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Liu Y, Yuan W, Zhan H, Kang H, Li X, Chen Y, Li H, Sun X, Cheng L, Zheng H, Wang W, Guo X, Li Y, Dai E. SARS-CoV-2 Vaccine Uptake among Patients with Chronic Liver Disease: A Cross-Sectional Analysis in Hebei Province, China. Vaccines (Basel) 2023; 11:1293. [PMID: 37631861 PMCID: PMC10458449 DOI: 10.3390/vaccines11081293] [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: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Chronic liver disease (CLD) patients have higher mortality and hospitalization rates after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to explore SARS-CoV-2 vaccine perceptions, side effects, factors associated with nonvaccination and attitudes toward fourth-dose vaccine among CLD patients. The differences between vaccinated and unvaccinated groups among 1491 CLD patients and the risk factors associated with nonvaccination status were analyzed. In total, 1239 CLD patients were immunized against SARS-CoV-2. CLD patients have a high level of trust in the government and clinicians and were likely to follow their recommendations for vaccination. Reasons reported for nonvaccination were mainly concerns about the vaccines affecting their ongoing treatments and the fear of adverse events. However, only 4.84% of patients reported mild side effects. Risk factors influencing nonvaccination included being older in age, having cirrhosis, receiving treatments, having no knowledge of SARS-CoV-2 vaccine considerations and not receiving doctors' positive advice on vaccination. Furthermore, 20.6% of completely vaccinated participants refused the fourth dose because they were concerned about side effects and believed that the complete vaccine was sufficiently protective. Our study proved that SARS-CoV-2 vaccines were safe for CLD patients. Our findings suggest that governments and health workers should provide more SARS-CoV-2 vaccination information and customize strategies to improve vaccination coverage and enhance vaccine protection among the CLD population.
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Affiliation(s)
- Yongmei Liu
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; (Y.L.); (H.Z.); (X.L.); (H.L.); (L.C.)
| | - Wenfang Yuan
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
| | - Haoting Zhan
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; (Y.L.); (H.Z.); (X.L.); (H.L.); (L.C.)
| | - Haiyan Kang
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
| | - Xiaomeng Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; (Y.L.); (H.Z.); (X.L.); (H.L.); (L.C.)
- Department of Clinical Laboratory, Peking University People’s Hospital, Beijing 100035, China
| | - Yongliang Chen
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
| | - Haolong Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; (Y.L.); (H.Z.); (X.L.); (H.L.); (L.C.)
| | - Xingli Sun
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
| | - Linlin Cheng
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; (Y.L.); (H.Z.); (X.L.); (H.L.); (L.C.)
| | - Haojie Zheng
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
| | - Wei Wang
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
| | - Xinru Guo
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
| | - Yongzhe Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; (Y.L.); (H.Z.); (X.L.); (H.L.); (L.C.)
| | - Erhei Dai
- Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, China; (W.Y.); (H.K.); (Y.C.); (X.S.); (H.Z.); (W.W.); (X.G.)
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Cheng Y, Li T, Zheng Y, Xu B, Bi Y, Hu Y, Zhou YH. Self-Reported adverse events among Chinese healthcare workers immunized with COVID-19 vaccines composed of inactivated SARS-CoV-2. Hum Vaccin Immunother 2022; 18:2064134. [PMID: 35452357 PMCID: PMC9897645 DOI: 10.1080/21645515.2022.2064134] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mass vaccination is critical to control the pandemic of coronavirus disease 2019 (COVID-19). Fear of adverse events (AEs) after COVID-19 vaccination is a main factor associated with vaccination hesitancy. We aimed to analyze AEs in healthcare workers (HCWs) vaccinated with COVID-19 vaccines (Aikewei or CoronaVac) composed of inactivated virus. We used a structured self-administered questionnaire to conduct two surveys on COVID-19 vaccination among HCWs in perinatal medicine and obstetrics/gynecology from April 5 to April 21, 2021. In total, 1392 HCWs who had received at least one vaccine dose were included. Of them, 1264 (90.8%) were females and 1047 (75.2%) received two doses. The overall incidence of any AEs after the first and second dose was 38.2% (532/1392) and 31.0% (325/1047) respectively (χ2 = 13.506, P = .0002). Female and HCWs aged 18-30 y were more likely to report AEs. The most common AEs were local reaction, accounting for 48.1% and 67.4% of all AEs after the first and second dose respectively. The systemic AEs were mainly neurological (9.8% and 4.8% after the first and second injection respectively) and flu-like symptoms (6.3% and 3.2%). Overall, most of AEs were mild, only 5.1% (after the first dose) and 2.8% (after the second dose) of individuals with AEs received symptomatic treatment or sick leaves, and none of them required hospitalization. Our data added more evidence that inactivated COVID-19 vaccines are highly safe. The data are valuable to overcome vaccine hesitancy associated with concerns about the safety of COVID-19 vaccines.
