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Yin A, Wang N, Shea PJ, Rosser EN, Kuo H, Shapiro JR, Fenstermacher KZJ, Pekosz A, Rothman RE, Klein SL, Morgan R. Sex and gender differences in adverse events following influenza and COVID-19 vaccination. Biol Sex Differ 2024; 15:50. [PMID: 38890702 PMCID: PMC11184791 DOI: 10.1186/s13293-024-00625-z] [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] [Received: 05/07/2024] [Accepted: 06/06/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. In a predominately young adult female population of healthcare workers, we sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of vaccine outcomes, which remains poorly characterized. METHODS This cohort study enrolled Johns Hopkins Health System healthcare workers (HCWs) who were recruited from the mandatory annual fall 2019-2022 influenza vaccine and the fall 2022 COVID-19 bivalent vaccine campaigns. Vaccine recipients were enrolled the day of vaccination and AE surveys were administered two days post-vaccination for bivalent COVID-19 and influenza vaccine recipients. Data were collected regarding the presence of a series of solicited local and systemic AEs. Open-ended answers about participants' experiences with AEs also were collected for the COVID-19 vaccine recipients. RESULTS Females were more likely to report local AEs after either influenza (OR = 2.28, p = 0.001) or COVID-19 (OR = 2.57, p = 0.008) vaccination compared to males, regardless of age or race. Males and females had comparable probabilities of reporting systemic AEs after either influenza (OR = 1.18, p = 0.552) or COVID-19 (OR = 0.96, p = 0.907) vaccination. Hormonal birth control use did not impact the rates of reported AEs following influenza vaccination among reproductive-aged female HCWs. Women reported more interruptions in their daily routine following COVID-19 vaccination than men and were more likely to seek out self-treatment. More women than men scheduled their COVID-19 vaccination before their days off in anticipation of AEs. CONCLUSIONS Our findings highlight the need for sex- and gender-inclusive policies to inform more effective mandatory occupational health vaccination strategies. Further research is needed to evaluate the potential disruption of AEs on occupational responsibilities following mandated vaccination for healthcare workers, a predominately female population, and to more fully characterize the post-vaccination behavioral differences between men and women.
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Affiliation(s)
- Anna Yin
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nadia Wang
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patrick J Shea
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Erica N Rosser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Helen Kuo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janna R Shapiro
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sabra L Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Dele-Ojo BF, Adesokan A, Fadare JO, Ajayi PO, Raimi TH, Dada SA, Ojo OD, Ogunmodede JA, Ipinnimo TM, Ariyo OE, Godman B. Short-term COVID-19 vaccine adverse effects among adults in Ekiti State, Nigeria. Curr Med Res Opin 2024; 40:621-627. [PMID: 38323854 DOI: 10.1080/03007995.2024.2316217] [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: 08/04/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND The safety of the COVID-19 vaccines has been a topic of concern globally. This issue of safety is associated with vaccine hesitancy due to concerns about the adverse effects of the vaccines. Consequently, this study determined the short-term safety profile of the Oxford/AstraZeneca COVID-19 vaccine in Ekiti State, Nigeria. METHODS Descriptive cross-sectional study conducted between May and July 2021 among individuals who had received the first dose of the first batch of the Oxford/AstraZeneca COVID-19 vaccine at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria. A Google form was used to collect data on the adverse effects of the vaccine. RESULTS Out of over 1,000 individuals who were approached, 758 respondents completed the study. A large percentage (57.4%) of those who received the vaccines were healthcare workers. Adverse effects were reported in 70.8% of the participants with most manifesting on the first day of the vaccination. The predominant adverse effects were injection site soreness (28.5%), followed by fatigue (18.7%) and muscle pain (8.6%). There was no report of severe adverse effects such as anaphylactic reactions, thrombosis, myocarditis, transient myelitis, or Guillen-Barre syndrome. CONCLUSION This study found that self-reported adverse effects of the Oxford/AstraZeneca COVID-19 vaccine were mild and short in duration. This outcome has promising implications for improving COVID-19 vaccine uptake in the immediate environment and Nigeria.
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Affiliation(s)
- Bolade Folasade Dele-Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Adedapo Adesokan
- Emergency Medicine Department, Kingsmill Hospital, Sutton-in-Ashfield, Scotland
| | | | - Paul Oladapo Ajayi
- Department of Community Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Taiwo Hussean Raimi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Samuel Ayokunle Dada
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Owolabi Dele Ojo
- Department of Surgery, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | | | - Olumuyiwa Elijah Ariyo
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, United Kingdom
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Yin A, Wang N, Shea PJ, Rosser EN, Kuo H, Shapiro JR, Fenstermacher KZJ, Pekosz A, Rothman RE, Klein SL, Morgan R. Sex and gender differences in adverse events following receipt of influenza and COVID-19 vaccination among healthcare workers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.17.24301440. [PMID: 38318206 PMCID: PMC10843156 DOI: 10.1101/2024.01.17.24301440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Introduction Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. We sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of vaccine outcomes, which remains poorly characterized. Methods This cohort study enrolled Johns Hopkins Health System healthcare workers (HCWs) who were recruited from the annual fall 2019-2022 influenza vaccine and the fall 2022 COVID-19 bivalent vaccine campaigns. Vaccine recipients were enrolled the day of vaccination and AE surveys were administered two days post-vaccination (DPV) for bivalent COVID-19 and Influenza vaccine recipients. Data were collected regarding the presence of a series of solicited local and systemic AEs. Open-ended answers about participants' experiences with AEs also were collected for the COVID-19 vaccine recipients. Results Females were more likely to report local AEs after influenza (OR=2.28, p=0.001) or COVID-19 (OR=2.57, p=0.008) vaccination compared to males, regardless of age or race. Males and females had comparable probabilities of reporting systemic AEs after influenza (OR=1.18, p=0.552) or COVID-19 (OR=0.96, p=0.907) vaccination. Exogenous hormones from birth control use did not impact the rates of reported AEs following COVID-19 vaccination among reproductive-aged female HCWs. Women reported more interruptions in their daily routine following COVID-19 vaccination than men and were more likely to seek out self-treatment. More women than men scheduled their COVID-19 vaccination before their days off in anticipation of AEs. Conclusions Our findings highlight the need for sex- and gender-inclusive policies to inform more effective occupational health vaccination strategies. Further research is needed to evaluate the potential disruption of AEs on occupational responsibilities following mandated vaccination for healthcare workers and to more fully characterize the post-vaccination behavioral differences between men and women. KEY MESSAGE What is already known on this topic: ⇒ Among diversely aged adults 18-64 years, females report more AEs to vaccines, including the influenza and COVID-19 vaccines, than males.⇒ Vaccine AEs play a role in shaping vaccine hesitancy and uptake.⇒ Vaccine uptake related to influenza and COVID-19 are higher among men than women.⇒ Research that addresses both the sex and gender disparities of vaccine outcomes and behaviors is lacking.What this study adds: ⇒ This prospective active reporting study uses both quantitative and qualitative survey data to examine sex and gender differences in AEs following influenza or COVID-19 vaccination among a cohort of reproductive-aged healthcare workers.How this study might affect research, practice, or policy: ⇒ Sex and gender differences in AEs and perceptions relating to vaccination should drive the development of more equitable and effective vaccine strategies and policies in occupational health settings.
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Shin J, Shim SR, Lee J, Ryu HS, Kim JY. Otorhinolaryngologic complications after COVID-19 vaccination, vaccine adverse event reporting system (VAERS). Front Public Health 2024; 11:1338862. [PMID: 38269374 PMCID: PMC10807421 DOI: 10.3389/fpubh.2023.1338862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024] Open
Abstract
Background There have been reports of otolaryngological adverse event following immunization (AEFI) such as instances of olfactory and gustatory dysfunction following COVID-19 vaccination. This study aimed to analyze otolaryngological AEFIs following COVID-19 vaccination. Methods This study was conducted with a secondary data analysis that the Vaccine Adverse Events Reporting System (VAERS) and the COVID-19 Data Tracker, which are both administered by the Centers for Disease Control and Prevention in the US. Using Medical Dictionary for Regulatory Activities (MedDRA) concepts, AEFIs included: Considering the overall frequency and similarity of symptoms in the first 153 PTs, they were grouped into major 19 AEFIs groups. The incidence rates (IRs) of AEFIs per 100,000 were calculated on individual and cumulative AEFIs levels, involving people who received complete primary series and an updated bivalent booster dose with one of the available COVID-19 vaccines in the US. The proportions of AEFIs by age, sex, and vaccine manufacturer were reported. We also calculated the proportional reporting ratio (PRR) of AEFIs. Results We identified 106,653 otorhinolaryngologic AEFIs from the VAERS database, and a total of 226,593,618 people who received complete primary series in the US. Overall, the IR of total Otorhinolaryngologic AEFIs was 47.068 of CPS (completed primary series) and 7.237 UBB (updated bivalent booster) per 100,000. For most symptoms, being female was associated with statistically significant higher AEFIs. Upon examining the impact of different vaccine manufacturers, the researchers found that Janssen's vaccine exhibited higher IRs for hearing loss (5.871), tinnitus (19.182), ear infection (0.709), dizziness (121.202), sinusitis (2.088), epistaxis (4.251), anosmia (5.264), snoring (0.734), allergies (5.555), and pharyngitis (5.428). The highest PRRs were for Anosmia (3.617), Laryngopharyngeal Reflux - Acid Reflux (2.632), and Tinnitus -Ringing in the ears (2.343), in that order, with these three significantly incidence than other background noises. Conclusion This study, utilizing an extensive sample sizes, represents a significant step toward comprehensively characterizing the otolaryngological AEFIs associated with COVID-19 vaccinations. This large-scale analysis aims to move beyond isolated case reports and anecdotal evidence, providing a robust and detailed portrait of the otolaryngological AEFIs landscape in response to COVID-19 vaccinations.
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Affiliation(s)
- Jieun Shin
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
- Konyang Medical data Research group-KYMERA, Konyang University Hospital, Daejeon, Republic of Korea
| | - Sung Ryul Shim
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
- Konyang Medical data Research group-KYMERA, Konyang University Hospital, Daejeon, Republic of Korea
| | - Jaekwang Lee
- Department of Emergency Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Hyon Shik Ryu
- Department of Emergency Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Jong-Yeup Kim
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
- Konyang Medical data Research group-KYMERA, Konyang University Hospital, Daejeon, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
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Fneish F, Frahm N, Peters M, Ellenberger D, Haas J, Löbermann M, Pöhlau D, Röper AL, Schilling S, Stahmann A, Temmes H, Paul F, Zettl UK. Occurrence and Risk Factors of Relapse Activity after Vaccination against COVID-19 in People with Multiple Sclerosis: 1-Year Follow-Up Results from a Nationwide Longitudinal Observational Study. Vaccines (Basel) 2023; 11:1859. [PMID: 38140262 PMCID: PMC10747540 DOI: 10.3390/vaccines11121859] [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: 11/08/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Several studies reported post-SARS-CoV-2-vaccination (PV) symptoms. Even people with multiple sclerosis (PwMS) have concerns about disease activity following the SARS-CoV-2 vaccination. We aimed to determine the proportion of PwMS with PV relapses, the PV annualized relapse rate (ARR), the time from vaccination to subsequent relapses, and identify sociodemographic/clinical risk factors for PV relapses. PwMS were surveyed several times at baseline and four follow-ups as part of a longitudinal observational study regarding the safety and tolerability of the SARS-CoV-2 vaccination. The inclusion criteria for this analysis were age ≥18 years, ≥1 SARS-CoV-2 vaccination, and ≥1-year observation period since initial vaccination. Of 2466 PwMS, 13.8% reported PV relapses (mostly after second [N = 147] or booster vaccination [N = 145]) at a median of 8.0 (first/third quantile: 3.55/18.1) weeks PV, with the shortest period following initial vaccination (3.95 weeks). The ARR was 0.153 (95% confidence interval: 0.138-0.168), with a median observation period since initial vaccination of 1.2 years. Risk factors for PV relapses were younger age, female gender, moderate-severe disability levels, concurrent autoimmune diseases, relapsing-remitting MS courses, no DMT, and relapses within the year prior to the first vaccination. Patients' health conditions before/during initial vaccination may play a more important role in PV relapse occurrence than vaccination per se.
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Affiliation(s)
- Firas Fneish
- MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]), German MS Registry, 30171 Hannover, Germany; (F.F.); (M.P.); (D.E.); (A.-L.R.); (S.S.); (A.S.)
| | - Niklas Frahm
- MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]), German MS Registry, 30171 Hannover, Germany; (F.F.); (M.P.); (D.E.); (A.-L.R.); (S.S.); (A.S.)
- Neuroimmunological Section, Department of Neurology, University Medical Center of Rostock, 18147 Rostock, Germany;
| | - Melanie Peters
- MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]), German MS Registry, 30171 Hannover, Germany; (F.F.); (M.P.); (D.E.); (A.-L.R.); (S.S.); (A.S.)
- Gesellschaft für Versorgungsforschung mbH (Society for Health Care Research [GfV]), German MS Registry, 30171 Hannover, Germany
| | - David Ellenberger
- MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]), German MS Registry, 30171 Hannover, Germany; (F.F.); (M.P.); (D.E.); (A.-L.R.); (S.S.); (A.S.)
| | - Judith Haas
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), 30171 Hannover, Germany; (J.H.); (D.P.); (H.T.)
| | - Micha Löbermann
- Department of Tropical Medicine, Infectious Diseases and Nephrology, University Medical Center of Rostock, 18057 Rostock, Germany;
| | - Dieter Pöhlau
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), 30171 Hannover, Germany; (J.H.); (D.P.); (H.T.)
| | - Anna-Lena Röper
- MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]), German MS Registry, 30171 Hannover, Germany; (F.F.); (M.P.); (D.E.); (A.-L.R.); (S.S.); (A.S.)
