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Oliveira LAR, Correa AS, de Jesus TA, Bortolini MJS, Taketomi EA, Resende RDO. Distinct Adverse Reactions to mRNA, Inactivated Virus, and Adenovirus Vector COVID-19 Vaccines: Insights from a Cohort Study on Atopic and Non-Atopic Subjects in Brazil. Vaccines (Basel) 2024; 12:408. [PMID: 38675790 PMCID: PMC11054204 DOI: 10.3390/vaccines12040408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
The emergence of COVID-19 caused by SARS-CoV-2 prompted an unprecedented global response to develop vaccines at an accelerated pace. Messenger RNA (mRNA) and adenovirus vector vaccines emerged as the frontrunners in global immunization efforts, significantly reducing hospitalization, severity, and mortality, supplemented by inactivated virus-based vaccines in developing countries. However, concerns regarding adverse effects, including allergic reactions, have been raised. This study aimed to investigate the adverse effects following COVID-19 vaccination, particularly in atopic and non-atopic individuals. A cohort of 305 volunteers receiving BNT162, ChAdOx1, or CoronaVac vaccines were assessed based on a Skin Prick Test (SPT), specific IgE levels, and clinical history of asthma and rhinitis. Adverse effects were self-reported and scored across the different vaccination shots. The results indicated a notable presence of mild adverse effects following the first and third doses, regardless of vaccine type. ChAdOx1 recipients experienced more adverse effects compared to those receiving BNT162 and CoronaVac, including headaches, muscle pain, fever, chills, nausea, and flu-like symptoms. Atopic individuals receiving ChAdOx1 reported more adverse effects, such as muscle pain, fever, and chills, compared to non-atopic individuals. Conversely, headaches were more frequently reported in non-atopic individuals receiving BNT162 compared to atopic individuals. No anaphylaxis or allergic reactions were reported, indicating valuable evidence supporting the safety of COVID-19 vaccination in individuals with respiratory allergies. This study highlights the importance of understanding vaccine-related adverse effects, particularly in vulnerable populations, to inform vaccination strategies and address safety concerns in global immunization campaigns.
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Affiliation(s)
- Laura Alves Ribeiro Oliveira
- Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia 38405-317, Brazil; (L.A.R.O.); (A.S.C.); (T.A.d.J.); (E.A.T.)
| | - Alessandro Sousa Correa
- Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia 38405-317, Brazil; (L.A.R.O.); (A.S.C.); (T.A.d.J.); (E.A.T.)
| | - Thiago Alves de Jesus
- Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia 38405-317, Brazil; (L.A.R.O.); (A.S.C.); (T.A.d.J.); (E.A.T.)
| | - Miguel Junior Sordi Bortolini
- Laboratory of Translational Immunology, Health and Sports Sciences Center, Federal University of Acre, Rio Branco 69920-900, Brazil;
| | - Ernesto Akio Taketomi
- Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia 38405-317, Brazil; (L.A.R.O.); (A.S.C.); (T.A.d.J.); (E.A.T.)
| | - Rafael de Oliveira Resende
- Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia 38405-317, Brazil; (L.A.R.O.); (A.S.C.); (T.A.d.J.); (E.A.T.)
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-900, Brazil
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Abdul-Nabi ZN, Mohamed-Jawad NK, Fareed NY, Neamah NF, Shari FH. Adverse Effects Post COVID-19 Vaccination and its Association with Age, Gender and Comorbid Disease in Basrah City Southern of Iraq. Curr Drug Saf 2024; 19:248-254. [PMID: 37231751 DOI: 10.2174/1574886318666230525142152] [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: 01/22/2023] [Revised: 03/10/2023] [Accepted: 04/06/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Vaccination against COVID-19 virus is the most valuable tool available for protection during the pandemic of coronavirus. The clinical manifestation post-vaccination is a barrier to vaccination for many people in Iraq and worldwide. OBJECTIVES The objective of this study is identifying various clinical manifestations occurring after receiving vaccines among individuals in Basrah Governorate. Moreover, we examine its association with respondents' demographics and the type of vaccine they received. METHODS A cross-section study was conducted in Basrah, southern Iraq. Research data were collected through an online questionnaire. The data were analyzed using both descriptive and analytic statistical tools using the SPSS program. RESULTS Most of the participants (86.68%) received the vaccine. The side effects were reported in 71.61% of vaccinated individuals. Fever and muscle pain were the two most experienced clinical manifestations, while lymph node enlargement and disturbances in taste and/or smell sensations were reported infrequently. Adverse effects were mostly reported with the Pfizer BioNTech vaccine receiver. Females and those in the younger age group also reported a significantly higher incidence of side effects. CONCLUSION Most adverse effects related to the COVID-19 vaccine were minor and could be tolerated without the need for hospital admission.