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Affiliation(s)
- Yandong Cheng
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Taishun Li
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yaning Zheng
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Biyun Xu
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yan Bi
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,CONTACT Yali Hu Department of Obstetrics and Gynecology, NanjingDrum Tower Hospital, Nanjing University Medical SchoolNanjing, Jiangsu, China
| | - Yi-Hua Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Yi-Hua Zhou Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing210008, China
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Shafie'ei M, Jamali M, Akbari Z, Sarvipour N, Ahmadzade M, Ahramiyanpour N. Cutaneous adverse reactions following COVID-19 vaccinations: A systematic review and meta-analysis. J Cosmet Dermatol 2022; 21:3636-3650. [PMID: 35861631 PMCID: PMC9350270 DOI: 10.1111/jocd.15261] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND COVID-19 vaccines are currently the most effective interventions in controlling and preventing severe disease progression. Dermatologic reactions to COVID-19 vaccinations may be rare among clinical trial participants. However, since global mass vaccination became a reality, these adverse effects may become more widespread, and different skin reactions would arise. OBJECTIVE To systematically review the cutaneous adverse reactions in cases subject to vaccines for COVID-19. METHODS We searched the PubMed, SCOPUS, Web of Science, and Embase databases, identifying the relevant records and including the eligible observational ones. After assessing the methodological quality of the included studies, we qualitatively and quantitatively synthesized the data regarding the cutaneous side effects experienced by those in the studies' population. RESULTS Overall, 36 studies were included in our systematic review, with the majority being cross-sectional. We found that pain, erythema, and swelling were the most common local side effects, while different types of rashes, urticaria, and angioedema were the most non-local. Few cases also reported experiencing flare-ups of their underlying diseases or developing newly-onset diseases of various etiologies. Our meta-analyses also found that while viral vector-based vaccines are, though insignificantly, safer in injection site complaints, individuals who received mRNA vaccines developed significantly fewer non-local cutaneous adverse events. DISCUSSION Cutaneous reactions to the COVID-19 vaccines are similar to common cutaneous drug eruptions and COVID-19 cutaneous manifestations. However, we believe that further high-quality research is needed to assess better how and why cutaneous reactions occur in different vaccines.
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Affiliation(s)
| | - Marzieh Jamali
- Gene Therapy Research CenterDigestive Diseases Research Institute, Tehran University of Medical SciencesTehranIran
| | - Zahra Akbari
- Faculty of MedicineKerman University of Medical SciencesKermanIran
| | | | - Mohadese Ahmadzade
- Departments of Plastic SurgeryShahid Beheshti University of Medical SciencesTehranIran
| | - Najmeh Ahramiyanpour
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of MedicineKerman University of Medical SciencesKermanIran
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Dadras O, Mehraeen E, Karimi A, Tantuoyir MM, Afzalian A, Nazarian N, Mojdeganlou H, Mirzapour P, Shamsabadi A, Dashti M, Ghasemzadeh A, Vahedi F, Shobeiri P, Pashaei Z, SeyedAlinaghi S. Safety and Adverse Events Related to Inactivated COVID-19 Vaccines and Novavax;a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e54. [PMID: 36033990 PMCID: PMC9397598 DOI: 10.22037/aaem.v10i1.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Knowledge of the safety of vaccines is crucial, both to prevent and cure them and to decrease the public hesitation in receiving vaccines. Therefore, this study aimed to systematically review the adverse events reported for inactivated vaccines and Novavax. Methods In this systematic review, the databases of PubMed, Scopus, Cochrane, and Web of Science were searched on September 15, 2021. Then we identified the eligible studies using a two-step title/abstract and full-text screening process. Data on the subjects, studies, and types of adverse events were extracted and entered in a word table, including serious, mild, local, and systemic adverse events as well as the timing of side effects' appearance. Results Adverse effects of inactivated coronavirus vaccines side effects were reported from phases 1, 2, and 3 of the vaccine trials. The most common local side effects included injection site pain and swelling, redness, and pruritus. Meanwhile, fatigue, headache, muscle pain, fever, and gastrointestinal symptoms including abdominal pain and diarrhea were among the most common systemic adverse effects. Conclusion This systematic review indicates that inactivated COVID-19 vaccines, including Sinovac, Sinopharm, and Bharat Biotech, as well as the protein subunit vaccines (Novavax) can be considered as safe choices due to having milder side effects and fewer severe life-threatening adverse events.