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), 30171 Hannover, Germany; (J.H.); (D.P.); (H.T.)
| | - Sarah Schilling
- MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]), German MS Registry, 30171 Hannover, Germany; (F.F.); (M.P.); (D.E.); (A.-L.R.); (S.S.); (A.S.)
| | - Alexander Stahmann
- MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]), German MS Registry, 30171 Hannover, Germany; (F.F.); (M.P.); (D.E.); (A.-L.R.); (S.S.); (A.S.)
| | - Herbert Temmes
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), 30171 Hannover, Germany; (J.H.); (D.P.); (H.T.)
| | - Friedemann Paul
- Experimental and Clinical Research Center, Joint Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, The Charité Medical Faculty, Campus Berlin-Buch, 13125 Berlin, Germany;
- Department of Neurology, Charité—Universitätsmedizin, 10117 Berlin, Germany
- NeuroCure Clinical Research Center, Charité—Universitätsmedizin, 10117 Berlin, Germany
| | - Uwe K. Zettl
- Neuroimmunological Section, Department of Neurology, University Medical Center of Rostock, 18147 Rostock, Germany;
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Asefa A, Derjachew N, Belete AM, Talargia F, Melese DM, Getachew B. Adverse reactions following COVID-19 vaccine among healthcare professionals working in Ethiopia: a facility-based cross-sectional study. Front Public Health 2023; 11:1187948. [PMID: 38026432 PMCID: PMC10654621 DOI: 10.3389/fpubh.2023.1187948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background of the study One of the best medical approaches for halting the spread of infectious diseases is vaccination. During the COVID-19 pandemic, healthcare workers (HCWs) were a high-risk population. Due to their susceptibility in terms of their working environment, front-line healthcare personnel should receive vaccinations before others. Objective The purpose of this study was to assess the adverse reactions to COVID-19 vaccines among Ethiopian healthcare professionals in 2022. Methods A facility-based cross-sectional study design was conducted in Addis Ababa Health Facilities, Ethiopia. A total of 290 health professionals who were vaccinated during the study period were involved. Data entry was done by Epidata (version 3.1) and analyzed using SPSS software version 26. Bivariable analysis was conducted and a p value of less than 0.25 was selected for further multivariable analysis. A p value of 0.05 was considered statistically significant at a 95% confidence level. Results A total of 277 study participants were successfully involved in the study, yielding a response rate of 95.5%. The study participants comprised 123 (44.4%) women and 154 (55.6%) men. The majority of them (202, 72.9%) had received the Oxford AstraZeneca vaccine. Among the 277 study participants, 142 (51.3%) had developed adverse reactions associated with vaccination. Of these, 81 (29.2%) had moderate adverse reactions. Only 2 (0.7%) had developed adverse reactions that led to hospitalization. The most reported short-term adverse reactions were injection site pain (151, 54.5%), headache (114, 41.2%), fever (104, 37.5%), fatigability and tiredness (94, 33.9%), chills (92, 33.2%), muscle pain (79, 28.5%), and decreased sleep quality (34, 12.3%). The multivariable logistic regression showed that the odds of having an adverse reaction were 1.501 times higher among women than men (AOR = 1.501, 95% CI [1.08, 2.754]). Conclusion and recommendations This study revealed that adverse effects following the COVID-19 vaccine were moderate in magnitude and minimal in severity. This study showed that adverse reactions that led to hospitalization were rare. Based on the findings of this study, it is recommended that national, multicenter, prospective, and randomized studies be conducted to assess the independent association of each vaccine.
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Affiliation(s)
- Adisu Asefa
- Department of Biomedical Science, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nitsuh Derjachew
- Department of Public Health, College of Health Science, Gamby Medical and Business College, Bahir Dar, Ethiopia
| | - Abebe Muche Belete
- Department of Biomedical Science, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Feredegn Talargia
- Department of Biomedical Science, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Daniel Molla Melese
- Department of Biomedical Science, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bekalu Getachew
- Department of Biomedical Science, College of Medicine, Jimma University, Jimma, Ethiopia
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Kaswandani N, Medise BE, Leonard E, Satari HI, Sundoro J, Hadinegoro SRH, Putra A, Angkasa PF. Safety profile of inactivated COVID-19 in healthy adults aged ≥ 18 years: A passive surveillance in Indonesia. PLoS One 2023; 18:e0286484. [PMID: 37824453 PMCID: PMC10569643 DOI: 10.1371/journal.pone.0286484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/17/2023] [Indexed: 10/14/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19) vaccination in Indonesia has shown effectiveness in reducing the morbidity and mortality of Covid-19. The study aims to evaluate the incidence rate and severity of Adverse Events Following Immunization (AEFI) of inactivated SARS-CoV-2 vaccine during the first quarter of 2021 until the second quarter of 2022 in Indonesia. More than two hundred million Sinovac/CoronaVac were given from January 13th, 2021, until June 30th, 2022. Data for this study were collected manually and electronically from the national vaccine safety website managed by the National Committee (NC) of AEFI Indonesia and the Ministry of Health Indonesia. The total number of injections observed in the study was 264,311,992 doses consisting of 142,449,795 (first dose), 121,613,324 (second dose), and 248,873 (booster dose). Of the injections given, 301 subjects with Serious AEFIs (SAE) and 10.261 subjects with non-serious AEFIs (AE) reported, with a majority of SAE and AEs found in the first dose. Most of the SAEs were classified as coincidental events by the NC AEFI (IR 0.8/1 million doses on first dose injection; 0.31 on second dose injection). ISRR (immunization stress-related response) is in the second rank of SAEs reported (0.59 IR/1 million doses on the first dose; 0.14 on the second dose). The incidence rate of SAEs and AEs, both in the variable of age, sex, and symptoms per 1 million dose injections in Indonesia, was very rare according to WHO guidelines. Most SAEs were classified as coincidences or unrelated to the vaccine. The result showed that the Sinovac/CoronaVac in Indonesia is safe.
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Affiliation(s)
- Nastiti Kaswandani
- Faculty of Medicine, Department of Child Health, University of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Bernie Endyarni Medise
- Faculty of Medicine, Department of Child Health, University of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Elcha Leonard
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Hindra Irawan Satari
- Faculty of Medicine, Department of Child Health, University of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Julitasari Sundoro
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Sri Rezeki Harun Hadinegoro
- Faculty of Medicine, Department of Child Health, University of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Ade Putra
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Putra Fajar Angkasa
- National Adverse Events Following Immunization (NC AEFI) of Indonesia, Central Jakarta, DKI Jakarta, Indonesia
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Pari B, Babbili A, Kattubadi A, Thakre A, Thotamgari S, Gopinathannair R, Olshansky B, Dominic P. COVID-19 Vaccination and Cardiac Arrhythmias: A Review. Curr Cardiol Rep 2023; 25:925-940. [PMID: 37530946 DOI: 10.1007/s11886-023-01921-7] [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] [Accepted: 07/03/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE OF REVIEW In this review, we aim to delve into the existing literature, seeking to uncover the mechanisms, investigate the electrocardiographic changes, and examine the treatment methods of various cardiac arrhythmias that occur after administration of the COVID-19 vaccine. RECENT FINDINGS A global survey has exposed an incidence of arrhythmia in 18.27% of hospitalized COVID-19 patients. Furthermore, any type of COVID-19 vaccine - be it mRNA, adenovirus vector, whole inactivated, or protein subunit - appears to instigate cardiac arrhythmias. Among the cardiac adverse events reported post-COVID-19 vaccination, myocarditis emerges as the most common and is thought to be a potential cause of bradyarrhythmia. When a patient post-COVID-19 vaccination presents a suspicion of cardiac involvement, clinicians should perform a comprehensive history and physical examination, measure electrolyte levels, conduct ECG, and carry out necessary imaging studies. In our extensive literature search, we uncovered various potential mechanisms that might lead to cardiac conduction abnormalities and autonomic dysfunction in patients who have received the COVID-19 vaccine. These mechanisms encompass direct viral invasion through molecular mimicry/spike (S) protein production, an escalated inflammatory response, hypoxia, myocardial cell death, and the eventual scar/fibrosis. They correspond to a range of conditions including atrial tachyarrhythmias, bradyarrhythmia, ventricular arrhythmias, sudden cardiac death, and the frequently occurring myocarditis. For treating these COVID-19 vaccination-induced arrhythmias, we should incorporate general treatment strategies, similar to those applied to arrhythmias from other causes.
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Affiliation(s)
- Bavithra Pari
- Department of Medicine, LSUHSC-S, Shreveport, LA, USA
| | | | | | - Anuj Thakre
- Department of Medicine, LSUHSC-S, Shreveport, LA, USA
| | | | - Rakesh Gopinathannair
- The Kansas City Heart Rhythm Institute (KCHRI) & Research Foundation, Overland Park Regional Medical Center, KS, Kansas City, USA
| | - Brian Olshansky
- Division of Cardiology, Department of Medicine, The University of Iowa, Carver College of Medicine, Iowa City, IA, USA
| | - Paari Dominic
- Division of Cardiology, Department of Medicine, The University of Iowa, Carver College of Medicine, Iowa City, IA, USA.
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9
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Premec H, Živko M, Mijić M, Jelić-Puškarić B, Lalovac M, Filipec Kanižaj T, Sobočan N. Acute Liver Failure Caused by Secondary Hemophagocytic Lymphohistiocytosis After COVID-19 Vaccination - Case Report and Literature Review. Int Med Case Rep J 2023; 16:449-455. [PMID: 37577009 PMCID: PMC10416787 DOI: 10.2147/imcrj.s417347] [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: 05/26/2023] [Accepted: 07/22/2023] [Indexed: 08/15/2023] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a congenital or acquired hyperinflammatory syndrome, in some cases accompanied by acute liver failure. We present a case report of acute liver failure associated with HLH after COVID-19 vaccination and bring a literature review of the connection between HLH and COVID-19 vaccination. HLH has significant mortality rate, and liver transplantation is not a therapeutic option. Therefore, early recognition and timely conservative treatment are corner stones in reducing HLH-related morbidity and mortality.
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Affiliation(s)
- Hrvoje Premec
- Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia
| | - Matea Živko
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Maja Mijić
- Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia
| | - Biljana Jelić-Puškarić
- Department of Pathology and Cytology, University Hospital Merkur, Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia
| | - Miloš Lalovac
- Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia
- University of Dubrovnik, Dubrovnik, Croatia
| | - Tajana Filipec Kanižaj
- Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nikola Sobočan
- Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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10
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Caruana Dingli M, Bugeja L, Camilleri R. Prolonged febrile illness following first dose of ChAdOx1. BMJ Case Rep 2023; 16:e253671. [PMID: 37536942 PMCID: PMC10401244 DOI: 10.1136/bcr-2022-253671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
A woman in her 40s, with a known history of fibromyalgia, presented with high-grade fever and constitutional symptoms occurring 5 days following vaccination with Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1). Her inflammatory markers and neutrophil count were found to be elevated and as such, she was started on antibiotics. Despite treatment, markers remained elevated and temperature spikes persisted for another 4 weeks before these symptoms subsided, and her blood tests normalised. All investigations taken in the interim were negative, with no source being identified for the fever. As a result, a positron emission tomography scan was performed to attempt to localise the source of these symptoms. This revealed low-to-moderate grade lymph node tracer uptake above and below the diaphragm most pervasive in the right axilla, with uptake in the right arm corresponding with the site of vaccination.
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Affiliation(s)
| | - Luke Bugeja
- Department of Gastroenterology, Mater Dei Hospital, Msida, Malta
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11
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Chayachinda C, Watananirun K, Phatihattakorn C, Anuwutnavin S, Niyomnaitham S, Phongsamart W, Lapphra K, Wittawatmongkol O, Rungmaitree S, Jansarikit L, Boonnak K, Wongprompitak P, Senawong S, Upadhya A, Toh ZQ, Licciardi PV, Chokephaibulkit K. Immunogenicity and reactogenicity of heterologous COVID-19 vaccination in pregnant women. Hum Vaccin Immunother 2023; 19:2228670. [PMID: 37439770 PMCID: PMC10406153 DOI: 10.1080/21645515.2023.2228670] [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: 04/29/2023] [Revised: 06/06/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023] Open
Abstract
This open-labeled non-inferiority trial evaluated immunogenicity and reactogenicity of heterologous and homologous COVID-19 vaccination schedules in pregnant Thai women. 18-45-year-old pregnant women with no history of COVID-19 infection or vaccination and a gestational age of ≥12 weeks were randomized 1:1:1 into three two-dose primary series scheduled 4 weeks apart: BNT162b2-BNT162b2 (Group 1), ChAdOx1-BNT162b2 (Group 2), and CoronaVac-BNT162b2 (Group 3). Serum antibody responses, maternal and cord blood antibody levels at delivery, and adverse events (AEs) following vaccination until delivery were assessed. The 124 enrolled participants had a median age of 31 (interquartile range [IQR] 26.0-35.5) years and gestational age of 23.5 (IQR 18.0-30.0) weeks. No significant difference in anti-receptor binding domain (RBD) IgG were observed across arms at 2 weeks after the second dose. Neutralizing antibody geometric mean titers against the ancestral Wuhan strain were highest in Group 3 (258.22, 95% CI [187.53, 355.56]), followed by Groups 1 (187.47, 95% CI [135.15, 260.03]) and 2 (166.63, 95% CI [124.60, 222.84]). Cord blood anti-RBD IgG was correlated with, and equal to or higher than, maternal levels at delivery (r = 0.719, P < .001) and inversely correlated with elapsed time after the second vaccination (r = -0.366, P < .001). No significant difference in cord blood antibody levels between groups were observed. Local and systemic AEs were mild-to-moderate and more frequent in Group 2. Heterologous schedules of CoronaVac-BNT162b2 or ChAdOx1-BNT162b2 induced immunogenicity on-par with BNT162b2-BNT162b2 and may be considered as alternative schedules for primary series in pregnant women in mRNA-limited vaccine settings.