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Affiliation(s)
| | | | - Noor Yousif Fareed
- Department of Pharmaceutics, College of Pharmacy, University of Basrah, Basrah, Iraq
| | | | - Falah Hassan Shari
- Department of Clinical Laboratory Sciences, College of Pharmacy, University of Basrah, Basra, Iraq
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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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Is SARS-CoV-2 Vaccination of Subjects with a Prior History of Allergies Dangerous? Experiences in the Veneto Region of Italy. Vaccines (Basel) 2023; 11:vaccines11030574. [PMID: 36992158 DOI: 10.3390/vaccines11030574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Adverse events after SARS-CoV-2 vaccinations have caused alarm to some individuals with previously diagnosed allergies. The aim of this study was to investigate whether the risk of adverse reactions was actually higher in this subgroup. To this end, we carried out an observational descriptive analysis of vaccines administered in a “protected setting” in the Veneto region of Italy between December 2020 and December 2022. Reactions were classified using systemic organic classification (SOC), and their severity was assessed using the criteria of the Italian Drug Agency (AIFA). A total of 421 subjects were vaccinated with 1050 doses, 95.0% of which were administered without adverse events. In all, 53 subjects reported 87 SOC reactions (1.6 reactions/person), and 18.3% of these reactions were severe. One person was hospitalized, but all subjects enjoyed complete remission. Reporting rates were 9.0%, 3.1%, and 1.2% for first, second, and third doses, respectively. The most frequent reactions involved the respiratory system (2.3%), the cutaneous and subcutaneous systems (2.1%), and the nervous system (1.7%). Multivariate analyses (adjOR (95% CI)) revealed that the probability of experiencing at least one reaction significantly declined with increases in age [0.95 (0.94–0.97)] and in the number of doses received, i.e., 75% [0.25 (0.13–0.49)] for second doses and 88% [0.12 (0.04–0.39)] for third doses. These results indicated that vaccinations could be safely administered; few reactions were reported, and there were no permanent adverse outcomes.
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Maltezou HC, Hatziantoniou S, Theodoridou K, Vasileiou K, Anastassopoulou C, Tsakris A. Anaphylaxis rates following mRNA COVID-19 vaccination in children and adolescents: Analysis of data reported to EudraVigilance. Vaccine 2023; 41:2382-2386. [PMID: 36872145 PMCID: PMC9968615 DOI: 10.1016/j.vaccine.2023.02.067] [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] [Received: 12/14/2022] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/01/2023]
Abstract
AIM The present study aimed to estimate the anaphylaxis rates following mRNA COVID-19 vaccination in children and adolescents in Europe. METHODS We retrieved data on 371 anaphylaxis cases following mRNA COVID-19 vaccination in children ≤ 17 years old notified to EudraVigilance as of October 8, 2022. Overall, 27,120,512 doses of BNT162b2 vaccine and 1,400,300 doses of mRNA-1273 vaccine have been delivered to children during the study period. RESULTS The overall mean anaphylaxis rate was 12.81 [95% confidence interval (CI): 11.49-14.12] per 106 mRNA vaccine doses [12.14 (95% CI: 6.37-17.91) per 106 doses for mRNA-1273 and 12.84 (95% CI: 11.49-14.19) per 106 doses for BNT162b2]. Children 12-17 years old accounted for 317 anaphylaxis cases, followed by 48 cases in children 3-11 years old, and 6 cases in children 0-2 years old. Children 10-17 years old had a mean anaphylaxis rate of 13.52 (95% CI: 12.03-15.00) cases per 106 mRNA vaccine doses and children 5-9 years old had a mean anaphylaxis rate of 9.51 (95% CI: 6.82-12.20) cases per 106 mRNA vaccine doses. There were two fatalities, both in the 12-17 years age group. The fatal anaphylaxis rate was 0.07 cases per 106 mRNA vaccine doses. CONCLUSIONS Anaphylaxis is a rare adverse event after receiving an mRNA COVID-19 vaccine in children. Continuous surveillance of serious adverse events is needed to guide vaccination policies as we move towards SARS-CoV-2 endemicity. Larger real-world studies on COVID-19 vaccination in children, using clinical case confirmation, are imperative.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece.
