac output, and/or myopericarditis. Patients admitted with severe acute COVID-19 should be monitored with continuous cardiac monitoring. Laboratory testing, as clinically indicated, includes tests for troponin and B-type natriuretic peptide or N-terminal pro-brain natriuretic peptide. Echocardiography with strain evaluation and/or cardiac magnetic resonance imaging should be considered to evaluate diastolic and systolic dysfunction, coronary anatomy, the pericardium and the myocardium. For patients with MIS-C, combination therapy with intravenous immunoglobulin and glucocorticoid therapy is safe and potentially disease altering. Treatment of MIS-C targets the hyperimmune response. Supportive care, including mechanical support, is needed in some cases. Conclusion Cardiovascular disease is a striking feature of SARS-CoV-2 infection. Most infants, children and adolescents with COVID-19 cardiac disease fully recover with no lasting cardiac dysfunction. However, long-term studies and further research are needed to assess cardiovascular risk with variants of SARS-CoV-2 and to understand the pathophysiology of cardiac dysfunction with COVID-19.
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Affiliation(s)
- Meredith Cg Broberg
- Division of Cardiac Critical Care, UH Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Monty B Mazer
- Division of Cardiac Critical Care, UH Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Ira M Cheifetz
- Division of Cardiac Critical Care, UH Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
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16
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Kountouras J, Papaefthymiou A, Zavos C, Chatzopoulos D, Tzitiridou-Chatzopoulou M, Kavaliotis J, Tzilves D, Lazaraki G, Vardaka E, Doulberis M. Viewing the Current Puzzling Issue of COVID-19 Vaccination Safety in Older Adults. J Am Med Dir Assoc 2023; 24:1612-1613. [PMID: 37582481 DOI: 10.1016/j.jamda.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 08/17/2023]
Affiliation(s)
- Jannis Kountouras
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece
| | - Apostolis Papaefthymiou
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece; Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London, United Kingdom
| | - Christos Zavos
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece
| | - Dimitrios Chatzopoulos
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece
| | - Maria Tzitiridou-Chatzopoulou
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece; School of Healthcare Sciences, Midwifery Department, University of West Macedonia, Koila, Kozani, Macedonia, Greece
| | - John Kavaliotis
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece
| | - Dimitrios Tzilves
- Gastroenterology Department, Theageneio Hospital, Thessaloniki, Macedonia, Greece
| | - Georgia Lazaraki
- Gastroenterology Department, Theageneio Hospital, Thessaloniki, Macedonia, Greece
| | - Elisabeth Vardaka
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece; Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Macedonia, Greece
| | - Michael Doulberis
- Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece; Gastroklinik, Private Gastroenterological Practice, Horgen, Switzerland
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17
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Abstract
The development of safe and effective vaccines against severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) was a major turning point in the fight against the Coronavirus 2019 (COVID-19) pandemic. However, pharmacovigilance has revealed a small but significant incidence of cardiac inflammation manifesting clinically as myocarditis or pericarditis, particularly in younger vaccine recipients. The incidence is the highest among men under age 40 within a week of receiving the second dose of the mRNA vaccine. In this review, we summarise the evidence for, and guidelines in relation to, SARS-CoV2 vaccine-related myocarditis.