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Affiliation(s)
- Chenchit Chayachinda
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanokwaroon Watananirun
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayawat Phatihattakorn
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sanitra Anuwutnavin
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suvimol Niyomnaitham
- Siriraj Institute of Clinical Research (SICRES), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanatpreeya Phongsamart
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Keswadee Lapphra
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Orasri Wittawatmongkol
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supattra Rungmaitree
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Laddawan Jansarikit
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kobporn Boonnak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patimaporn Wongprompitak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sansnee Senawong
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Avishek Upadhya
- Department of Sciences, Mahidol University International College, Salaya, Nakhon Pathom, Thailand
| | - Zheng Quan Toh
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Paul V. Licciardi
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Kulkanya Chokephaibulkit
- Siriraj Institute of Clinical Research (SICRES), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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12
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Moll MEC, Martínez AMS, Cisneros BT, Onofre JIG, Floriano GN, de León MB. Side Effects of COVID-19 Vaccines in Pregnant and Lactating Mexican Women and Breastfed Infants: A Survey-Based Study. Vaccines (Basel) 2023; 11:1280. [PMID: 37631848 PMCID: PMC10459654 DOI: 10.3390/vaccines11081280] [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: 05/16/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 08/27/2023] Open
Abstract
COVID-19 vaccines' safety has been extensively studied; however, further analysis is required in pregnant women, nursing mothers, and breastfed infants. Our aim was to compare the extension and severity of self-reported COVID-19 vaccine side effects in pregnant and breastfeeding women, and breastfed infants. In this cross-sectional study, COVID-19-vaccinated subjects were enrolled using an online survey in Mexico. Women were classified by pregnancy and breastfeeding status at the time of vaccination (n = 3167). After the first or only dose, there was a trend toward fewer systemic effects in pregnant women (p = 0.06). BNT162b2 (Pfizer-BioNTech) had a higher frequency of local symptoms in pregnancy. Lactating women experienced fewer local symptoms after the first or single dose (p = 0.04) and the opposite occurred after the second dose (p = 0.001). ChAdOx1 (AstraZeneca) increased the chances of developing both local and systemic symptoms after the first dose but decreased them after the second dose. The severity was similar across groups, although the result of lack of association in pregnancy requires studies with a larger sample size. Irritability was the most reported symptom in breastfed infants. This study contributes to the knowledge about the side effects in pregnant and lactating women, and breastfed babies.
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Affiliation(s)
- María Elena Camacho Moll
- Department of Molecular Biology, Northeast Biomedical Research Center, Mexican Institute of Social Security, Monterrey 64720, N.L., Mexico;
- Center for Molecular Diagnosis and Personalized Medicine, Health Sciences Division, Universidad de Monterrey, San Pedro Garza García 66238, N.L., Mexico
| | - Ana María Salinas Martínez
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Monterrey 64360, N.L., Mexico
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey 64460, N.L., Mexico
| | - Benjamín Tovar Cisneros
- School of Biological Sciences, Autonomous University of Nuevo Leon, Monterrey 66455, N.L., Mexico;
| | - Juan Ignacio García Onofre
- Family Medicine Unit No. 64, Mexican Institute of Social Security, Santa Catarina 66358, N.L., Mexico; (J.I.G.O.); (G.N.F.)
| | - Gloria Navarrete Floriano
- Family Medicine Unit No. 64, Mexican Institute of Social Security, Santa Catarina 66358, N.L., Mexico; (J.I.G.O.); (G.N.F.)
| | - Mario Bermúdez de León
- Department of Molecular Biology, Northeast Biomedical Research Center, Mexican Institute of Social Security, Monterrey 64720, N.L., Mexico;
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13
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Kocatürk E, Muñoz M, Elieh-Ali-Komi D, Criado PR, Peter J, Kolkhir P, Can P, Wedi B, Rudenko M, Gotua M, Ensina LF, Grattan C, Maurer M. How Infection and Vaccination Are Linked to Acute and Chronic Urticaria: A Special Focus on COVID-19. Viruses 2023; 15:1585. [PMID: 37515272 PMCID: PMC10386070 DOI: 10.3390/v15071585] [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: 06/16/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Since more than a century ago, there has been awareness of the connection between viral infections and the onset and exacerbation of urticaria. Our knowledge about the role of viral infection and vaccination in acute and chronic urticaria improved as a result of the COVID-19 pandemic but it has also highlighted knowledge gaps. Viral infections, especially respiratory tract infections like COVID-19, can trigger the onset of acute urticaria (AU) and the exacerbation of chronic urticaria (CU). Less frequently, vaccination against viruses including SARS-CoV-2 can also lead to new onset urticaria as well as worsening of CU in minority. Here, with a particular focus on COVID-19, we review what is known about the role of viral infections and vaccinations as triggers and causes of acute and chronic urticaria. We also discuss possible mechanistic pathways and outline the unmet needs in our knowledge. Although the underlying mechanisms are not clearly understood, it is believed that viral signals, medications, and stress can activate skin mast cells (MCs). Further studies are needed to fully understand the relevance of viral infections and vaccinations in acute and chronic urticaria and to better clarify causal pathways.
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Affiliation(s)
- Emek Kocatürk
- Institute of Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 12203 Berlin, Germany (D.E.-A.-K.)
- Department of Dermatology, Koç University School of Medicine, Istanbul 34010, Turkey
| | - Melba Muñoz
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 12203 Berlin, Germany (D.E.-A.-K.)
- Department of Dermatology, Koç University School of Medicine, Istanbul 34010, Turkey
| | - Daniel Elieh-Ali-Komi
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 12203 Berlin, Germany (D.E.-A.-K.)
- Department of Dermatology, Koç University School of Medicine, Istanbul 34010, Turkey
| | - Paulo Ricardo Criado
- Department of Dermatology, School of Medicine, Centro Universitário Faculdade de Medicina do ABC (CUFMABC), Santo André 09060-870, Brazil
| | - Jonny Peter
- Lung Institute, Division of Allergy and Clinical Immunology, Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa
| | - Pavel Kolkhir
- Institute of Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 12203 Berlin, Germany (D.E.-A.-K.)
| | - Pelin Can
- Department of Dermatology, Bahçeşehir University, Istanbul 34070, Turkey;
| | - Bettina Wedi
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, 30625 Hannover, Germany
| | | | - Maia Gotua
- Center of Allergy and Immunology, David Tvildiani Medical University, Tbilisi 0159, Georgia
| | - Luis Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo 01308-000, Brazil
| | - Clive Grattan
- Guy’s Hospital, St John’s Institute of Dermatology, London SE1 7EP, UK
| | - Marcus Maurer
- Institute of Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 12203 Berlin, Germany (D.E.-A.-K.)
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14
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Teófilo VSG, Pinho PRA, Cordeiro GJ, Saldanha NAF, Matos PMM, Ribeiro RAM, Moreira SM, Miller MSF, Dias ARM, Couto MFR, Norton PMPNS. Spontaneous reporting of adverse reactions associated with the COVID-19 vaccine in health care professionals: A descriptive observational study conducted in a Portuguese hospital. Porto Biomed J 2023; 8:e219. [PMID: 37383526 PMCID: PMC10299789 DOI: 10.1097/j.pbj.0000000000000219] [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: 04/14/2023] [Accepted: 05/26/2023] [Indexed: 06/30/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) was classified as a pandemic in March 2020 by the World Health Organization. The Pfizer-BioNTech COVID-19 vaccine was the first to be authorized in the European Union, based on data from phase 1, 2, and 3 clinical trials of limited duration. Concerns have been raised regarding the vaccine's safety profile. Some of the adverse drug reactions (ADRs) associated with vaccines may not have been identified during clinical trials. This study aimed to identify ADRs associated with the Pfizer-BioNTech vaccine in health care professionals at a Portuguese tertiary university hospital. Methods The data used in this analysis consist of ADRs reported through a spontaneous notification system from vaccines administered between December 27, 2020, and January 31, 2021. ADRs were categorized according to the MedDRA terminology. Results A total of 8,605 Pfizer-BioNTech vaccines were administered to 4568 health care professionals. ADRs were reported among 520 of the vaccines, with an incidence of 13.56% in women and 5.31% in men. The mean age of the population reporting ADRs was 41.52 years, with a standard deviation of 9.83 years. The most frequent ADRs were myalgia (n = 274), headache (n = 199), pyrexia (n = 164), injection site pain (n = 160), fatigue (n = 84), nausea (n = 81), chills (n = 65), lymphadenopathy (n = 64), and arthralgia (n = 53). Hypersensitivity reactions occurred in 15 health care professionals, with no anaphylactic reactions observed. A total of four Important Medical Events were observed, which consisted of two cases of syncope, one case of sudden hearing loss, and one case of transverse myelitis. Conclusion The vaccine was well-tolerated among the study participants. Reactogenicity was greater after the second dose. The incidence of ADRs was higher in women and individuals aged between 40 to 49 years. Systemic adverse reactions were most frequently reported. Systematic monitoring of ADRs of COVID-19 vaccines in real-life context is essential for a more robust establishment of its safety profile.
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Affiliation(s)
- Vanessa S G Teófilo
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Paulo R A Pinho
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Gonçalo J Cordeiro
- Clinical Pharmacology Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Nuno A F Saldanha
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Pedro M M Matos
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Rui A M Ribeiro
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Salomé M Moreira
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Mariana S F Miller
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Andreia R M Dias
- Clinical Pharmacology Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Marta F R Couto
- Clinical Pharmacology Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Pedro M P N S Norton
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
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15
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Kim AS, Kim SM, Song JE, Hwang S, Nam E, Kwon KT. Adverse Reactions after BNT162b2 Messenger RNA Vaccination for Coronavirus Disease 2019 in Healthcare Workers Compared with Influenza Vaccination. Vaccines (Basel) 2023; 11:vaccines11020363. [PMID: 36851243 PMCID: PMC9958848 DOI: 10.3390/vaccines11020363] [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: 01/12/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
This study aimed to compare adverse reactions following BNT162b2 and influenza vaccinations in healthcare workers. This study included healthcare workers who received the BNT162b2 vaccine and/or inactivated influenza vaccine, quadrivalent (IIV4), on 18-29 October 2021 at a tertiary hospital in Korea. IIV4 was administered and BNT162b2 was subsequently administered one week later. The participants responded to a mobile questionnaire regarding adverse events. The overall adverse reaction rates were 90.6% in the BNT162b2 + IIV4 group, 90.4% in the BNT162b2 alone group, and 44.1% in the IIV4 alone group (p < 0.001). Fever occurred in 19.5%, 26.9%, and 3.3% of participants in the BNT162b2 + IIV4, BNT162b2 alone, and IIV4 alone groups, respectively (p < 0.001). The most common local and systemic adverse reactions were injection site pain (65.0%) and fatigue (58.6%), respectively. Injection-site pain was experienced by 88.7%, 88.5%, and 37.5% of the BNT162b2 + IIV4, BNT162b2 alone, and IIV4 alone groups, respectively (p < 0.001). Fatigue was experienced by 74.8%, 78.8%, and 38.6% of the BNT162b2 + IIV4, BNT162b2 alone, and IIV4 alone groups, respectively (p < 0.001). Adverse reactions occurred at a significantly higher frequency after BNT162b2 than after IIV4. The frequency of adverse reactions one week after vaccination with IIV4 and BNT162b2 was not different from that after vaccination with BNT162b2 alone. Therefore, coadministration of influenza vaccine with BNT162b2 can be expected to be safe.
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Affiliation(s)
- A-Sol Kim
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Republic of Korea
| | - Sung-Min Kim
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Republic of Korea
| | - Ji-Eun Song
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Republic of Korea
| | - Soyoon Hwang
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Republic of Korea
| | - Eunkyung Nam
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Republic of Korea
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Republic of Korea
- Correspondence:
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16
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Yasmin F, Najeeb H, Siddiqui HF, Asghar MS, Awan HA, Usama RM, Allahuddin Z, Tahir MJ, Ullah K, Mahmmoud Fadelallah Eljack M. Frequency of COVID-19 vaccine side effects and its associated factors among the vaccinated population of Pakistan: A cross-sectional study. Health Sci Rep 2023; 6:e1071. [PMID: 36698706 PMCID: PMC9847396 DOI: 10.1002/hsr2.1071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 01/19/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) vaccine side effects have an important role in the hesitancy of the general population toward vaccine administration. Therefore, this study was conducted to document the COVID-19 vaccine side effects in our population. Materials and Methods An online survey-based, cross-sectional study was carried out from September 1, 2021, to October 1, 2021, to document the side effects of the COVID-19 vaccine among the general public. The questionnaire included participants' sociodemographic data, type of vaccine, comorbidities, previous COVID-19 infection, and assessment of side effects reported by them. Results The majority of the participants were <20 years of age (62.2%), females (74.9%), belonged to the educational sector (58.1%), residents of Sindh (65.7%), and were previously unaffected by COVID-19 infection (73.3%). Sinovac (38.7%) followed by Sinopharm (30.4%) and Moderna (18.4%) were administered more frequently. Commonly reported side effects were injection site pain (82%), myalgia (55%), headache (46%), fatigue/malaise (45%), and fever (41%). Vaccine side effects were more likely to be reported with the first dose as compared to the second dose. On regression analysis, factors associated with occurrence of side effects included younger age (odds ratio [OR]: 6.000 [2.065-17.431], p < 0.001), female gender (OR: 2.373 [1.146-4.914], p = 0.020), marital status (OR: 0.217 [0.085-0.556], p < 0.001), graduate level of education (OR: 0.353 [0.153-0.816], p = 0.015), and occupation being either retired, freelancers, or social workers (OR: 0.310 [0.106-0.909]), p = 0.033). Previous infection with COVID-19 (p = 0.458) and comorbidities were found unrelated (p = 0.707) to the occurrence of side effects. Conclusion The overall prevalence of local side effects was quite higher than the systemic ones. Further large-scale studies on vaccine safety are required to strengthen public confidence in the vaccination drive.