| | - Sophia Hatziantoniou
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Kalliopi Theodoridou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Department of Microbiology, Andreas Syggros Hospital for Skin and Venereal Diseases, National and Kapodistrian University of Athens, 161 21 Athens, Greece
| | | | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Atanasov V, Barreto N, Whittle J, Meurer J, Weston BW, Luo Q(E, Franchi L, Yuan AY, Zhang R, Black B. Understanding COVID-19 Vaccine Effectiveness against Death Using a Novel Measure: COVID Excess Mortality Percentage. Vaccines (Basel) 2023; 11:379. [PMID: 36851256 PMCID: PMC9959409 DOI: 10.3390/vaccines11020379] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
COVID-19 vaccines have saved millions of lives; however, understanding the long-term effectiveness of these vaccines is imperative to developing recommendations for booster doses and other precautions. Comparisons of mortality rates between more and less vaccinated groups may be misleading due to selection bias, as these groups may differ in underlying health status. We studied all adult deaths during the period of 1 April 2021-30 June 2022 in Milwaukee County, Wisconsin, linked to vaccination records, and we used mortality from other natural causes to proxy for underlying health. We report relative COVID-19 mortality risk (RMR) for those vaccinated with two and three doses versus the unvaccinated, using a novel outcome measure that controls for selection effects. This measure, COVID Excess Mortality Percentage (CEMP), uses the non-COVID natural mortality rate (Non-COVID-NMR) as a measure of population risk of COVID mortality without vaccination. We validate this measure during the pre-vaccine period (Pearson correlation coefficient = 0.97) and demonstrate that selection effects are large, with non-COVID-NMRs for two-dose vaccinees often less than half those for the unvaccinated, and non-COVID NMRs often still lower for three-dose (booster) recipients. Progressive waning of two-dose effectiveness is observed, with an RMR of 10.6% for two-dose vaccinees aged 60+ versus the unvaccinated during April-June 2021, rising steadily to 36.2% during the Omicron period (January-June, 2022). A booster dose reduced RMR to 9.5% and 10.8% for ages 60+ during the two periods when boosters were available (October-December, 2021; January-June, 2022). Boosters thus provide important additional protection against mortality.
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Affiliation(s)
- Vladimir Atanasov
- Mason College of Business, William & Mary, Williamsburg, VA 23185, USA
| | - Natalia Barreto
- Department of Economics, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA
| | - Jeff Whittle
- Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - John Meurer
- Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | - Qian (Eric) Luo
- Department of Health Policy and Management, George Washington University, Washington, DC 20052, USA
| | - Lorenzo Franchi
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
| | - Andy Ye Yuan
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
| | - Ruohao Zhang
- Department of Data Science, Centre College, Danville, KY 40422, USA
| | - Bernard Black
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
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T Sathyapalan D, Moni M, Prasanna P, Marwaha V, Bala Madathil S, Edathadathil F, Jose SA, Pavithran S, Muralikrishanan R, Ramachandran N, P R R, T S T, Nair AS, Kuriachan S, Louis Palatty P. Adverse events associated with Covishield vaccination among healthcare workers in a tertiary hospital in South India. Vaccine X 2022; 12:100210. [PMID: 36059598 PMCID: PMC9420054 DOI: 10.1016/j.jvacx.2022.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 04/28/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022] Open
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Tuzer C, Sezer S. Clinical Effects of BNT162b2 Vaccine on the Short-Term Course of Chronic Spontaneous Urticaria Patients. Indian J Dermatol 2022; 67:674-681. [PMID: 36998869 PMCID: PMC10043695 DOI: 10.4103/ijd.ijd_543_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Background The clinical effects of Pfizer-BioNTech coronavirus disease 2019 (COVID-19; BNT162b2) vaccine on the clinical course of chronic spontaneous urticaria (CSU) is unclear. Aims and Objectives To evaluate the clinical effects of BNT162b2 vaccine on the clinical course of CSU. Methods In this study, 90 CSU patients vaccinated with one or two repeated doses of BNT162b2 vaccine were included. Urticaria Activity Score over 28 days (UAS28), Urticaria Control Test (UCT), Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), and Medication Scores (MSs) were obtained before the vaccination, 28 days after the first and, if available, after the second dose of BNT162b2 vaccine. The demographic, clinical, and laboratory features were compared between the subjects with exacerbated (group A) and non-exacerbated (group B) disease activity. Results Among the 90 study participants, 14 (15.5%) experienced exacerbations in their urticarial activity after the first or repeated doses of BNT162b2 vaccinations. The demographic, clinical, and laboratory features were similar between the exacerbated and non-exacerbated CSU patients. However, the rate of adverse reactions within 48 hours, such as hives, injection site reactions and wheals lasting <1 hour, were significantly higher in group A than in group B (P = 0.004, P < 0.001, P = 0.001, P = 0.018). Conclusions BNT162b2 vaccination caused an exacerbation in 15.5% of CSU patients during the short-term follow-up. The long-term evaluation can be informative about the lasting effects of BNT162b2 vaccine on the clinical course of CSU patients.