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Affiliation(s)
| | - Alina Hua
- Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London UK
| | - Tevfik Ismail
- King's College London, London, UK, and reader, King's College London, UK
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18
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Parry PI, Lefringhausen A, Turni C, Neil CJ, Cosford R, Hudson NJ, Gillespie J. 'Spikeopathy': COVID-19 Spike Protein Is Pathogenic, from Both Virus and Vaccine mRNA. Biomedicines 2023; 11:2287. [PMID: 37626783 PMCID: PMC10452662 DOI: 10.3390/biomedicines11082287] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/17/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
The COVID-19 pandemic caused much illness, many deaths, and profound disruption to society. The production of 'safe and effective' vaccines was a key public health target. Sadly, unprecedented high rates of adverse events have overshadowed the benefits. This two-part narrative review presents evidence for the widespread harms of novel product COVID-19 mRNA and adenovectorDNA vaccines and is novel in attempting to provide a thorough overview of harms arising from the new technology in vaccines that relied on human cells producing a foreign antigen that has evidence of pathogenicity. This first paper explores peer-reviewed data counter to the 'safe and effective' narrative attached to these new technologies. Spike protein pathogenicity, termed 'spikeopathy', whether from the SARS-CoV-2 virus or produced by vaccine gene codes, akin to a 'synthetic virus', is increasingly understood in terms of molecular biology and pathophysiology. Pharmacokinetic transfection through body tissues distant from the injection site by lipid-nanoparticles or viral-vector carriers means that 'spikeopathy' can affect many organs. The inflammatory properties of the nanoparticles used to ferry mRNA; N1-methylpseudouridine employed to prolong synthetic mRNA function; the widespread biodistribution of the mRNA and DNA codes and translated spike proteins, and autoimmunity via human production of foreign proteins, contribute to harmful effects. This paper reviews autoimmune, cardiovascular, neurological, potential oncological effects, and autopsy evidence for spikeopathy. With many gene-based therapeutic technologies planned, a re-evaluation is necessary and timely.
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Affiliation(s)
- Peter I. Parry
- Children’s Health Research Clinical Unit, Faculty of Medicine, The University of Queensland, South Brisbane, QLD 4101, Australia
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia
| | - Astrid Lefringhausen
- Children’s Health Defence (Australia Chapter), Huskisson, NSW 2540, Australia; (A.L.); (R.C.); (J.G.)
| | - Conny Turni
- Microbiology Research, QAAFI (Queensland Alliance for Agriculture and Food Innovation), The University of Queensland, St. Lucia, QLD 4072, Australia;
| | - Christopher J. Neil
- Department of Medicine, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Robyn Cosford
- Children’s Health Defence (Australia Chapter), Huskisson, NSW 2540, Australia; (A.L.); (R.C.); (J.G.)
| | - Nicholas J. Hudson
- School of Agriculture and Food Science, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Julian Gillespie
- Children’s Health Defence (Australia Chapter), Huskisson, NSW 2540, Australia; (A.L.); (R.C.); (J.G.)
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19
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Yamamoto J, Awaya T, Nakagawa T, Tamura A, Hiroi Y. Myocarditis with ventricular tachycardia following bivalent COVID-19 mRNA vaccination. CJC Open 2023:S2589-790X(23)00121-X. [PMID: 37362315 PMCID: PMC10193770 DOI: 10.1016/j.cjco.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/28/2023] Open
Affiliation(s)
- Jumpei Yamamoto
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toru Awaya
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Takashi Nakagawa
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Asuka Tamura
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukio Hiroi
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan
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20
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Halma MTJ, Plothe C, Marik P, Lawrie TA. Strategies for the Management of Spike Protein-Related Pathology. Microorganisms 2023; 11:1308. [PMID: 37317282 PMCID: PMC10222799 DOI: 10.3390/microorganisms11051308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 06/16/2023] Open
Abstract
In the wake of the COVID-19 crisis, a need has arisen to prevent and treat two related conditions, COVID-19 vaccine injury and long COVID-19, both of which can trace at least part of their aetiology to the spike protein, which can cause harm through several mechanisms. One significant mechanism of harm is vascular, and it is mediated by the spike protein, a common element of the COVID-19 illness, and it is related to receiving a COVID-19 vaccine. Given the significant number of people experiencing these two related conditions, it is imperative to develop treatment protocols, as well as to consider the diversity of people experiencing long COVID-19 and vaccine injury. This review summarizes the known treatment options for long COVID-19 and vaccine injury, their mechanisms, and their evidentiary basis.