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Affiliation(s)
- Farah Yasmin
- Department of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Hala Najeeb
- Department of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Hasan Fareed Siddiqui
- Department of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Muhammad Sohaib Asghar
- Department of Medicine, Dow University Hospital‐Ojha CampusDow University of Health SciencesKarachiPakistan
| | - Hashir Ali Awan
- Department of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | | | - Zoha Allahuddin
- Department of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Muhammad Junaid Tahir
- Department of RadiologyPakistan Kidney and Liver Institute and Research Center (PKLI & RC)LahorePakistan
| | - Kaleem Ullah
- Department of Surgery, Liver Transplant and Hepatobiliary UnitPir Abdul Qadir Shah Jelani Institute of Medical SciencesGambatPakistan
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17
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Nakajima K, Miyata A, Kato S, Oshima Y, Tanaka S. Calcific tendinitis of the shoulder induced by an mRNA vaccine for COVID-19: A case report. Mod Rheumatol Case Rep 2023; 7:211-214. [PMID: 35134200 PMCID: PMC8903335 DOI: 10.1093/mrcr/rxac006] [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: 11/05/2021] [Revised: 01/05/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Coronavirus disease 2019 (COVID-19) vaccines have been widely used and have been shown to be effective in combating the pandemic. However, various side effects have been reported following vaccination. For instance, a condition called 'shoulder injury related to vaccine administration' (SIRVA) is characterized by shoulder pain and limited range of motion after intramuscular injection of a vaccine into the deltoid muscle of the shoulder. Despite an increase in SIRVA cases, the exact incidence of the disease is unclear, and there are a few reports of SIRVA about the COVID-19 vaccine. Here, we report a rare case of an 83-year-old woman who was diagnosed with calcification in her left shoulder 1 year ago and developed calcific tendinitis after receiving an mRNA vaccine for COVID-19 (Pfizer-BioNTech). Radiographs showed calcification of the supraspinatus tendon, and magnetic resonance images showed continuous inflammatory findings from the subdeltoid bursa to the subacromial bursa. We treated the patient with celecoxib and acetaminophen, and she recovered after about 2 months. In order to prevent SIRVA, the presence of shoulder joint disease should be carefully asked during a pre-vaccination assessment. The puncture point should be chosen with the median point of the deltoid muscle or the anterior-posterior axillary line as landmarks because the more cephalad the puncture position, the greater the chance of causing SIRVA.
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Affiliation(s)
- Koji Nakajima
- Corresponding author: Koji Nakajima, Department of Orthopaedic Surgery, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan, 113-8655. Tel: 81-3-3815-5411, E-mail:
| | - Akira Miyata
- Department of Orthopaedic Surgery, Tokatsu Hospital, Chiba, Japan
| | - So Kato
- Department of Orthopaedic Surgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yasushi Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan
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18
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Alkhalifah JM, Al Seraihi A, Al-Tawfiq JA, Alshehri BF, Alhaluli AH, Alsulais NM, Alessa MM, Seddiq W, Aljeri T, Qahtani MH, Barry M, Al-Otaiby M. Pattern of self-reported adverse events related to COVID-19 vaccines in Saudi Arabia: A nationwide study. Front Public Health 2023; 11:1043696. [PMID: 36908451 PMCID: PMC9995884 DOI: 10.3389/fpubh.2023.1043696] [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: 09/13/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Background Vaccination against coronavirus disease 2019 (COVID-19) is the most effective way to end the pandemic. Any development of adverse events (AEs) from various vaccines should be reported. We therefore aimed to explore major and minor AEs among vaccinated individuals in Saudi Arabia. Methods This is a nationwide report based on the Saudi Arabian Ministry of Health (MOH) registry. It included those who received COVID-19 vaccines from 17th December 2020 to 31st December 2021. The study included spontaneous self-reported adverse effects to COVID-19 vaccines where the study participants used a governmental mobile app (Sehhaty) to report their AEs following vaccination using a checklist option that included a selection of side-effects. The primary outcome was to determine AEs reported within 14 days of vaccination which included injection site itching, pain, reaction, redness, swelling, anxiety, dizziness, fever, headache, hoarseness, itchiness, loss of consciousness, nausea, heartburn, sleep disruption, fatigue, seizures, anaphylaxis, shortness of breath, wheezing, swelling of lips, face, and throat, loss of consciousness, and admissions into the intensive care unit (ICU). Results The study included a total number of 28,031 individuals who reported 71,480 adverse events (AEs); which were further classified into minor and major adverse events including ICU admissions post vaccination. Of the reported AEs, 38,309 (53. 6%) side-effects were reported following Pfizer-BioNTech, 32,223 (45%) following Oxford-AstraZeneca, and 948 (1.3%) following Moderna. The following reported AEs were statistically significant between the different vaccine types: shortness of breath\difficulty of breathing, dizziness, fever above 39°C, headache, hoarseness, injection site reactions, itchiness, nausea, sleep disruption, fatigue, wheezing, swelling of lips/face and\or throat, and loss of consciousness (p-value < 0.05). Fever and seizure were the only statistically significant AEs amongst the number of vaccine doses received (p-value < 0.05). Ten ICU admissions were reported in the 14 days observation period post-COVID-19 vaccination with the following diagnoses: acute myocardial infarction, pneumonia, atherosclerosis, acute respiratory failure, intracranial hemorrhage, grand mal seizure, Guillain-Barré syndrome, abnormal blood gas levels, and septic shock. Conclusion This study demonstrated that the most prevalent SARS-CoV-2 vaccine side-effects among adults in Saudi Arabia were mild in nature. This information will help reduce vaccine hesitancy and encourage further mass vaccination to combat the COVID-19 pandemic, especially as booster doses are now available. Further studies are warranted to obtain a better understanding of the association between risk factors and the experiencing of side-effects post vaccination.
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Affiliation(s)
| | | | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.,Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | | | | | | | - Waleed Seddiq
- Center for Stem Cell and Translational Immunotherapy (CSTI), Harvard Medical School, Boston, MA, United States.,Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | | | | | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Infectious Diseases, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Maram Al-Otaiby
- The Saudi Ministry of Health, Riyadh, Saudi Arabia.,Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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19
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Duijster JW, Lieber T, Pacelli S, Van Balveren L, Ruijs LS, Raethke M, Kant A, Van Hunsel F. Sex-disaggregated outcomes of adverse events after COVID-19 vaccination: A Dutch cohort study and review of the literature. Front Immunol 2023; 14:1078736. [PMID: 36793715 PMCID: PMC9922710 DOI: 10.3389/fimmu.2023.1078736] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
Background Albeit the need for sex-disaggregated results of adverse events after immunization (AEFIs) is gaining attention since the COVID-19 pandemic, studies with emphasis on sexual dimorphism in response to COVID-19 vaccination are relatively scarce. This prospective cohort study aimed to assess differences in the incidence and course of reported AEFIs after COVID-19 vaccination between males and females in the Netherlands and provides a summary of sex-disaggregated outcomes in published literature. Methods Patient reported outcomes of AEFIs over a six month period following the first vaccination with BioNTech-Pfizer, AstraZeneca, Moderna or the Johnson&Johnson vaccine were collected in a Cohort Event Monitoring study. Logistic regression was used to assess differences in incidence of 'any AEFI', local reactions and the top ten most reported AEFIs between the sexes. Effects of age, vaccine brand, comorbidities, prior COVID-19 infection and the use of antipyretic drugs were analyzed as well. Also, time-to-onset, time-to-recovery and perceived burden of AEFIs was compared between the sexes. Third, a literature review was done to retrieve sex-disaggregated outcomes of COVID-19 vaccination. Results The cohort included 27,540 vaccinees (38.5% males). Females showed around two-fold higher odds of having any AEFI as compared to males with most pronounced differences after the first dose and for nausea and injection site inflammation. Age was inversely associated with AEFI incidence, whereas a prior COVID-19 infection, the use of antipyretic drugs and several comorbidities were positively associated. The perceived burden of AEFIs and time-to-recovery were slightly higher in females. Discussion The results of this large cohort study correspond to existing evidence and contribute to the knowledge gain necessary to disentangle the magnitude of the effect sex in response to vaccination. Whilst females have a significant higher probability of experiencing an AEFI than males, we observed that the course and burden is only to a minor extent different between the sexes.
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Affiliation(s)
- Janneke W Duijster
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Thomas Lieber
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Silvia Pacelli
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands.,School of Pharmacy, Biotechnology, and Sport Sciences, University of Bologna, Bologna, Italy
| | | | - Loes S Ruijs
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Monika Raethke
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Agnes Kant
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
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20
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Segni MT, Demissie HF, Adem MK, Geleto AK, Kelkile MW, Sori BK, Heyi ML, Iticha DG, Bejiga GS, Guddisa AB, Sima YA, Amente LT, Bayisa DA, Hurisa MB, Jiru TK. Post COVID-19 vaccination side effects and associated factors among vaccinated health care providers in Oromia region, Ethiopia in 2021. PLoS One 2022; 17:e0278334. [PMID: 36480564 PMCID: PMC9731451 DOI: 10.1371/journal.pone.0278334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Severe Acute Respiratory Syndrome (SARS COV-2) known as COVID-19 since its outbreak in 2019, more than 375 and 5.6 million were infected and dead, respectively. Its influence in all disciplines stimulated different industries to work day to night relentlessly to develop safe and effective vaccines to reduce the catastrophic effect of the disease. With the increasing number of people globally who have been vaccinated, the reports on possible adverse events have grown and gained great public attention. This study aims to determine post-COVID-19 vaccination adverse effects and associated factors among vaccinated Health care providers in the Oromia region, Ethiopia in 2021. METHODS A cross-sectional study was conducted among 912 health care workers working in government hospitals in the central Oromia region from November 20 to December 15/2021. Respondents absent from work due to different reasons were excluded during the interview. The outcome variable was COVID-19 side effects (response as Yes/No). A descriptive analysis displayed findings in the form of the frequencies and percentages, and logistic regression was employed to see the association of different variables with side effects experienced. RESULT Overall, 92.1% of the participants experienced side effects either in 1st or 2nd doses of post-COVID-19 vaccination; 84.0% and (71.5%) of participants experienced at least one side effect in the 1st and 2nd dose of the vaccines, respectively. COVID-19 infection preventive protocols like keeping distance, hand wash using soap, wearing mask and using sanitizer were decreased post vaccination. About 74.3% of the respondents were worried about the adverse effects of the COVID-19 vaccine they received. The majority (80.2%) of the respondent felt fear while receiving the vaccine and 22.5% of the respondents suspect the effectiveness of the vaccine they took. About 14.8% of the vaccinated Health workers were infected by COVID-19 post-vaccination. Engaging in moderate physical activity and feeling fear when vaccinated were the independent factors associated with reported side effects of post-COVID-19 vaccination using multiple logistic regression. Respondents who did not engage in physical activity were 7.54 fold more likely to develop post-COVID-19 vaccination side effects compared to those who involved at least moderate-intensity physical activity[AOR = 7.54, 95% CI;2.46,23.12]. The odds of experiencing side effects among the respondents who felt fear when vaccinated were 10.73 times compared not felt fear (AOR = 10.73, 95% CI; 2.47,46.64), and similarly, those who felt little fear were 4.28 times more likely to experience side effects(AOR = 4.28, 95% CI; 1.28, 14.39). CONCLUSION Significant numbers of the respondents experienced side effects post COVID-19 vaccination. It is recommended to provide pre-awareness about the side effects to reduce observed anxiety related to the vaccine. It is also important to plan monitoring and evaluation of the post-vaccine effect using standard longitudinal study designs to measure the effects directly.
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Affiliation(s)
- Mesfin Tafa Segni
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
- * E-mail:
| | - Hailu Fekadu Demissie
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
| | - Muhammedawel Kaso Adem
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
| | - Adem Kedir Geleto
- Department of Agricultural Economics, College of Agriculture and Environmental Science, Arsi University, Asella, Ethiopia
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21
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Nham E, Song JY, Noh JY, Cheong HJ, Kim WJ. COVID-19 Vaccination in Korea: Past, Present, and the Way Forward. J Korean Med Sci 2022; 37:e351. [PMID: 36472087 PMCID: PMC9723191 DOI: 10.3346/jkms.2022.37.e351] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Since its first emergence in late 2019, severe acute respiratory syndrome coronavirus-2 has claimed more than 6.5 million lives worldwide and continues to infect hundreds of thousands of people daily. To combat this once-in-a-century disaster, several vaccines have been developed at unprecedented speeds. Novel vaccine platforms (messenger ribonucleic acid vaccines and adenoviral vector vaccines) have played a major role in the current pandemic. In Korea, six vaccines, including a domestically developed recombinant vaccine, have been approved. As in other countries, vaccines have been proven to be safe and highly effective in Korea. However, rare serious adverse events and breakthrough infections have undermined public trust in the vaccines, even while the benefits of vaccination far outweigh the risks. The rise of the omicron variant and the subsequent increase in excess mortality demonstrated that while vaccines are a key component of the pandemic response, it alone can fail without non-pharmaceutical interventions like masking and social distancing. The pandemic of coronavirus disease has revealed both the strengths and weaknesses of our healthcare system and pandemic preparedness. When the next pandemic arrives, improved risk communication and vaccine development should be prioritized. To enable timely vaccine development, it is essential to make strategic and sufficient investments in vaccine research and development.