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Affiliation(s)
- Can Tuzer
- From the Adult Immunology and Allergy Clinic, Batman Training and Research Hospital, Batman, Turkey
| | - Suat Sezer
- Dermatology Clinic, Batman Training and Research Hospital, Batman, Turkey
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Filon FL, Lazzarato I, Patriarca E, Iavernig T, Peratoner A, Perri G, Ponis G, Rocco G, Cegolon L. Allergic Reactions to COVID-19 Vaccination in High-Risk Allergic Patients: The Experience of Trieste University Hospital (North-Eastern Italy). Vaccines (Basel) 2022; 10:vaccines10101616. [PMID: 36298481 PMCID: PMC9607499 DOI: 10.3390/vaccines10101616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/12/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Allergic patients may develop reactions following COVID-19 vaccination more frequently than non-allergic individuals. The aim of our study was to assess the risk of reactions in high-risk allergic patients vaccinated for COVID-19 at the University Health Agency Giuliano-Isontina (ASUGI) of Trieste (northeastern Italy). Methods. Patients were considered at high risk for allergic reactions in case of: prior anaphylactic reaction to any drug/vaccine; multiple drug allergy; intolerance to polyethylene glycol (PEG) or polysorbate 80 (PS80) containing drugs; and mast cell disorders. High-risk allergic patients were immunized in hospital by a dedicated allergy team supported by resuscitation staff. Patients were interviewed over the phone one month after vaccination to complete a structured questionnaire investigating signs and symptoms developed after immunization. Results. From March 2021 to February 2022, 269 patients with a history of severe allergic reactions were assessed, of whom 208 (77.3%) eventually received COVID-19 vaccination, 50 (18.6%) refused to be immunized, 10 (3.7%) were deferred for medical reasons and one was declared exempted due to testing positive for PS80. Mild reactions (urticaria, angioedema, rhinitis, erythema) to COVID-19 vaccines were reported by 30.3% of patients, 8.7% within 4 h and 21.6% > 4 h after immunization. No anaphylactic events were observed. Although they were 80 times (3.8%) more prevalent than in COVID-19 vaccinees from the general population (0.047%), vaccine allergic reactions in high-risk patients were mainly mild and late, more likely affecting women (OR = 3.05; 95% CI 1.22−7.65). Conclusions. High-risk allergic patients with urticaria and angioedema may experience mild flare-ups of mast cell activation-like symptoms following COVID-19 vaccination, supporting antihistamine premedication before vaccination and to be continued for one week afterwards.
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Affiliation(s)
- Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Unit of Occupational Medicine, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Ilaria Lazzarato
- Unit of Occupational Medicine, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Emilia Patriarca
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Correspondence: (E.P.); or (L.C.)
| | - Thomas Iavernig
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Alberto Peratoner
- Accident & Emergency, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Giuseppe Perri
- Directorate Office, Cattinara Hospital, University Health Agency Giuliano-Isontina (ASUGI), 34149 Trieste, Italy
| | - Giuliano Ponis
- Hospital Pharmacy, Giuliano Area, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
| | - Giulio Rocco
- Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
| | - Luca Cegolon
- Unit of Occupational Medicine, Department of Medical Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
- Correspondence: (E.P.); or (L.C.)
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Imai K, Tanaka F, Kawano S, Esaki K, Arakawa J, Nishiyama T, Seno S, Hatanaka K, Sugiura T, Kodama Y, Yamada S, Iwamoto S, Takeshima S, Abe N, Kamae C, Aono S, Ito T, Yamamoto T, Mizuguchi Y. Incidence and Risk Factors of Immediate Hypersensitivity Reactions and Immunization Stress-related Responses With COVID-19 mRNA Vaccine. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:2667-2676.e10. [PMID: 35953016 PMCID: PMC9359595 DOI: 10.1016/j.jaip.2022.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 07/01/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022]
Abstract
Background With the implementation of mass vaccination campaigns against COVID-19, the safety of vaccine needs to be evaluated. Objective We aimed to assess the incidence and risk factors for immediate hypersensitivity reactions (IHSR) and immunization stress–related responses (ISRR) with the Moderna COVID-19 vaccine. Methods This nested case-control study included recipients who received the Moderna vaccine at a mass vaccination center, Japan. Recipients with IHSR and ISRR were designated as cases 1 and 2, respectively. Controls 1 and 2 were selected from recipients without IHSR or ISRR and matched (1 case: 4 controls) with cases 1 and cases 2, respectively. Conditional logistic regression analysis was used to identify risk factors associated with IHSR and ISRR. Results Of the 614,151 vaccine recipients who received 1,201,688 vaccine doses, 306 recipients (cases 1) and 2478 recipients (cases 2) showed 318 events of IHSR and 2558 events of ISRR, respectively. The incidence rates per million doses were estimated as IHSR: 266 cases, ISRR: 2129 cases, anaphylaxis: 2 cases, and vasovagal syncope: 72 cases. Risk factors associated with IHSR included female, asthma, atopic dermatitis, thyroid diseases, and a history of allergy; for ISRR, the risk factors were younger age, female, asthma, thyroid diseases, mental disorders, and a history of allergy and vasovagal reflex. Conclusion In the mass vaccination settings, the Moderna vaccine can be used safely owing to the low incidence rates of IHSR and anaphylaxis. However, providers should be aware of the occurrence of ISRR. Although recipients with risk factors are associated with slightly increased risks of IHSR and ISRR, this is not of sufficient magnitude to warrant special measures regarding their vaccination.