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Affiliation(s)
| | - Christof Plothe
- Center for Biophysical Osteopathy, Am Wegweiser 27, 55232 Alzey, Germany
| | - Paul Marik
- Front Line COVID-19 Critical Care Alliance (FLCCC), 2001 L St. NW Suite 500, Washington, DC 20036, USA;
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21
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Barmada A, Klein J, Ramaswamy A, Brodsky NN, Jaycox JR, Sheikha H, Jones KM, Habet V, Campbell M, Sumida TS, Kontorovich A, Bogunovic D, Oliveira CR, Steele J, Hall EK, Pena-Hernandez M, Monteiro V, Lucas C, Ring AM, Omer SB, Iwasaki A, Yildirim I, Lucas CL. Cytokinopathy with aberrant cytotoxic lymphocytes and profibrotic myeloid response in SARS-CoV-2 mRNA vaccine-associated myocarditis. Sci Immunol 2023; 8:eadh3455. [PMID: 37146127 PMCID: PMC10468758 DOI: 10.1126/sciimmunol.adh3455] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/19/2023] [Indexed: 05/07/2023]
Abstract
Rare immune-mediated cardiac tissue inflammation can occur after vaccination, including after SARS-CoV-2 mRNA vaccines. However, the underlying immune cellular and molecular mechanisms driving this pathology remain poorly understood. Here, we investigated a cohort of patients who developed myocarditis and/or pericarditis with elevated troponin, B-type natriuretic peptide, and C-reactive protein levels as well as cardiac imaging abnormalities shortly after SARS-CoV-2 mRNA vaccination. Contrary to early hypotheses, patients did not demonstrate features of hypersensitivity myocarditis, nor did they have exaggerated SARS-CoV-2-specific or neutralizing antibody responses consistent with a hyperimmune humoral mechanism. We additionally found no evidence of cardiac-targeted autoantibodies. Instead, unbiased systematic immune serum profiling revealed elevations in circulating interleukins (IL-1β, IL-1RA, and IL-15), chemokines (CCL4, CXCL1, and CXCL10), and matrix metalloproteases (MMP1, MMP8, MMP9, and TIMP1). Subsequent deep immune profiling using single-cell RNA and repertoire sequencing of peripheral blood mononuclear cells during acute disease revealed expansion of activated CXCR3+ cytotoxic T cells and NK cells, both phenotypically resembling cytokine-driven killer cells. In addition, patients displayed signatures of inflammatory and profibrotic CCR2+ CD163+ monocytes, coupled with elevated serum-soluble CD163, that may be linked to the late gadolinium enhancement on cardiac MRI, which can persist for months after vaccination. Together, our results demonstrate up-regulation in inflammatory cytokines and corresponding lymphocytes with tissue-damaging capabilities, suggesting a cytokine-dependent pathology, which may further be accompanied by myeloid cell-associated cardiac fibrosis. These findings likely rule out some previously proposed mechanisms of mRNA vaccine--associated myopericarditis and point to new ones with relevance to vaccine development and clinical care.