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Affiliation(s)
- Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , , ,School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand. E-mail:
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran. E-mail:
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Marcarious M. Tantuoyir
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , , ,Biomedical Engineering Unit, University of Ghana Medical Center (UGMC), Accra, Ghana. E-mail:
| | - Arian Afzalian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Newsha Nazarian
- School of Medicine, Islamic Azad University, Tehran, Iran. E-mail:
| | - Hengameh Mojdeganlou
- Department of Pathology, Urmia University of Medical Sciences,Urmia, Iran. E-mail:
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , ,
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran. E-mail:
| | - Mohsen Dashti
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail: ,
| | - Afsaneh Ghasemzadeh
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail: ,
| | - Farzin Vahedi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , ,
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , , ,Corresponding Author: SeyedAhmad SeyedAlinaghi, Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. , Tel: 0098 (021) 66581583, ORCID:0000-0003-3210-7905
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5
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Finsterer J. Side effects of SARS-CoV-2 vaccines should be assessed by unbiased professionals on-site. Hum Vaccin Immunother 2022; 18:2090178. [PMID: 35736565 PMCID: PMC9620994 DOI: 10.1080/21645515.2022.2090178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Josef Finsterer
- Department of Neurology, Neurology & Neurophysiology Center, Vienna, Austria
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Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:1947-1968. [PMID: 35666609 PMCID: PMC9348179 DOI: 10.1111/jdv.18294] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side effects which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from January 1, 2019, to December 31, 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies, and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946,366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions, or scheduled for filler injections should receive additional pre-counseling and monitoring. A better understanding of potential side effects may strengthen public confidence in those wary of new vaccine technologies.
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Affiliation(s)
- C Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Ullman
- Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
| | - P Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
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Chen L, Cai X, Zhao T, Han B, Xie M, Cui J, Zhang J, Wang C, Liu B, Lu Q, Cui F. Safety of Global SARS-CoV-2 Vaccines, a Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10040596. [PMID: 35455344 PMCID: PMC9030038 DOI: 10.3390/vaccines10040596] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines were developed in only a short amount of time and were widely distributed. We conducted this meta-analysis to understand the safety of SARS-CoV-2 vaccines. (2) Methods: We searched the corresponding literature published from 1 January 2020 to 20 October 2021. Information of adverse events (AEs) of each selected work was collected. The quality and bias of studies was evaluated, and meta-analysis was carried out by using Stata 17.0. (3) Results: Totally, 11,451 articles were retrieved, and 53 of them were included for analysis. The incidence rate of AEs was 20.05–94.48%. The incidence rate of vascular events increased after viral vector vaccination, while the incidence rate of vascular events decreased after mRNA vaccination. Viral vector vaccine had a higher AE rate compared to mRNA vaccines and inactivated vaccines. In most circumstances, the incidence of AEs was higher in older people, female and after the second dose. The sensitivity of meta-analysis was acceptable; however, the literature was subject to a certain publication bias. (4) Conclusions: The safety of SARS-CoV-2 vaccines was acceptable. The incidence of allergic symptoms and cardiovascular and cerebrovascular symptoms was low. Viral vector vaccine had a higher risk of leading to thrombosis events. The understanding of SARS-CoV-2 vaccine AEs should be enhanced, so as to promote the vaccination.