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Affiliation(s)
- Kazuo Imai
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Internal Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan; NBC Countermeasure Medical Unit, Japan Ground Self-Defence Force, Tokyo, Japan.
| | - Fumika Tanaka
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Shuichi Kawano
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Internal Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Kotoba Esaki
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Internal Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan; NBC Countermeasure Medical Unit, Japan Ground Self-Defence Force, Tokyo, Japan
| | - Junko Arakawa
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Internal Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan; NBC Countermeasure Medical Unit, Japan Ground Self-Defence Force, Tokyo, Japan
| | - Takashi Nishiyama
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Soichiro Seno
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Kosuke Hatanaka
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Takao Sugiura
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Yu Kodama
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Seigo Yamada
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Shinichiro Iwamoto
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Shigeto Takeshima
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Emergency Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Nobujiro Abe
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Internal Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan; NBC Countermeasure Medical Unit, Japan Ground Self-Defence Force, Tokyo, Japan
| | - Chikako Kamae
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Eastern Army Medical Unit, Japan Ground Self-Defence Force, Tokyo, Japan
| | - Shigeaki Aono
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Internal Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Toshimitsu Ito
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Internal Medicine, Self-Defence Forces Central Hospital, Tokyo, Japan
| | - Tetsuo Yamamoto
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; NBC Countermeasure Medical Unit, Japan Ground Self-Defence Force, Tokyo, Japan
| | - Yasunori Mizuguchi
- Self-Defence Forces Tokyo Large-scale Vaccination Centre, Tokyo, Japan; Department of Urology, Self-Defence Forces Central Hospital, Tokyo, Japan
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Marković I, Božan M, Perković T, Paušek K, Nedeljković V, Perković M, Kelava T, Artuković M, Stipić Marković A. Incidence of immediate allergic reactions to mRNA COVID-19 vaccines in adults with drug allergies and other allergic disorders. Medicine (Baltimore) 2022; 101:e29571. [PMID: 35905225 PMCID: PMC9333079 DOI: 10.1097/md.0000000000029571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Concerns have been raised about allergic reactions to messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccines. A history of allergic reactions, including anaphylaxis to drugs, has been frequently reported in individuals with anaphylaxis to mRNA vaccines. To estimate the rate of immediate allergic reactions in patients with a history of drug allergy or other allergic disorders. We included adult patients who had received at least 1 dose of an mRNA COVID-19 vaccine at the Special Hospital for Pulmonary Diseases between March 1, 2021, and October 1, 2021, and who reported a history of drug allergy or other allergic diseases (asthma, allergic rhinitis, atopic dermatitis, food or insect venom allergy, mastocytosis, idiopathic anaphylaxis, acute or chronic urticaria, and/or angioedema). Immediate allergic reactions, including anaphylaxis, occurring within 4 hours of vaccination were recorded. Six immediate allergic reactions were noted in the cohort of 1679 patients (0.36%). One patient experienced anaphylaxis (0.06%), which resolved after epinephrine administration, and the other reactions were mild and easily treatable. Most patients with a history of allergies can safely receive an mRNA COVID-19 vaccine, providing adequate observation periods and preparedness to recognize and treat anaphylaxis.