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Affiliation(s)
- Anis Barmada
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Jon Klein
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Anjali Ramaswamy
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Nina N. Brodsky
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Jillian R. Jaycox
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Hassan Sheikha
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Kate M. Jones
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Victoria Habet
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Melissa Campbell
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Tomokazu S. Sumida
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Amy Kontorovich
- The Zena and Michael A. Wiener Cardiovascular Institute; Mindich Child Health and Development Institute; Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dusan Bogunovic
- The Zena and Michael A. Wiener Cardiovascular Institute; Mindich Child Health and Development Institute; Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Inborn Errors of Immunity; Precision Immunology Institute; Mindich Child Health and Development Institute; Department of Pediatrics; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carlos R. Oliveira
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Jeremy Steele
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - E. Kevin Hall
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Mario Pena-Hernandez
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Valter Monteiro
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Carolina Lucas
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Yale Center for Infection and Immunity, Yale University, New Haven, CT, USA
| | - Aaron M. Ring
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Saad B. Omer
- Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
- Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Akiko Iwasaki
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
- Yale Center for Infection and Immunity, Yale University, New Haven, CT, USA
| | - Inci Yildirim
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
- Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
- Yale Center for Infection and Immunity, Yale University, New Haven, CT, USA
| | - Carrie L. Lucas
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
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22
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Manu P. Fatal Myocarditis After COVID-19 Vaccination: Fourteen Autopsy-Confirmed Cases. Am J Ther 2023; 30:e259-e260. [PMID: 37278705 DOI: 10.1097/mjt.0000000000001631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Peter Manu
- Department of Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY and South Oaks Hospital, Amityville, NY
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23
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Kuhbandner C, Reitzner M. Estimation of Excess Mortality in Germany During 2020-2022. Cureus 2023; 15:e39371. [PMID: 37378220 PMCID: PMC10292034 DOI: 10.7759/cureus.39371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Background This study estimates the burden of COVID-19 on mortality in Germany. It is expected that many people have died because of the new COVID-19 virus who otherwise would not have died. Estimating the burden of the COVID-19 pandemic on mortality by the number of officially reported COVID-19-related deaths has been proven to be difficult due to several reasons. Because of this, a better approach, which has been used in many studies, is to estimate the burden of the COVID-19 pandemic by calculating the excess mortality for the pandemic years. An advantage of such an approach is that additional negative impacts of a pandemic on mortality are covered as well, such as a possible pandemic-induced strain on the healthcare system. Methods To calculate the excess mortality in Germany for the pandemic years 2020 to 2022, we compare the reported number of all-cause deaths (i.e., the number of deaths independently of underlying causes) with the number of statistically expected all-cause deaths. For this, the state-of-the-art method of actuarial science, based on population tables, life tables, and longevity trends, is used to estimate the expected number of all-cause deaths from 2020 to 2022 if there had been no pandemic. Results The results show that the observed number of deaths in 2020 was close to the expected number with respect to the empirical standard deviation; approximately 4,000 excess deaths occurred. By contrast, in 2021, the observed number of deaths was two empirical standard deviations above the expected number and even more than four times the empirical standard deviation in 2022. In total, the number of excess deaths in the year 2021 is about 34,000 and in 2022 about 66,000 deaths, yielding a cumulated 100,000 excess deaths in both years. The high excess mortality in 2021 and 2022 was mainly due to an increase in deaths in the age groups between 15 and 79 years and started to accumulate only from April 2021 onward. A similar mortality pattern was observed for stillbirths with an increase of about 9.4% in the second quarter and 19.4% in the fourth quarter of the year 2021 compared to previous years. Conclusions These findings indicate that something must have happened in spring 2021 that led to a sudden and sustained increase in mortality, although no such effects on mortality had been observed during the early COVID-19 pandemic so far. Possible influencing factors are explored in the discussion.
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24
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Giannotta G, Murrone A, Giannotta N. COVID-19 mRNA Vaccines: The Molecular Basis of Some Adverse Events. Vaccines (Basel) 2023; 11:vaccines11040747. [PMID: 37112659 PMCID: PMC10145134 DOI: 10.3390/vaccines11040747] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Each injection of any known vaccine results in a strong expression of pro-inflammatory cytokines. This is the result of the innate immune system activation, without which no adaptive response to the injection of vaccines is possible. Unfortunately, the degree of inflammation produced by COVID-19 mRNA vaccines is variable, probably depending on genetic background and previous immune experiences, which through epigenetic modifications could have made the innate immune system of each individual tolerant or reactive to subsequent immune stimulations.We hypothesize that we can move from a limited pro-inflammatory condition to conditions of increasing expression of pro-inflammatory cytokines that can culminate in multisystem hyperinflammatory syndromes following COVID-19 mRNA vaccines (MIS-V). We have graphically represented this idea in a hypothetical inflammatory pyramid (IP) and we have correlated the time factor to the degree of inflammation produced after the injection of vaccines. Furthermore, we have placed the clinical manifestations within this hypothetical IP, correlating them to the degree of inflammation produced. Surprisingly, excluding the possible presence of an early MIS-V, the time factor and the complexity of clinical manifestations are correlated to the increasing degree of inflammation: symptoms, heart disease and syndromes (MIS-V).