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Affiliation(s)
- Linyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Xianming Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Bingfeng Han
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Mingzhu Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Jiahao Cui
- Faculty of Medicine, Imperial College London, London SW7 2AZ, UK;
| | - Jiayu Zhang
- Bioinformatics Program, School of Science, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China;
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
- Correspondence: ; Tel./Fax: +86-10-8280-1518
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Castaldo M, Waliszewska-Prosół M, Koutsokera M, Robotti M, Straburzyński M, Apostolakopoulou L, Capizzi M, Çibuku O, Ambat FDF, Frattale I, Gadzhieva Z, Gallo E, Gryglas-Dworak A, Halili G, Jusupova A, Koperskaya Y, Leheste AR, Manzo ML, Marcinnò A, Marino A, Mikulenka P, Ong BE, Polat B, Popovic Z, Rivera-Mancilla E, Roceanu AM, Rollo E, Romozzi M, Ruscitto C, Scotto di Clemente F, Strauss S, Taranta V, Terhart M, Tychenko I, Vigneri S, Misiak B, Martelletti P, Raggi A. Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. J Headache Pain 2022; 23:41. [PMID: 35361131 PMCID: PMC8969402 DOI: 10.1186/s10194-022-01400-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/05/2022] [Indexed: 12/15/2022] Open
Abstract
Background Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are used to reduce the risk of developing Coronavirus Disease 2019 (COVID-19). Despite the significant benefits in terms of reduced risk of hospitalization and death, different adverse events may present after vaccination: among them, headache is one of the most common, but nowadays there is no summary presentation of its incidence and no description of its main features. Methods We searched PubMed and EMBASE covering the period between January 1st 2020 and August 6th, 2021, looking for record in English and with an abstract and using three main search terms (with specific variations): COVID-19/SARS-CoV-2; Vaccination; headache/adverse events. We selected manuscript including information on subjects developing headache after injection, and such information had to be derived from a structured form (i.e. no free reporting). Pooled estimates and 95% confidence intervals were calculated. Analyses were carried out by vaccine vs. placebo, by first vs. second dose, and by mRNA-based vs. “traditional” vaccines; finally, we addressed the impact of age and gender on post-vaccine headache onset. Results Out of 9338 records, 84 papers were included in the review, accounting for 1.57 million participants, 94% of whom received BNT162b2 or ChAdOx1. Headache was generally the third most common AE: it was detected in 22% (95% CI 18–27%) of subjects after the first dose of vaccine and in 29% (95% CI 23–35%) after the second, with an extreme heterogeneity. Those receiving placebo reported headache in 10–12% of cases. No differences were detected across different vaccines or by mRNA-based vs. “traditional” ones. None of the studies reported information on headache features. A lower prevalence of headache after the first injection of BNT162b2 among older participants was shown. Conclusions Our results show that vaccines are associated to a two-fold risk of developing headache within 7 days from injection, and the lack of difference between vaccine types enable to hypothesize that headache is secondary to systemic immunological reaction than to a vaccine-type specific reaction. Some descriptions report onset within the first 24 h and that in around one-third of the cases, headache has migraine-like features with pulsating quality, phono and photophobia; in 40–60% of the cases aggravation with activity is observed. The majority of patients used some medication to treat headache, the one perceived as the most effective being acetylsalicylic acid. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01400-4.
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Wu Q, Dudley MZ, Chen X, Bai X, Dong K, Zhuang T, Salmon D, Yu H. Evaluation of the safety profile of COVID-19 vaccines: a rapid review. BMC Med 2021; 19:173. [PMID: 34315454 PMCID: PMC8315897 DOI: 10.1186/s12916-021-02059-5] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The rapid process of research and development and lack of follow-up time post-vaccination aroused great public concern about the safety profile of COVID-19 vaccine candidates. To provide comprehensive overview of the safety profile of COVID-19 vaccines by using meta-analysis technique. METHODS English-language articles and results posted on PubMed, Embase, Web of Science, PMC, official regulatory websites, and post-authorization safety surveillance data were searched through June 12, 2021. Publications disclosing safety data of COVID-19 candidate vaccines in humans were included. A meta-analysis of proportions was performed to estimate the pooled incidence and the pooled rate ratio (RR) of safety outcomes of COVID-19 vaccines using different platforms. RESULTS A total of 87 publications with safety data from clinical trials and post-authorization studies of 19 COVID-19 vaccines on 6 different platforms were included. The pooled rates of local and systemic reactions were significantly lower among inactivated vaccines (23.7%, 21.0%), protein subunit vaccines (33.0%, 22.3%), and DNA vaccines (39.5%, 29.3%), compared to RNA vaccines (89.4%, 83.3%), non-replicating vector vaccines (55.9%, 66.3%), and virus-like particle vaccines (100.0%, 78.9%). Solicited injection-site pain was the most common local reactions, and fatigue and headache were the most common systemic reactions. The frequency of vaccine-related serious adverse events was low (< 0.1%) and balanced between treatment groups. Vaccine platforms and age groups of vaccine recipients accounted for much of the heterogeneity in safety profiles between COVID-19 vaccines. Reporting rates of adverse events from post-authorization observational studies were similar to results from clinical trials. Crude reporting rates of adverse events from post-authorization safety monitoring (passive surveillance) were lower than in clinical trials and varied between countries. CONCLUSIONS Available evidence indicates that eligible COVID-19 vaccines have an acceptable short-term safety profile. Additional studies and long-term population-level surveillance are strongly encouraged to further define the safety profile of COVID-19 vaccines.
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Affiliation(s)
- Qianhui Wu
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Matthew Z Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Xinghui Chen
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Xufang Bai
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Kaige Dong
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Tingyu Zhuang
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Daniel Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Hongjie Yu
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
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