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Affiliation(s)
- Ivan Marković
- Special Hospital for Pulmonary Diseases, Zagreb, Croatia
- *Correspondence: Ivan Marković, Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia (e-mail: )
| | - Marina Božan
- Special Hospital for Pulmonary Diseases, Zagreb, Croatia
| | | | | | | | | | - Tomislav Kelava
- Department of Physiology and Immunology, University of Zagreb, School of Medicine, Zagreb, Croatia
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Tolerability and Reactogenicity Profile of mRNA SARS-Cov-2 Vaccines from a Mass Vaccination Campaign in a Tertiary Hospital: Between-Vaccine and Between-Population Prospective Observational Study (VigilVacCOVID Study). BioDrugs 2022; 36:509-520. [PMID: 35764768 PMCID: PMC9243773 DOI: 10.1007/s40259-022-00543-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/24/2022]
Abstract
Background The comparative safety profile of SARS-Cov2 vaccines requires further characterization in real-world settings. Objectives The aim of the VigilVacCOVID study was to assess the short-term safety of BNT162b2 and mRNA-1273 during the vaccination campaign of healthcare professionals (HCPs) and solid-organ transplant recipients (SOTRs) at a hospital clinic. Methods We conducted an observational, prospective, single-center, post-authorization study to characterize short-term adverse reactions (ARs) after vaccination. The primary endpoint was to assess between-vaccine differences (HCPs receiving BNT162b2 or mRNA-1273) and between-population differences (HCPs and SOTRs, both receiving mRNA-1273) in the risk of any ARs. Propensity score and covariate-adjusted multivariate models were used. The key secondary endpoint was to provide a descriptive assessment of the frequencies and intensity distribution of ARs. Results We included 5088 HCPs and 1289 patients. mRNA-1273 showed greater reactogenicity than BNT162b2, with an odds ratio (OR) for any AR of 3.04 (95% confidence interval (CI) 2.48–3.73; p value: < 0.001) and a higher frequency and intensity of reported ARs. Compared with HCPs vaccinated with mRNA-1273, SOTRs showed a lower risk of ARs (OR = 0.36; 95% CI 0.25–0.50), with fewer and less severe ARs. Age, sex, and previous SARS-CoV-2 infection were statistically significant covariates for the risk of any AR. A history of drug allergy was significant in the comparison between vaccines (BNT162b2 vs. mRNA-1273), but not in that between SOTRs and HCPs. Conclusions Our study shows that mRNA-1273 had greater reactogenicity than BNT162b2. Overall, both vaccines had an adequate tolerability profile. mRNA-1273 vaccination caused fewer ARs with milder severity in SOTRs. Supplementary Information The online version contains supplementary material available at 10.1007/s40259-022-00543-9.
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Hidayat R, Mustika AP, Avisha F, Djuliannisaa Z, Winari DD, Putri RA, Lisman HM, Davin V, Widhani A, Aini MH, Rahmadani M, Istanti ND, Giantini A. Surveillance of Adverse Events Following Immunization (AEFI) after Third Dose Booster Vaccination with mRNA-Based Vaccine in Universitas Indonesia Hospital Health Personnel. Vaccines (Basel) 2022; 10:vaccines10060877. [PMID: 35746485 PMCID: PMC9229967 DOI: 10.3390/vaccines10060877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/25/2022] Open
Abstract
Facing the rising cases of with higher fatalities COVID-19, some countries decided to give the third dose of vaccine as a booster. As of 9 January 2022, 90.31% of health workers in Indonesia have received the third dose vaccine. This study aims to provide an evaluation of adverse events following immunization (AEFI) in a single center in Indonesia to form a basis for ensuring safety for booster administration nationally. A retrospective, cross-sectional study was conducted using an online survey. Demographic data, AEFI complaints, and factors influencing AEFIs were evaluated. In this study, there were a total of 311 subjects were gathered. The most common AEFI symptoms found at onset <24 h to 28 days were pain at the injection site, fever, shoulder pain, and headache. Most of the AEFI severity of <24 h to 28 days post-vaccination was grade 1 (reduced or uninterrupted daily activities). There was a significant correlation between AEFI and several factors, such as the history of drug allergy, exercise after vaccination, age, BMI < 25, history of symptoms after the first and second vaccinations, and history of COVID-19. There was no anaphylactic reaction in this study. Several AEFI should be considered for the third dose of COVID-19 vaccine administration.
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Affiliation(s)
- Rakhmad Hidayat
- Faculty of Medicine, Universitas Indonesia, Depok 16424, Indonesia; (A.P.M.); (Z.D.); (A.W.); (A.G.)
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
- Correspondence:
| | - Alyssa Putri Mustika
- Faculty of Medicine, Universitas Indonesia, Depok 16424, Indonesia; (A.P.M.); (Z.D.); (A.W.); (A.G.)
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Fhathia Avisha
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Zlatikha Djuliannisaa
- Faculty of Medicine, Universitas Indonesia, Depok 16424, Indonesia; (A.P.M.); (Z.D.); (A.W.); (A.G.)
| | - Dinisa Diah Winari
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Ria Amiliah Putri
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Heydi Marizky Lisman
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Vandra Davin
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Alvina Widhani
- Faculty of Medicine, Universitas Indonesia, Depok 16424, Indonesia; (A.P.M.); (Z.D.); (A.W.); (A.G.)
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Muhammad Hafiz Aini
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Meilisa Rahmadani
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Novita Dwi Istanti
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
| | - Astuti Giantini
- Faculty of Medicine, Universitas Indonesia, Depok 16424, Indonesia; (A.P.M.); (Z.D.); (A.W.); (A.G.)