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25
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Badaró R, Novaes G, Andrade AC, de Araujo Neto CA, Machado BA, Barbosa JDV, Soares MBP. Myocardial infarction or myocarditis? A case report and review of a myocardial adverse event associated with mRNA vaccine. Front Med (Lausanne) 2023; 10:1071239. [PMID: 36817791 PMCID: PMC9932914 DOI: 10.3389/fmed.2023.1071239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/02/2023] [Indexed: 02/05/2023] Open
Abstract
A 23-year-old man started with chest pain 8 h after his first Pfizer-BioNTech COVID-19 vaccination. ECG evaluation showed sinus tachycardia with ST-segment elevation in D1, AVL, V5, and V6, the findings compatible with acute subepicardial myocardial damage. However, cardiac MRI documented myocardial fibrosis, with cardiac late enhancement non-ischemic pattern with diffuse edema. He had no other symptoms to suggest another etiology than the vaccination. The patient was hospitalized and received corticosteroid (prednisolone) daily. Then, 2 weeks after hospitalization, all laboratory parameters and ECG were normal and the patient was discharged from the hospital. The patient had a history of Wolf-Parkinson White that was corrected with ablation when he was 11 years old. This report calls attention to myocardial adverse reaction risk for mRNA COVID-19 vaccines for people with a previous cardiac disease history.
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Affiliation(s)
- Roberto Badaró
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil,Allmed Specialized Clinic, Salvador, Brazil,*Correspondence: Roberto Badaró,
| | | | | | | | - Bruna Aparecida Machado
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil
| | - Josiane Dantas Viana Barbosa
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil
| | - Milena Botelho Pereira Soares
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil,Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil,Milena Botelho Pereira Soares,
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26
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Kountouras J, Tzitiridou-Chatzopoulou M, Papaefthymiou A, Chatzopoulos D, Doulberis M. COVID-19 mRNA Vaccine Effectiveness against Elderly Frail People. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020202. [PMID: 36837403 PMCID: PMC9962607 DOI: 10.3390/medicina59020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/07/2023] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
The frail, elderly population is often characterized by poor immunogenicity post COVID-19 mRNA vaccination. "Inflame-ageing" and "immune-senescence" are pathogenetic mechanisms that might explain this phenomenon. Complex interplay with cytokines and microbiota is also implicated in this inflammatory cascade. The abovementioned population, although very important from immunologic perspective, has barely been included in the mRNA vaccination clinical trials.
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Affiliation(s)
- Jannis Kountouras
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Correspondence: (J.K.); (M.D.)
| | - Maria Tzitiridou-Chatzopoulou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Midwifery Department, School of Healthcare Sciences, University of West Macedonia, Koila, 50100 Kozani, Greece
| | - Apostolis Papaefthymiou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Department of Gastroenterology, University Hospital of Larisa, 41110 Larisa, Greece
| | - Dimitrios Chatzopoulos
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Michael Doulberis
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Correspondence: (J.K.); (M.D.)
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27
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Kerbl R. [Pediatrics up to date-Brief notes on research]. Monatsschr Kinderheilkd 2023; 171:103-104. [PMID: 36620096 PMCID: PMC9807289 DOI: 10.1007/s00112-022-01684-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Reinhold Kerbl
- grid.508273.bAbteilung für Kinder und Jugendliche, LKH Hochsteiermark/Leoben, Vordernbergerstr. 42, 8700 Leoben, Österreich
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