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Affiliation(s)
- Eliel Nham
- Division of Infectious diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul, Korea
| | - Joon Young Song
- Division of Infectious diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul, Korea.
| | - Ji Yun Noh
- Division of Infectious diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul, Korea
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22
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Widyasari K, Jang J, Lee S, Kang T, Kim S. Evaluation of the T cell and B cell response following the administration of COVID-19 vaccines in Korea. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:1013-1024. [PMID: 36261313 PMCID: PMC9516877 DOI: 10.1016/j.jmii.2022.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND The coronavirus disease (COVID-19) has been a worldwide concern since 2019. Vaccines are predicted to be crucial in preventing further outbreaks. The development and kinetics of immune responses determine the efficacy of COVID-19 vaccines. METHODS We measured interferon-gamma (IFN-γ) levels upon administering homologous adenovirus vector-based (ChAdOx1-S [AZ], Ad26.COV2.S [JAN]), mRNA-based (BNT162b2 [PF]; mRNA-1273 [MO]), and heterologous (AZ/PF) vaccines in healthy Korean individuals using two IFN-γ release assays: the Covi-FERON ELISA and T-SPOT Discovery SARS-CoV-2 assay. B cell responses were evaluated by assessing the production of neutralizing antibodies by surrogate virus neutralization assay. The immune response among the vaccine groups was compared after adjusting the vaccination dose and interactions between each group. RESULTS AZ triggered the highest T cell response after the first dose but showed instability after the second. PF and MO yielded stable and higher increments of T and B cell responses compared to AZ. MO yielded a higher immune response than PF. JAN yielded T and B cell responses at lower levels than the other vaccines. The booster dose triggered significant increases in the T and B cell responses and is therefore needed to protect against SARS-CoV-2 given the possibility of waning immune responses. CONCLUSION Administering two doses of mRNA vaccines provides the most effective results among the administered vaccines in triggering the immune response specific to SARS-CoV-2 in healthy Korean individuals. Administration of booster doses demonstrated a significant increase in the immune response and may provide longer protection against SARS-CoV-2.
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Affiliation(s)
- Kristin Widyasari
- Department of Laboratory Medicine, Gyeongsang National University Changwon Hospital, Changwon, 51472, South Korea
| | - Jieun Jang
- Gyeongnam Center for Infectious Disease Control and Prevention, Changwon 51154, South Korea
| | - Seungjun Lee
- Department of Laboratory Medicine, Gyeongsang National University Changwon Hospital, Changwon, 51472, South Korea,Gyeongsang National University College of Medicine, Gyeongsang Institute of Health Sciences, Jinju 52727, South Korea
| | - Taejoon Kang
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, South Korea,School of Pharmacy, Sungkyunkwan University, Suwon, 16419, South Korea
| | - Sunjoo Kim
- Department of Laboratory Medicine, Gyeongsang National University Changwon Hospital, Changwon, 51472, South Korea,Gyeongnam Center for Infectious Disease Control and Prevention, Changwon 51154, South Korea,Gyeongsang National University College of Medicine, Gyeongsang Institute of Health Sciences, Jinju 52727, South Korea,Corresponding author. Department of Laboratory Medicine, Gyeongsang University Changwon Hospital, Samjungja-ro 11, Seongsan-gu, Changwon-si, Gyeongnam 51472, South Korea. Fax: +82 55 214 3087
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23
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Hyun J, Park Y, Song YG, Han SH, Park SY, Kim SH, Park JS, Jeon SY, Lee HS, Lee KH. Reactogenicity and Immunogenicity of the ChAdOx1 nCOV-19 Coronavirus Disease 2019 Vaccine in South Korean Healthcare Workers. Yonsei Med J 2022; 63:1078-1087. [PMID: 36444543 PMCID: PMC9760890 DOI: 10.3349/ymj.2022.0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/22/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The association between reactogenicity and immunogenicity of the ChAdOx1 nCOV-19 is controversial. We aimed to evaluate this association among South Korean healthcare workers (HCWs). MATERIALS AND METHODS Participants received two doses of the ChAdOx1vaccine 12 weeks apart. Blood samples were tested for anti-severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) spike protein receptor binding domain antibodies about 2 months after the first and second doses using the Elecsys Anti-SARS-CoV-2 S assay kits. Adverse events were noted using an online self-reporting questionnaire. RESULTS Among the 232 HCWs, pain (85.78% after the first dose vs. 58.62% after the second dose, p<0.001) was the most prominent local reaction, and myalgia or fatigue (84.05% vs. 53.02%, p<0.001) was the most prominent systemic reaction. The frequency of all adverse events was significantly reduced after the second dose. After the first dose, the anti-SARS-CoV-2 S showed significantly higher titer in the group with swelling, itching, fever, and nausea. Also, the anti-SARS-CoV-2 S titer significantly increased as the grade of fever (p=0.007) and duration of fever (p=0.026) increased; however, there was no significant correlation between immunogenicity and adverse event after the second dose. The group with pain after the first dose showed a greater increase in the anti-SARS-CoV-2 S difference between the second and first doses compared to the group without pain (542.2 U/mL vs. 363.8 U/mL, p=0.037). CONCLUSION The frequency of adverse events occurring after the first dose of the ChAdOx1 was significantly reduced after the second dose. Interestingly, the elevation of anti-SARS-CoV-2 S titer was significantly increased in the group with pain after the first dose.
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Affiliation(s)
- JongHoon Hyun
- Division of Infectious Diseases, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Yongjung Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young Goo Song
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Han
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Young Park
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sin Hye Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Su Park
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - So Young Jeon
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
| | - Kyoung Hwa Lee
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
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24
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Granados Villalpando JM, Romero Tapia SDJ, Baeza Flores GDC, Ble Castillo JL, Juarez Rojop IE, Lopez Junco FI, Olvera Hernández V, Quiroz Gomez S, Ruiz Quiñones JA, Guzmán Priego CG. Prevalence and Risk Factors of Adverse Effects and Allergic Reactions after COVID-19 Vaccines in a Mexican Population: An Analytical Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10122012. [PMID: 36560422 PMCID: PMC9781330 DOI: 10.3390/vaccines10122012] [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: 10/18/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Vaccinations have helped to control the COVID-19 pandemic; however, few studies focus on the adverse effects and allergic reactions of these vaccines and fewer have a scope in the Latin American population. The objective of this study was to assess the associations between vaccinations, sex, age, allergic reactions, and adverse effects. This was an analytical cross-sectional study conducted between 1 July and 1 October 2022. The sample consisted of 443 surveyed participants, with a total of 1272 COVID-19 vaccine doses. Seven vaccines (Pfizer BioNTech, Oxford-AstraZeneca, CanSino, Moderna, Johnson and Johnson, Sinovac, and Sputnik V) were evaluated. A total of 12.6% of those surveyed had at least one allergic reaction posterior to vaccination, and females had a greater chance of developing one (p < 0.001, OR 3.1). The most common allergic reaction was chest pain, and Pfizer-BioNTech and Oxford-AstraZeneca were associated with the onset of allergic reactions (p < 0.005). A total of 54.6% of those surveyed developed adverse effects, the most common of which were myalgia, fever, cephalea, asthenia or adynamia, and arthralgia; moreover, older age was associated with the onset of adverse effects (p < 0.5). This study concludes that the BNT162b2 (Pfizer BioNTech) and ChAdOX1 nCOV-19 (Oxford-AstraZeneca) vaccines are strongly associated with the onset of allergic reactions, with ORs of 1.6 (CI 95%, 1.18 to 2.3) and 1.87 (CI 95%, 1.35 to 2.6), respectively. In addition, females have a greater chance of developing allergic reactions associated with COVID-19 vaccinations, and there was a relation found between older age and a greater prevalence of comorbidities, adverse effects after vaccination, and COVID-19 infection after vaccination.
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Affiliation(s)
- Jesús Maximiliano Granados Villalpando
- Cardiometabolism Laboratory, Research Center, Academic Division of Health Sciences (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Sergio de Jesus Romero Tapia
- Health Sciences Academic Division (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Guadalupe del Carmen Baeza Flores
- Cardiometabolism Laboratory, Research Center, Academic Division of Health Sciences (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Jorge Luis Ble Castillo
- Metabolic Disease Biochemistry Laboratory, Research Center, Academic Division of Health Sciences (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Isela Esther Juarez Rojop
- Lipid Metabolism Laboratory, Research Center, Academic Division of Health Sciences (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Frida Isabel Lopez Junco
- Cardiometabolism Laboratory, Research Center, Academic Division of Health Sciences (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Viridiana Olvera Hernández
- Metabolic Disease Biochemistry Laboratory, Research Center, Academic Division of Health Sciences (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Sergio Quiroz Gomez
- Health Sciences Academic Division (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - Jesús Arturo Ruiz Quiñones
- Research Center for Tropical and Emerging Diseases, High Specialty Regional Hospital “Dr. Juan Graham Casasús”, Villahermosa 86126, Mexico
| | - Crystell Guadalupe Guzmán Priego
- Cardiometabolism Laboratory, Research Center, Academic Division of Health Sciences (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
- Correspondence: or ; Tel.: +52-993-242-8993
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25
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Sangpornsuk N, Rungpradubvong V, Tokavanich N, Srisomwong S, Ananwattanasuk T, Teerawongsakul P, Kerr SJ, Suwanwalaikorn M, Jongnarangsin K, Chokesuwattanaskul R. Arrhythmias after SARS-CoV-2 Vaccination in Patients with a Cardiac Implantable Electronic Device: A Multicenter Study. Biomedicines 2022; 10:biomedicines10112838. [PMID: 36359357 PMCID: PMC9687180 DOI: 10.3390/biomedicines10112838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
One of the most concerning adverse events related to the SARS-CoV-2 vaccination is arrhythmia. To ascertain the relationship between vaccination and arrhythmic events, we studied the occurrence of arrhythmia in patients with cardiac implantable electronic devices (CIEDs) before and after a SARS-CoV-2 vaccination. Patients with CIEDs aged ≥18 who visited the CIED clinic at King Chulalongkorn Memorial Hospital and Vajira hospital from August 2021 to February 2022 were included. Information about the SARS-CoV-2 vaccination and side effects was obtained. One hundred eighty patients were included in our study, which compared the incidence of arrhythmias in the 14 days post-vaccination to the 14 days before vaccination. The median age was 70 years. The number of patients who received one, two, and three doses of the vaccine was 180, 88, and 4, respectively. ChAdOx1 was the primary vaccine used in our institutes, accounting for 86% of vaccinations. The vaccination was significantly associated with a 73% increase incidence of supraventricular tachycardia (SVT). In an adjusted model, factors associated with the incidence of SVT were the post-vaccination period, female sex, increasing BMI, chronic kidney disease, and a history of atrial fibrillation. Increased ventricular arrhythmia (VA) episodes were also associated with the post-vaccination period, female sex, decreasing BMI, and chronic kidney disease, but to a lesser degree than those with SVT episodes. No life-threatening arrhythmia was noted in this study. In conclusion, the incidence of arrhythmia in patients implanted with CIEDs was significantly increased after the SARS-CoV-2 vaccination.
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Affiliation(s)
- Naruepat Sangpornsuk
- Center of Excellence in Arrhythmia Research, Cardiac Center, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
- Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
| | - Voravut Rungpradubvong
- Center of Excellence in Arrhythmia Research, Cardiac Center, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
- Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
| | - Nithi Tokavanich
- Cardiology Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Sathapana Srisomwong
- Cardiology Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Teetouch Ananwattanasuk
- Cardiology Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Padoemwut Teerawongsakul
- Cardiology Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Stephen J. Kerr
- Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Mathurin Suwanwalaikorn
- Center of Excellence in Arrhythmia Research, Cardiac Center, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
- Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
| | - Krit Jongnarangsin
- Frankel Cardiovascular Center, Division of Cardiovascular Medicine, University of Michigan Health, Ann Arbor, MI 48109, USA
| | - Ronpichai Chokesuwattanaskul
- Center of Excellence in Arrhythmia Research, Cardiac Center, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
- Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
- Correspondence: ; Tel.: +66-(22)-564265; Fax: +66-(22)-564356
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Frahm N, Fneish F, Ellenberger D, Haas J, Loebermann M, Parciak T, Peters M, Pöhlau D, Rodgers J, Röper AL, Schilling S, Stahmann A, Temmes H, Zettl UK, Middleton RM. SARS-CoV-2 vaccination in patients with multiple sclerosis in Germany and the United Kingdom: Gender-specific results from a longitudinal observational study. Lancet Reg Health Eur 2022; 22:100502. [PMID: 36090519 PMCID: PMC9438509 DOI: 10.1016/j.lanepe.2022.100502] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Niklas Frahm
- German MS-Registry, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]) Krausenstr. 50, 30171 Hannover, Germany
- Department of Neurology, Neuroimmunological Section, University Medical Center of Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
- Corresponding author at: MS Research and Project Development gGmbH, Krausenstr. 50, 30171 Hannover, Germany.
| | - Firas Fneish
- German MS-Registry, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]) Krausenstr. 50, 30171 Hannover, Germany
| | - David Ellenberger
- German MS-Registry, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]) Krausenstr. 50, 30171 Hannover, Germany
| | - Judith Haas
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), Krausenstr. 50, 30171 Hannover, Germany
| | - Micha Loebermann
- Department of Tropical Medicine, Infectious Diseases and Nephrology, University Medical Center of Rostock, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany
| | - Tina Parciak
- Biomedical Research Institute & Data Science Institute, Hasselt University, Diepenbeek 3590, Belgium
| | - Melanie Peters
- Gesellschaft für Versorgungsforschung mbH (Society for Health Care Research [GfV]), Krausenstr. 50, 30171 Hannover, Germany
| | - Dieter Pöhlau
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), Krausenstr. 50, 30171 Hannover, Germany
| | - Jeff Rodgers
- UK MS Register, Swansea University Medical School, Data Science Building, Swansea SA2 8PP, United Kingdom
| | - Anna-Lena Röper
- German MS-Registry, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]) Krausenstr. 50, 30171 Hannover, Germany
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), Krausenstr. 50, 30171 Hannover, Germany
| | - Sarah Schilling
- German MS-Registry, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]) Krausenstr. 50, 30171 Hannover, Germany
| | - Alexander Stahmann
- German MS-Registry, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH [MSFP]) Krausenstr. 50, 30171 Hannover, Germany
| | - Herbert Temmes
- Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German MS Society Federal Association [DMSG]), Krausenstr. 50, 30171 Hannover, Germany
| | - Uwe K. Zettl
- Department of Neurology, Neuroimmunological Section, University Medical Center of Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Rodden M. Middleton
- UK MS Register, Swansea University Medical School, Data Science Building, Swansea SA2 8PP, United Kingdom
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Rueda-Fernández M, Melguizo-Rodríguez L, Costela-Ruiz VJ, González-Acedo A, Ramos-Torrecillas J, Illescas-Montes R. The current status of COVID-19 vaccines. A scoping review. Drug Discov Today 2022; 27:103336. [PMID: 35995361 PMCID: PMC9389839 DOI: 10.1016/j.drudis.2022.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/11/2022] [Accepted: 08/09/2022] [Indexed: 12/12/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new disease that has led to a worldwide pandemic, resulting in millions of deaths and a high economic burden. Here, we analyze the current status of preventive vaccines authorized by the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). Published clinical trials have shown the effectiveness of mRNA (BNT162b2 and Spikevax), adenovirus vector-based (Ad26.COV2.S and ChAdOx1 nCoV-19), and recombinant protein S (NVX-CoV2373) vaccines to be between 52.9% and 100%. The most-frequent adverse effects include local pain, fatigue, headache, or chills. Serious events are associated with Ad26.COV2.S and ChAdOx1 nCoV-19 vaccines.