- Universitas Indonesia Hospital, Depok 16424, Indonesia; (F.A.); (D.D.W.); (R.A.P.); (H.M.L.); (V.D.); (M.H.A.); (M.R.); (N.D.I.)
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Homologous COVID-19 BNT162b2 mRNA Vaccination at a German Tertiary Care University Hospital: A Survey-Based Analysis of Reactogenicity, Safety, and Inability to Work among Healthcare Workers. Vaccines (Basel) 2022; 10:vaccines10050650. [PMID: 35632406 PMCID: PMC9147477 DOI: 10.3390/vaccines10050650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 01/14/2023] Open
Abstract
At the start of the SARS-CoV-2 pandemic, healthcare workers had an increased risk of acquiring coronavirus disease (COVID)-19. As tertiary care hospitals are critical for the treatment of severely ill patients, the University Hospital Erlangen offered BNT162b2 mRNA vaccination against COVID-19 to all employees when the vaccine became available in Germany. Here, we performed a survey to assess the age- and sex-dependent reactogenicity and safety of BNT162b2 in a real-life setting with a special emphasis on the rate of vaccine-related incapacity to work amongst the employees. All vaccinated employees were invited to participate in the survey and received access to an electronic questionnaire between 31 March and 14 June 2021, which allowed them to report local and systemic adverse effects after the first or second vaccine dose. A total of 2372 employees completed the survey. After both the first and second dose, women had a higher risk than men for vaccine-related systemic side effects (odds ratio (OR) 1.48 (1.24–1.77) and 1.49 (1.23–1.81), respectively) and for inability to work (OR 1.63 (1.14–2.34) and 1.85 (1.52–2.25), respectively). Compared to employees ≥ 56 years of age, younger vaccinated participants had a higher risk of systemic reactions after the first (OR 1.35 (1.07–1.70)) and second vaccination (OR 2.08 (1.64–2.63)) and were more often unable to work after dose 2 (OR 2.20 (1.67–2.88)). We also recorded four anaphylactic reactions and received two reports of severe adverse effects indicative of vaccine complications. After the first and second vaccination, 7.9% and 34.7% of the survey participants, respectively, were temporarily unable to work, which added up to 1700 days of sick leave in this cohort. These real-life data extend previous results on the reactogenicity and safety of BNT162b2. Loss of working time due to vaccine-related adverse effects was substantial, but was outweighed by the potential benefit of prevented cases of COVID-19.
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15
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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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Anahideh H, Kang L, Nezami N. Fair and diverse allocation of scarce resources. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 80:101193. [PMID: 34812203 PMCID: PMC8597936 DOI: 10.1016/j.seps.2021.101193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 09/30/2021] [Accepted: 11/07/2021] [Indexed: 06/02/2023]
Abstract
We aim to design a fairness-aware allocation approach to maximize the geographical diversity and avoid unfairness in the sense of demographic disparity. During the development of this work, the COVID-19 pandemic is still spreading in the U.S. and other parts of the world on large scale. Many poor communities and minority groups are much more vulnerable than the rest. To provide sufficient vaccine and medical resources to all residents and effectively stop the further spreading of the pandemic, the average medical resources per capita of a community should be independent of the community's demographic features but only conditional on the exposure rate to the disease. In this article, we integrate different aspects of resource allocation and create a synergistic intervention strategy that gives vulnerable populations higher priority in medical resource distribution. This prevention-centered strategy seeks a balance between geographical coverage and social group fairness. The proposed principle can be applied to other scarce resources and social benefits allocation.
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Affiliation(s)
| | - Lulu Kang
- Illinois Institute of Technology, United States
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17
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Laisuan W. COVID-19 Vaccine Anaphylaxis: Current Evidence and Future Approaches. FRONTIERS IN ALLERGY 2021; 2:801322. [PMID: 35387045 PMCID: PMC8974674 DOI: 10.3389/falgy.2021.801322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/02/2021] [Indexed: 12/26/2022] Open
Abstract
Vaccine anaphylaxis is rare; however, severe allergic reactions after administration of a coronavirus disease 2019 (COVID-19) vaccines have been reported. Excipients in the vaccine may play a role in severe allergic reactions post-vaccination. Various mechanisms, including IgE-mediated pathways, direct mass cell stimulation via the Mas-related G protein-coupled receptor-X2, and complement pathway activation, have been proposed to cause the anaphylaxis. Skin testing, using the basophil activation test, has been used to clarify the mechanism of the anaphylaxis and provide safety information for the next injection. Here, we review the current evidence and suggested approaches for patients who experienced an immediate severe allergic reaction to the first dose of a COVID-19 vaccine.