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Affiliation(s)
- Manuel Rueda-Fernández
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. Ilustración 60, 18016 Granada, Spain; Institute of Biosanitary Research, Ibs.Granada, C/ Doctor Azpitarte 4, 4a Planta, 18012 Granada, Spain
| | - Lucía Melguizo-Rodríguez
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. Ilustración 60, 18016 Granada, Spain; Institute of Biosanitary Research, Ibs.Granada, C/ Doctor Azpitarte 4, 4a Planta, 18012 Granada, Spain
| | - Víctor J Costela-Ruiz
- Institute of Biosanitary Research, Ibs.Granada, C/ Doctor Azpitarte 4, 4a Planta, 18012 Granada, Spain; Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences of Ceuta, University of Granada, C/ Cortadura del Valle, Sn, 51001 Ceuta, Spain
| | - Anabel González-Acedo
- Institute of Biosanitary Research, Ibs.Granada, C/ Doctor Azpitarte 4, 4a Planta, 18012 Granada, Spain; Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences of Melilla, University of Granada, C/ Santander, 1, 52005 Melilla, Spain
| | - Javier Ramos-Torrecillas
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. Ilustración 60, 18016 Granada, Spain; Institute of Biosanitary Research, Ibs.Granada, C/ Doctor Azpitarte 4, 4a Planta, 18012 Granada, Spain.
| | - Rebeca Illescas-Montes
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. Ilustración 60, 18016 Granada, Spain; Institute of Biosanitary Research, Ibs.Granada, C/ Doctor Azpitarte 4, 4a Planta, 18012 Granada, Spain
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Puspitarani F, Sitaresmi MN, Ahmad RA. Adverse events following immunization of COVID-19 vaccine among children aged 6-11 years. Front Public Health 2022; 10:999354. [PMID: 36388348 PMCID: PMC9640945 DOI: 10.3389/fpubh.2022.999354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/04/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction Starting in December 2021, the Indonesian Government has recommended inactivated SARS-CoV-2 vaccine (CoronaVac) for children aged 6-11 years. This study aims to determine the prevalence and determinant factors of adverse events following immunization (AEFI) of the first dose and the second dose of the COVID-19 vaccine among children aged 6-11 years old. Materials and methods We conducted a cross-sectional study in Bantul District, Yogyakarta, Indonesia, in February-March 2022. Data were collected by trained interviews with 1,093 parents of children 6-11 years old who received the first dose and the second dose of the COVID-19 vaccine. Data were analyzed with chi-square and logistic regression. Results The prevalence of AEFI in the first dose of the COVID-19 vaccine was 16.7%, while the second dose was 22.6%. The most common symptoms of AEFI at the first dose were local site pain and fever, while at the second dose were cough and cold. Determinants of AEFI of COVID-19 vaccination among children were girls with OR 1.31 (95% CI 1.0-1.7; P 0.04), mass-setting of vaccination with OR 0.70 (95% CI 0.5-0.9; P 0.01), the history of AEFI in childhood vaccination with OR 1.63 (95% CI 1.2-2.2; P < 0.01) and administering other vaccines within 1 month before COVID-19 vaccination, with OR 5.10 (95% CI 2.1-12.3 P < 0.01). Conclusion The prevalence of AEFI in the first and the second dose of inactivated COVID-19 vaccine was comparable to that reported in the clinical trial study and the communities. Risk communication should be provided to the child and their parents regarding the risk of mild AEFI of the COVID-19 vaccine, especially for children with a history of AEFI in childhood vaccination and who received other vaccines containing the same adjuvant with CoronaVac within 1 month. A mass-setting of vaccination should be taken as an advantage to educate parents about the risk of AEFI and also about the reporting pathways.
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Affiliation(s)
- Fitriana Puspitarani
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
| | - Mei Neni Sitaresmi
- Departement of Child Health, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, DR. Sardjito Hospital, Yogyakarta, Indonesia,*Correspondence: Mei Neni Sitaresmi
| | - Riris Andono Ahmad
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, Indonesia,Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
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29
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Velhal GD, Kamath YV, Agrawal AS, Vora DS, Dwivedi VR. Incidence of Early Adverse Events Following Covishield (ChAdOx1 nCoV-19) Vaccination: A Prospective Study. Indian J Community Med 2022; 47:613-617. [PMID: 36742958 PMCID: PMC9891042 DOI: 10.4103/ijcm.ijcm_93_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/22/2022] [Indexed: 02/07/2023] Open
Abstract
Background Minor adverse event following immunizations (AEFIs) are often underreported and self-treated. This study aimed to collect information regarding any and every probable adverse event experienced by the recipient of Covishield vaccine up to 10 days following the first and second dose of vaccine. To find the incidence of minor adverse events following Covishield vaccination; draw an association between adverse events and individuals' demographic factors and comorbidities; and report new adverse events, if any. Materials and Methods A descriptive observational study was conducted among 409 participants randomly sampled from the Vaccination Centre at a Tertiary Care Hospital, Mumbai. Participants were followed up post their first and second doses to enquire about adverse events. Results Most commonly reported adverse events included injection site pain, tenderness, chills, fatigue, fever, and myalgia. Females reported more adverse events compared to men (p < 0.05). Younger individuals (18-24) experienced adverse events more as compared to individuals above 40 years of age (p < 0.005). Reported adverse events were lesser after the second dose in comparison with the first dose. Few participants reported dysgeusia. Conclusions Covishield vaccination has a mild AEFI profile, most commonly: injection site pain, tenderness, chills, and fatigue. It is hoped that the findings of this study will dispel anxiety around the adverse events of vaccination and reduce any persisting vaccine hesitancy. Effective communication with the population on vaccination will enable individuals to make educated and informed decisions.
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Affiliation(s)
- Gajanan D. Velhal
- Department of Community Medicine, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Yash V. Kamath
- Department of Community Medicine, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Ansh S. Agrawal
- Department of Community Medicine, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Devanshi S. Vora
- Department of Community Medicine, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Vaibhav R. Dwivedi
- Department of Community Medicine, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Nham E, Ko JH, Song KH, Choi JY, Kim ES, Kim HJ, Kim B, Lim HY, Kim KC, Jang HC, Lee KH, Song YG, Baek YJ, Ahn JY, Choi JY, Kim YC, Park YS, Choi WS, Bae S, Kim SH, Kang ES, Jeong HW, Kim SW, Kwon KT, Kim SS, Peck KR. Kinetics of vaccine-induced neutralizing antibody titers and estimated protective immunity against wild-type SARS-CoV-2 and the Delta variant: A prospective nationwide cohort study comparing three COVID-19 vaccination protocols in South Korea. Front Immunol 2022; 13:968105. [PMID: 36211416 PMCID: PMC9538478 DOI: 10.3389/fimmu.2022.968105] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionDespite vaccine development, the COVID-19 pandemic is ongoing due to immunity-escaping variants of concern (VOCs). Estimations of vaccine-induced protective immunity against VOCs are essential for setting proper COVID-19 vaccination policy.MethodsWe performed plaque-reduction neutralizing tests (PRNTs) using sera from healthcare workers (HCWs) collected from baseline to six months after COVID-19 vaccination and from convalescent COVID-19 patients. The 20.2% of the mean PRNT titer of convalescent sera was used as 50% protective value, and the percentage of HCWs with protective immunity for each week (percent-week) was compared among vaccination groups. A correlation equation was deduced between a PRNT 50% neutralizing dose (ND50) against wild type (WT) SARS-CoV-2 and that of the Delta variant.ResultsWe conducted PRNTs on 1,287 serum samples from 297 HCWs (99 HCWs who received homologous ChAdOx1 vaccination (ChAd), 99 from HCWs who received homologous BNT162b2 (BNT), and 99 from HCWs who received heterologous ChAd followed by BNT (ChAd-BNT)). Using 365 serum samples from 116 convalescent COVID-19 patients, PRNT ND50 of 118.25 was derived as 50% protective value. The 6-month cumulative percentage of HCWs with protective immunity against WT SARS-CoV-2 was highest in the BNT group (2297.0 percent-week), followed by the ChAd-BNT (1576.8) and ChAd (1403.0) groups. In the inter-group comparison, protective percentage of the BNT group (median 96.0%, IQR 91.2–99.2%) was comparable to the ChAd-BNT group (median 85.4%, IQR 15.7–100%; P =0.117) and significantly higher than the ChAd group (median 60.1%, IQR 20.0–87.1%; P <0.001). When Delta PRNT was estimated using the correlation equation, protective immunity at the 6-month waning point was markedly decreased (28.3% for ChAd group, 52.5% for BNT, and 66.7% for ChAd-BNT).ConclusionDecreased vaccine-induced protective immunity at the 6-month waning point and lesser response against the Delta variant may explain the Delta-dominated outbreak of late 2021. Follow-up studies for newly-emerging VOCs would also be needed.
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Affiliation(s)
- Eliel Nham
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Ju-Yeon Choi
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Hye-Jin Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Byoungguk Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Hee-Young Lim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Kyung-Chang Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Hee-Chang Jang
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Kyoung Hwa Lee
- Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Goo Song
- Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yae Jee Baek
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Ahn
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Chan Kim
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Yoon Soo Park
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Won Jeong
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, South Korea
- *Correspondence: Hye Won Jeong, ; Shin-Woo Kim, ; Ki Tae Kwon, ; Sung Soon Kim, ; Kyong Ran Peck,
| | - Shin-Woo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
- *Correspondence: Hye Won Jeong, ; Shin-Woo Kim, ; Ki Tae Kwon, ; Sung Soon Kim, ; Kyong Ran Peck,
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, South Korea
- *Correspondence: Hye Won Jeong, ; Shin-Woo Kim, ; Ki Tae Kwon, ; Sung Soon Kim, ; Kyong Ran Peck,
| | - Sung Soon Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
- *Correspondence: Hye Won Jeong, ; Shin-Woo Kim, ; Ki Tae Kwon, ; Sung Soon Kim, ; Kyong Ran Peck,
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Hye Won Jeong, ; Shin-Woo Kim, ; Ki Tae Kwon, ; Sung Soon Kim, ; Kyong Ran Peck,
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Park HW, Min GJ, Kim TY, Cho SG. A Case of Hemophagocytic Lymphohistiocytosis following Second Dose of COVID-19 Vaccination. Acta Haematol 2022; 146:65-71. [PMID: 36096118 PMCID: PMC9747738 DOI: 10.1159/000526980] [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: 03/23/2022] [Accepted: 09/02/2022] [Indexed: 02/05/2023]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare, severe hyperinflammatory disease characterized by overproduction of cytokines and hemophagocytosis of hematopoietic cells, resulting in multiorgan failure. Prompt treatment initiation is essential for patient survival. The coronavirus disease 2019 (COVID-19) pandemic has led to the rapid development of several vaccines, including BNT162b2 by Pfizer-BioNTech. Few cases of immune-mediated complications of COVID-19 and its vaccines have been reported, characterized by persistent stimulation of the immune system, resembling HLH. We report the case of a 21-year-old man with secondary HLH following a second dose of the BNT162b2 vaccine. The patient did not have primary HLH or other contributors to secondary HLH and met the HLH-2004 diagnostic criteria. He was safely treated with steroid pulse therapy alone, without etoposide, cyclosporin, or immunoglobulins, which are recommended for pediatric patients. Physicians need to be aware of such severe complications following a second dose of the COVID-19 vaccine.
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Adverse events following introduction of the ChAdOx1 nCoV-19 vaccine in Somalia in 2021: findings from a fragile setting and implications for the future. IJID REGIONS 2022; 4:47-52. [PMID: 35720961 PMCID: PMC9169432 DOI: 10.1016/j.ijregi.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022]
Abstract
Adverse event following immunization (AEFI) data against coronavirus disease 2019 (COVID-19) vaccines in fragile settings are limited. To the authors’ knowledge, this is the first study to reports information on AEFIs after COVID-19 vaccination. ChAdOx1nCoV19 vaccine produced mild side effects amongst the vaccinated population Some variables (sex, profession, age) increase the odds that vaccine recipients will report AEFIs. This study confirms that COVID-19 vaccines are safe, and the benefits outweigh associated risks.
Background Vaccination against coronavirus disease 2019 (COVID-19) began in Somalia on 16 March 2021 with the Covishield (ChAdOx1 nCoV-19) vaccine. However, by the end of 2021, only a small percentage of the population had been fully vaccinated. As side effects play an important role in determining public confidence in vaccines and their uptake, this study aimed to examine reported adverse events following immunization (AEFIs) of vaccine recipients. Methods This cross-sectional-survey-based study was conducted between March and October 2021 in Somalia. Vaccine recipients who were eligible to receive the first dose of the Covishield vaccine in the first phase of COVID-19 vaccination were eligible for study inclusion. P<0.05 was considered to indicate significance. Results Of the 149,985 respondents who had received the first dose of the Covishield vaccine, 378 reported side effects. This represented a reported AEFI rate of 2.5 per 1000 population. Amongst those who reported adverse events, males (2.8 per 1000; P<0.001), respondents aged 35–49 years (3.3 per 1000; P=0.001) and teachers (3.5 per 1000; P=0.000) had higher rates of adverse events compared with females, other age groups and other occupations. Amongst population settlement types, a higher rate of AEFIs was observed amongst refugees (23.9 per 1000; P=0.000) and internally displaced populations (19 per 1000; P=0.000). Nearly half of the vaccine recipients who reported side effects (48%) reported one local symptom, and most symptoms were mild in nature. The probability of having acute and severe side effects was found to be 66% lower among males compared with females [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.26–0.73; P=0.002]. Respondents aged >60 years (OR 1.52, 95% CI 0.64–3.62; P=0.34) were more likely to develop acute and severe AEFIs. None of the study population reported any severe life-threatening symptoms or death. Conclusion Some variables (sex, profession, age) put recipients at higher odds of acute and severe AEFIs, but the Covishield vaccine generally produced mild side effects in a small proportion of the vaccinated population in Somalia. This study confirms that COVID-19 vaccines are safe, and their benefits clearly outweigh any associated risk.
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Adverse Events following Immunization with COVID-19 Vaccines: A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2911333. [PMID: 36017393 PMCID: PMC9398801 DOI: 10.1155/2022/2911333] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/08/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022]
Abstract
Numerous COVID-19 vaccines are being administered to people around the world. Adverse events following immunization (AEFI) with COVID-19 vaccines have been reported by health care workers as well as surveillance bodies. A wealth of information on the efficacy and safety of vaccines exists in the literature, and the knowledge in this sector is growing exponentially. A narrative literature review was conducted on sources accessed from PubMed, Google Scholar, and Cochrane Review from March 2021 to July 2021. This review is aimed at describing AEFI associated with currently available COVID-19 vaccines, with an emphasis on narrating probable AEFI, and at assisting in a better understanding of the COVID-19 vaccines.
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Psychological and Psychiatric Events Following Immunization with Five Different Vaccines against SARS-CoV-2. Vaccines (Basel) 2022; 10:vaccines10081297. [PMID: 36016185 PMCID: PMC9415094 DOI: 10.3390/vaccines10081297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Despite the high number of vaccines administered against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide, the information on the psychological/psychiatric adverse events following immunization (AEFI) with these newly developed vaccines remains scarce. Objective: To describe the frequency of psychological/psychiatric symptoms among recipients of five different anti-SARS-CoV-2 vaccines and to explore the factors associated with their development reported in the nationwide Mexican registry of AEFI against SARS-CoV-2. Methods: Descriptive study of all the psychological/psychiatric symptoms, including anxiety, panic attacks, insomnia, and agitation reported to the Mexican Epidemiological Surveillance System from 21 December 2020 to 27 April 2021, among adult (≥18 years old) recipients of 7,812,845 doses of BNT162b2, ChAdOx1 nCov-19, rAd26-rAd5, Ad5-nCoV, or CoronaVac. The factors associated with their development are determined by multivariate regression analysis. Results: There were 19,163 AEFI reports during the study period; amongst them, 191 (1%) patients had psychological/psychiatric symptoms (median age of 41 years, interquartile range of 32–54; 149 [78%] women) for an observed incidence of 2.44 cases per 100,000 administered doses (95% confidence interval [CI] 2.12–2.82), 72.8% of psychiatric AEFIs were reported among recipients of BNT162b2. The median time from vaccination to symptom onset was 35 min (interquartile range: 10–720). Overall, the most common psychological/psychiatric symptoms were anxiety in 129 (67.5%) patients, panic attacks in 30 (15.7%), insomnia in 25 (13%), and agitation in 11 (5.7%). After adjusting for the confounding factors, the odds for developing psychological/psychiatric symptoms were higher for those concurrently reporting syncope (odds ratio [OR]: 4.73, 95% CI: 1.68–13.33); palpitations (OR: 2.47, 95% CI: 1.65–3.70), and dizziness (OR: 1.59, 95% CI: 1.10–2.28). Conclusion: In our population, psychological/psychiatric symptoms were extremely infrequent AEFIs. No severe psychiatric AEFIs were reported. Immunization stress-related responses might explain most of the detected cases.
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Sánchez-Saez F, Peiró S, Cuenca L, Vanaclocha H, Limón R, Salas D, Burgos JS, Sánchez-Payá J, Meneu R, Díez J, García-Sempere A, Navarro IH, Rodríguez-Bernal C, Sanfélix-Gimeno G, Navarro D. Side effects during the week after first dose vaccination with four Covid-19 vaccines. Results of the ProVaVac Survey Study with 13,837 people in Spain. Vaccine 2022; 40:5942-5949. [PMID: 36068110 PMCID: PMC9420721 DOI: 10.1016/j.vaccine.2022.08.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/12/2022] [Accepted: 08/15/2022] [Indexed: 12/23/2022]
Abstract
Background In 2021, four vaccines against Covid-19 (BNT162b2, mRNA-1273, ChAdOx1nCoV-19, and JNJ-78436735) were employed in the region of Valencia, Spain. We conducted a survey to identify real-world, self-reported frequency and severity of side effects during the week after vaccination. Methods Survey data was obtained from April 19, 2021, to October 6, 2021, at three different moments in time: day one, day three and day seven after vaccination. Answers were linked to individual-level, personal and clinical information. Respondents were stratified by the vaccine they received and reported effects were presented over time and stratified by severity. We compared our results per vaccine with the frequencies stated in each Summary of Product Characteristics (SmPC). We used binomial logistic models to identify associations between respondent characteristics and side effects. Results No symptoms were reported by 1,986 respondents (14.35 %), 6,254 informed exclusively mild symptoms (45.20 %), 3,444 up to moderate symptoms (24.89 %), and 2,153 people (15.56 %) notified also severe symptoms. Among the latter, the more frequent were extreme tiredness (7.0 %), and nausea or vomiting (7.1 %). The reported frequency of facial paralysis (0.4 %) was much higher than reflected in SmPCs. Female sex, younger age, previous positive Active Infection Diagnostic Test, chronicity, and vaccination with other than the BNT162b2 vaccine were associated to an increased risk of side effects (p < 0.001). Conclusions Side effects after vaccination are common in the real-world. However, they are principally mild, and their frequency declines after a few days. Providing patients with dependable, beforehand information about side effects may improve outcomes and reinforce vaccination programs.
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Affiliation(s)
- Francisco Sánchez-Saez
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Community (FISABIO), Valencia, Spain
| | - Salvador Peiró
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Community (FISABIO), Valencia, Spain
| | - Llanos Cuenca
- General Directorate for Planning, Technological Efficiency and Patient Care, Department of Health, Valencia Government, Valencia, Spain; Universitat Politècnica de Valencia, UPV
| | - Hermelinda Vanaclocha
- General Directorate of Public Health, Department of Health, Valencia Government, Valencia, Spain
| | - Ramón Limón
- General Directorate of Healthcare, Department of Health, Valencia Government, Valencia, Spain
| | - Dolores Salas
- General Directorate of Public Health, Department of Health, Valencia Government, Valencia, Spain
| | - Javier S Burgos
- General Directorate of Research and Healthcare Supervision, Department of Health, Valencia Government, Valencia, Spain
| | - José Sánchez-Payá
- Preventive Medicine Service, Alicante General and University Hospital, Alicante, Spain; Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Ricard Meneu
- General Directorate of Research and Healthcare Supervision, Department of Health, Valencia Government, Valencia, Spain
| | - Javier Díez
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Community (FISABIO), Valencia, Spain
| | - Aníbal García-Sempere
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Community (FISABIO), Valencia, Spain.
| | - Isabel Hurtado Navarro
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Community (FISABIO), Valencia, Spain
| | - Clara Rodríguez-Bernal
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Community (FISABIO), Valencia, Spain
| | - Gabriel Sanfélix-Gimeno
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Community (FISABIO), Valencia, Spain
| | - David Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain; Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
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Dattner AM. Potential Immunologic and Integrative Methods to Enhance Vaccine Safety. Vaccines (Basel) 2022; 10:1108. [PMID: 35891272 PMCID: PMC9322796 DOI: 10.3390/vaccines10071108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 01/27/2023] Open
Abstract
Vaccine safety is measured by the disease protection it confers compared to the harm it may cause; both factors and their relative numbers have been the subject of disagreement. Cross-reactive attack of analogous self-antigens modified by dietary and microbiome factors is one of the poorly explored likely causes of harm. Screening for that and other risk factors might point out those most likely to develop severe vaccine reactions. Cooperation from those with opinions for and against vaccination in data gathering and vetting will lead to greater safety. Screening should include an integrative medical perspective regarding diet, microbiome, leaky gut, and other antigen sources. It might include emerging electronic technology or integrative energetic techniques vetted ultimately by cross-reactive lymphocyte testing or genetic evaluation. The knowledge gained from evaluating those with reactions could enhance the screening process and, since similar antigenic stimuli and reactions are involved, help long COVID sufferers. Centers for early identification and rescue from vaccine reactions could lower morbidity and mortality, and increase the percentage of people choosing to be vaccinated. Additional platforms for boosting; using lower dosage; other routes of administration, such as intranasal or intradermal needles; and possibly different antigens could make it easier to vaccinate globally to address the new variants of viruses rapidly arising.
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Affiliation(s)
- Alan M Dattner
- Integrative Dermatology and Medicine, Sarasota, FL 34231, USA
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Choi JY, Lee YJ, Ko JH, Kim SH, Kim HJ, Lee HW, Jeong H, Kim TY, Jang YG, Hong HJ, Kim MS, Lee SE, Kim YG, Chung EJ, Lim H, Jang S, Kim K, Kim SS, Ahn JY, Choi JY, Kim YC, Park YS, Peck KR, Kim B. Neutralizing Activity Against SARS-CoV-2 Delta and Omicron Variants Following a Third BNT162b2 Booster Dose According to Three Homologous or Heterologous COVID-19 Vaccination Schedules. Front Cell Infect Microbiol 2022; 12:948014. [PMID: 35899050 PMCID: PMC9309354 DOI: 10.3389/fcimb.2022.948014] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/20/2022] [Indexed: 01/14/2023] Open
Abstract
With the emergence and rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants, escaping vaccine-induced immunity is a concern. Three vaccination schedules, homologous or heterologous, have been initially applied due to an insufficient supply of vaccines in Korea. We investigated neutralizing activities against Omicron and Delta variants in each schedule. Three schedules using three doses of the BNT162b2 (BNT) or the ChAdOx1 (ChAd) vaccines include ChAd-ChAd-BNT, ChAd-BNT-BNT, and BNT-BNT-BNT. Neutralizing activities were evaluated using plaque-reduction neutralization test (PRNT) against wild type (WT) SARS-CoV-2, Delta variant, and Omicron variant. A total of 170 sera from 75 participants were tested, and the baseline characteristics of participants were not significantly different between groups. After the 2nd vaccine dose, geometric mean titers of PRNT ND50 against WT, Delta, and Omicron were highest after ChAd-BNT vaccination (2,463, 1,097, and 107) followed by BNT-BNT (2,364, 674, and 38) and ChAd-ChAd (449, 163, and 25). After the 3rd dose of BNT, the increase of PRNT ND50 against WT, Delta, and Omicron was most robust in ChAd-ChAd-BNT (4,632, 988, and 260), while the BNT-BNT-BNT group showed the most augmented neutralizing activity against Delta and Omicron variants (2,315 and 628). ChAd-BNT-BNT showed a slight increase of PRNT ND50 against WT, Delta, and Omicron (2,757, 1,279, and 230) compared to the 2nd dose. The results suggest that a 3rd BNT booster dose induced strengthened neutralizing activity against Delta and Omicron variants. The waning of cross-reactive neutralizing antibodies after the 3rd dose and the need for additional boosting should be further investigated.
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Affiliation(s)
- Ju-yeon Choi
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Young Jae Lee
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Su-Hwan Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Hye-Jin Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Hye Won Lee
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Hyeonji Jeong
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Tae-Yong Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Yeong Gyeong Jang
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Hyo-jeong Hong
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Min-Seong Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Sang Eun Lee
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Yong Guan Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Eun Joo Chung
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Heeji Lim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Sundong Jang
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Kwangwook Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Sung Soon Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Jin Young Ahn
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Chan Kim
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Yoon Soo Park
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Byoungguk Kim, ; Kyong Ran Peck,
| | - Byoungguk Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
- *Correspondence: Byoungguk Kim, ; Kyong Ran Peck,
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Maruyama A, Sawa T, Teramukai S, Katoh N. Adverse reactions to the first and second doses of Pfizer-BioNTech COVID-19 vaccine among healthcare workers. J Infect Chemother 2022; 28:934-942. [PMID: 35361536 PMCID: PMC8947941 DOI: 10.1016/j.jiac.2022.03.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/22/2022] [Accepted: 03/22/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION In the current coronavirus infection 2019 (COVID-19) pandemic, the messenger RNA vaccines have been shown to help protect high-risk groups from COVID-19. Among healthcare workers vaccinated with Pfizer-BioNTech COVID-19 vaccine, a survey was conducted to analyze the relationship between the incidence and severity of adverse reactions after vaccination. METHODS We conducted a prospective self-reported survey of adverse reactions among healthcare workers vaccinated with the Pfizer-BioNTech COVID-19 vaccine (Comirnaty®) in Japan. After the first and second dose of vaccine, local and systemic reactions for 8 days after vaccination were reported by volunteer participants using a website. After receiving vaccination, 374 respondents participated in this matched-pair study. RESULTS Both the incidence and severity of adverse reactions tended to be higher after the second vaccine dose than after the first dose. However, the incidence and numeric rating scale (NRS) score of muscle and skin pain were nearly the same after the first and second doses. In a comparison by sex, women had significantly higher incidence and NRS scores for adverse reactions such as headache, skin pain, erythema, and itching. The results also showed that younger age groups had higher incidence rates and NRS scores for all adverse reactions investigated, except for muscle pain, compared with older age groups. CONCLUSION Some adverse reactions to the Pfizer-BioNTech Comirnaty® COVID-19 vaccine showed gender and age differences. However, generally speaking, all side reactions disappear within a week. Therefore, these side reactions are not a significant concern in recommending vaccination.