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Maltezou HC, Anastassopoulou C, Hatziantoniou S, Poland GA, Tsakris A. Anaphylaxis rates associated with COVID-19 vaccines are comparable to those of other vaccines. Vaccine 2021; 40:183-186. [PMID: 34863620 PMCID: PMC8626274 DOI: 10.1016/j.vaccine.2021.11.066] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 02/02/2023]
Abstract
We retrieved data on 8940 anaphylaxis cases post-COVID-19 vaccination from the US Vaccine Adverse Event Reporting System and the European EudraVigilance from week 52/2020 through week 31/2021 and compared them with those of other vaccines. Overall, 837,830,000 COVID-19 vaccine doses were delivered in the US and Europe during the study period, for which the vaccine name was known. The mean anaphylaxis rate was estimated at 10.67 cases per 106 doses of COVID-19 vaccines (range: 7.99-19.39 cases per 106 doses depending on the vaccine). COVID-19 vaccines ranked fifth in reported anaphylaxis rates, behind rabies, tick-borne encephalitis, measles-mumps-rubella-varicella, and human papillomavirus vaccines (70.77, 20, 19.8, and 13.65 cases per 106 vaccine doses, respectively). COVID-19 vaccines are within the range of anaphylaxis rates reported across several common vaccines in these two passive reporting systems. These data should be communicated to reassure the general population about the safety profile of COVID-19 vaccines.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece.
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Hatziantoniou
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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19
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Calina D, Hernández AF, Hartung T, Egorov AM, Izotov BN, Nikolouzakis TK, Tsatsakis A, Vlachoyiannopoulos PG, Docea AO. Challenges and Scientific Prospects of the Newest Generation of mRNA-Based Vaccines against SARS-CoV-2. Life (Basel) 2021; 11:life11090907. [PMID: 34575056 PMCID: PMC8467884 DOI: 10.3390/life11090907] [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: 08/10/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 02/07/2023] Open
Abstract
In the context of the current COVID-19 pandemic, traditional, complex and lengthy methods of vaccine development and production would not have been able to ensure proper management of this global public health crisis. Hence, a number of technologies have been developed for obtaining a vaccine quickly and ensuring a large scale production, such as mRNA-based vaccine platforms. The use of mRNA is not a new concept in vaccine development but has leveraged on previous knowledge and technology. The great number of human resources and capital investements for mRNA vaccine development, along with the experience gained from previous studies on infectious diseases, allowed COVID-19 mRNA vaccines to be developed, conditionally approved and commercialy available in less than one year, thanks to decades of basic research. This review critically presents and discusses the COVID-19 mRNA vaccine-induced immunity, and it summarizes the most common anaphylactic and autoimmune adverse effects that have been identified until now after massive vaccination campaigns.
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Affiliation(s)
- Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (D.C.); (A.O.D.)
| | - Antonio F. Hernández
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, 18016 Granada, Spain;
- Biomedical Research Institute of Granada ibs.GRANADA, Avda. de las Fuerzas Armadas, 2, 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública), CIBERESP, Instituto de Salud Carlos III, Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Thomas Hartung
- CAAT-Europe, University of Konstanz, 78464 Konstanz, Germany;
- CAAT, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Alexey M. Egorov
- Chumakov Federal Scientific Center for Research and Development of Immune and Biological Products, Russian Academy of Sciences, 108819 Moscow, Russia;
- Division of Medical Sciences, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Boris Nikolaevich Izotov
- Department of Analytical and Forensic Medical Toxicology, Sechenov University, 119991 Moscow, Russia; (B.N.I.); (A.T.)
| | | | - Aristidis Tsatsakis
- Department of Analytical and Forensic Medical Toxicology, Sechenov University, 119991 Moscow, Russia; (B.N.I.); (A.T.)
- Laboratory of Toxicology, Medical School, University of Crete, 70013 Heraklion, Greece;
| | | | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (D.C.); (A.O.D.)
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COVID-19 Vaccines in Children with Cow's Milk and Food Allergies. Nutrients 2021; 13:nu13082637. [PMID: 34444795 PMCID: PMC8401713 DOI: 10.3390/nu13082637] [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: 05/19/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 01/05/2023] Open
Abstract
The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a debate on the safety in allergic patients following post marketing findings by different agencies. Our aim is to understand from current experiences whether children with cow’s milk or food allergy are at higher risk than a general population for allergic reactions to COVID-19 vaccines. Current data indicate that patients with a history of allergy to cow’s milk or other foods, even if severe, should receive COVID-19 vaccine in a setting with availability of treatments for anaphylactic reactions and under medical supervision. Recipients should be discharged after a protracted observation period of 30 min if no reaction developed.
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