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Affiliation(s)
- Ayano Maruyama
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
| | - Teiji Sawa
- Medical Safety Promotion Division of the University Hospital, and Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
| | - Norito Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
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Allergic Reactions to COVID-19 Vaccines: Risk Factors, Frequency, Mechanisms and Management. BioDrugs 2022; 36:443-458. [PMID: 35696066 PMCID: PMC9190452 DOI: 10.1007/s40259-022-00536-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/01/2022]
Abstract
Conventional vaccines have been widely studied, along with their risk of causing allergic reactions. These generally consist of mild local reactions and only rarely severe anaphylaxis. Although all the current COVID-19 vaccines marketed in Europe have been shown to be safe overall in the general population, early post-marketing evidence has shown that mRNA-based vaccines using novel platforms (i.e., lipid nanoparticles) were associated with an increased risk of severe allergic reactions as compared to conventional vaccines. In this paper we performed an updated literature review on frequency, risk factors, and underlying mechanisms of COVID-19 vaccine-related allergies by searching MEDLINE and Google Scholar databases. We also conducted a qualitative search on VigiBase and EudraVigilance databases to identify reports of “Hypersensitivity” and “Anaphylactic reaction” potentially related to COVID-19 vaccines (Comirnaty, Spikevax, Vaxzevria and COVID-19 Janssen Vaccine), and in EudraVigilance to estimate the reporting rates of “Anaphylactic reaction” and “Anaphylactic shock” after COVID-19 vaccination in the European population. We also summarized the scientific societies’ and regulatory agencies’ recommendations for prevention and management of COVID-19 vaccine-related allergic reactions, especially in those with a history of allergy.
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Majumder MAA, Lutfor AB, Rabbi AMF, Alam ABMM, Rahman M, Saha N, Campbell MH, Haque M, Nessa K, Khondoker MU, Das TR, Rahman S, Jahan F, Mashreky SR, Wahab A, Siddiqui MTH, Hinkson‐Lacorbiniere K, Ivy R, Islam R, Haider Y, Omar E, Ahmed SMM, Reza AMS, Daud AKM, Choudhury MUA, Hossain MA, Pappu AM, Jahan N, Razzaque MS. Prevalence of COVID-19 vaccine reactogenicity among Bangladeshi physicians. FASEB Bioadv 2022; 4:379-390. [PMID: 35601057 PMCID: PMC9111157 DOI: 10.1096/fba.2021-00158] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 11/26/2022] Open
Abstract
Increased COVID-19 vaccine hesitancy presents a major hurdle in global efforts to contain the COVID-19 pandemic. This study was designed to estimate the prevalence of adverse events after the first dose of the Covishield (AstraZeneca) vaccine among physicians in Bangladesh. A cross-sectional study was conducted using an online questionnaire for physicians (n = 916) in Bangladesh. Physicians who received at least one dose of the COVID-19 vaccine were included. The study was carried out from April 12 to May 31, 2021. More than 58% of respondents (n = 533) reported one or more adverse events. Soreness of the injected arm (71.9%), tiredness (56.1%), fever (54.4%), soreness of muscles (48.4%), headache (41.5%) and sleeping more than usual (26.8%) were the most commonly reported adverse events. Most vaccine-related reactogenicities were reported by the younger cohorts (<45 years). The majority of respondents reported severity of reactogenicity as "mild," experienced on the day of vaccination, and lasting for 1-3 days. The most common reactogenicity was pain at the injection site; the second most common was tiredness. Almost half (49.2%) of the physicians took acetaminophen (paracetamol) to minimize the effects of vaccine reactogenicity. Multivariate logistic regression analyses showed that physicians with diabetes and hypertension (OR = 2.729 95% CI: 1.282-5.089) and asthma with other comorbidities (OR = 1.885 95% CI: 1.001-3.551) had a significantly higher risk of vaccine-related reactogenicities than physicians without comorbidities. Further safety studies with larger cohorts are required to monitor vaccine safety and provide assurance to potential vaccine recipients.
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Affiliation(s)
- Md. Anwarul Azim Majumder
- Public Health Foundation of BangladeshDhakaBangladesh
- The University of the West IndiesBridgetownBarbados
| | | | | | | | | | - Narayan Saha
- National Institute of Neurosciences & HospitalDhakaBangladesh
| | | | - Mainul Haque
- National Defence University of MalaysiaKuala LumpurMalaysia
| | | | | | | | - Sayeeda Rahman
- American University of Integrative SciencesBridgetownBarbados
| | | | | | - Abrar Wahab
- Centre for Injury Prevention and Research Bangladesh (CIPRB)DhakaBangladesh
| | | | | | - Roksana Ivy
- Shaheed Suhrawardy Medical CollegeDhakaBangladesh
| | - Rezaul Islam
- Shaheed Monsur Ali Medical College HospitalDhakaBangladesh
| | - Yusuf Haider
- Colonel Malek Medical CollegeManikganjBangladesh
| | - Eliza Omar
- Shaheed Suhrawardy Medical CollegeDhakaBangladesh
| | | | | | - A. K. M. Daud
- Jalalabad Ragib‐Rabeya Medical CollegeSylhetBangladesh
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Schoenardie BO, Schoenardie AO, Damke JP. Monoarthritis induced by the Oxford-AstraZenecaR SARS-CoV-2 vaccine. REVISTA COLOMBIANA DE REUMATOLOGÍA 2022. [PMCID: PMC8810414 DOI: 10.1016/j.rcreu.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We describe the case of a 25-year-old woman who presented with monoarthritis of the proximal interphalangeal articulation of the fourth left finger 4 days after receiving the second dose of the Oxford-AstraZenecaR SARS-CoV-2 vaccine. She had no abnormalities in her X-ray or blood exams, but she had a cousin diagnosed with juvenile rheumatoid arthritis. The patient had an excellent response to anti-inflammatory medication, the arthritis was transient and left no sequelae. Studies have shown some vaccines may be associated with acute arthritis, in particular the measles–mumps–rubella vaccine. Young women such as our patient seem to be more susceptible to post-vaccination arthritis. Most of the cases reported were transient and left no articular sequelae, thus we did not contraindicate further doses of the Oxford-AstraZenecaR SARS-CoV-2 vaccine (should they be recommended in the future) in this case.
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Immediate Hypersensitivity Reactions Induced by COVID-19 Vaccines: Current Trends, Potential Mechanisms and Prevention Strategies. Biomedicines 2022; 10:biomedicines10061260. [PMID: 35740283 PMCID: PMC9219714 DOI: 10.3390/biomedicines10061260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/14/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023] Open
Abstract
As the world deals with the COVID-19 pandemic, vaccination remains vital to successfully end this crisis. However, COVID-19-vaccine-induced immediate hypersensitivity reactions presenting with potentially life-threatening systemic anaphylactic reactions are one of the reasons for vaccine hesitancy. Recent studies have suggested that different mechanisms, including IgE-mediated and non-IgE-mediated mast cell activation, may be involved in immediate hypersensitivity. The main culprits triggering hypersensitivity reactions have been suggested to be the excipients of vaccines, including polyethylene glycol and polysorbate 80. Patients with a history of allergic reactions to drugs, foods, or other vaccines may have an increased risk of hypersensitivity reactions to COVID-19 vaccines. Various strategies have been suggested to prevent hypersensitivity reactions, including performing skin tests or in vitro tests before vaccination, administering different vaccines for the primary and following boosters, changing the fractionated doses, or pretreating the anti-IgE antibody. This review discusses the current trends, potential mechanisms, and prevention strategies for COVID-19-vaccine-induced immediate hypersensitivity reactions.
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Hamza MS, Tikamdas R, El Baghdady NS, Sayed M, Elbarazi AS, Badary OA, Elmazar MM. Safety and Effectiveness of COVID-19 Vaccines: Results from a Cross-Sectional Survey among Staff, Workers and Students at an Egyptian University. Vaccines (Basel) 2022; 10:vaccines10060846. [PMID: 35746454 PMCID: PMC9230523 DOI: 10.3390/vaccines10060846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Mass vaccination is the most effective strategy against the spread of the COVID-19 pandemic. However, concerns about the vaccine’s safety and effectiveness remain a huge obstacle to vaccine acceptance. The aim of the present study was to explore different COVID-19 vaccine outcomes, including the development of adverse events and/or COVID-19 infection following COVID-19 vaccination. A cross-sectional study was conducted by distributing an online survey targeting staff and students at the British university in Egypt. A total of 637 participants fully completed the survey. Of these, 609 (95.6%) participants received the COVID-19 vaccine. Only 12.6% of the total vaccinated participants reported COVID-19 infection after vaccination. Of these, only 2.8% reported having severe symptoms while 9.9% reported having no or mild symptoms. The most common side effects reported after the first vs. second dose were headache (36.3% vs. 14.6%), tiredness and fatigue (26.9% vs. 10.7), and fever (25.6% vs. 6.7%). In conclusion, the present study explored different COVID-19 vaccine outcomes where the overall incidence of side effects is higher after the first dose than after the second dose. There is a relationship between COVID-19 vaccines’ side effects and gastrointestinal disorders, gender, and the type of COVID-19 vaccine. Post-vaccination symptoms were more frequently reported in women compared to men and more frequent with viral vector vaccines compared to other types. The effectiveness of different types of COVID-19 vaccines was confirmed by the lower incidence rate of post-vaccination COVID-19 infection.
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Affiliation(s)
- Marwa S. Hamza
- Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo 11837, Egypt; (R.T.); (N.S.E.B.); (M.S.); (A.S.E.); (O.A.B.)
- Correspondence:
| | - Rajiv Tikamdas
- Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo 11837, Egypt; (R.T.); (N.S.E.B.); (M.S.); (A.S.E.); (O.A.B.)
| | - Noha S. El Baghdady
- Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo 11837, Egypt; (R.T.); (N.S.E.B.); (M.S.); (A.S.E.); (O.A.B.)
| | - Moustafa Sayed
- Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo 11837, Egypt; (R.T.); (N.S.E.B.); (M.S.); (A.S.E.); (O.A.B.)
| | - Amani S. Elbarazi
- Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo 11837, Egypt; (R.T.); (N.S.E.B.); (M.S.); (A.S.E.); (O.A.B.)
| | - Osama A. Badary
- Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo 11837, Egypt; (R.T.); (N.S.E.B.); (M.S.); (A.S.E.); (O.A.B.)
| | - Mohamed M. Elmazar
- Pharmacology and Biochemistry Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo 11837, Egypt;
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Bae S, Ko JH, Choi JY, Park WJ, Lim SY, Ahn JY, Song KH, Lee KH, Song YG, Chan Kim Y, Park YS, Choi WS, Jeong HW, Kim SW, Kwon KT, Kang ES, Kim AR, Jang S, Kim B, Kim SS, Jang HC, Choi JY, Kim SH, Peck KR. Heterologous ChAdOx1 and BNT162b2 vaccination induces strong neutralizing antibody responses against SARS-CoV-2 including delta variant with tolerable reactogenicity. Clin Microbiol Infect 2022; 28:1390.e1-1390.e7. [PMID: 35598855 PMCID: PMC9117169 DOI: 10.1016/j.cmi.2022.04.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/11/2022] [Accepted: 04/20/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We assessed humoral responses and reactogenicity following the heterologous vaccination compared to the homologous vaccination groups. METHODS We enrolled healthcare workers (HCWs) who were either vaccinated with ChAdOx1 followed by BNT162b2 (heterologous group) or two doses of ChAdOx1 (ChAdOx1 group) or BNT162b2 (BNT162b2 group). Immunogenicity was assessed by measuring antibody titers against receptor-binding domain (RBD) of SARS-CoV-2 spike protein in all participants and neutralizing antibody titer in 100 participants per group. Reactogenicity was evaluated by a questionnaire-based survey. RESULTS We enrolled 499 HCWs (ChAdOx1, n=199; BNT162b2, n=200; heterologous ChAdOx1/BNT162b2, n=100). The geometric mean titer of anti-RBD antibody at 14 days after the booster dose was significantly higher in the heterologous group (11780.55 BAU/mL [95% CI, 10891.52-12742.14]) than in the ChAdOx1 (1561.51 [1415.03-1723.15]) or BNT162b2 (2895.90 [2664.01-3147.98]) groups (both P value<.001). The neutralizing antibody titer of the heterologous group (geometric mean ND50, 2367.74 [1970.03-2845.74]) was comparable to that of the BNT162b2 group (2118.63 [1755.88-2556.32], P >.05) but higher than that of the ChAdOx1 group (391.77 [326.16-470.59], P value<.001). Compared with those against wild-type SARS-CoV-2, the geometric mean neutralizing antibody titers against the delta variant at 14 days after the boosting were reduced by 3.0-fold in the heterologous group (geometric mean ND50. 872.01 [95% CI, 685.33-1109.54]), 4.0-fold in the BNT162b2 group (337.93 [262.78-434.57]), and 3.2-fold in the ChAdOx1 group (206.61 [144.05-296.34]). The local or systemic reactogenicity after the booster dose in the heterologous group was higher than that of the ChAdOx1 group but comparable to that of the BNT162b2 group. CONCLUSIONS Heterologous ChAdOx1 followed by BNT162b2 vaccination with a 12-week interval induced a robust humoral immune response against SARS-CoV-2 including the delta variant that was comparable to the homologous BNT162b2 vaccination and stronger than the homologous ChAdOx1 vaccination, with a tolerable reactogenicity profile.
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Affiliation(s)
- Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ju-Yeon Choi
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Woo-Jung Park
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Young Ahn
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Kyoung Hwa Lee
- Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Goo Song
- Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Chan Kim
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Yoon Soo Park
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
| | - Hye Won Jeong
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Shin-Woo Kim
- Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ah-Ra Kim
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Sundong Jang
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Byoungguk Kim
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Sung Soon Kim
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Hee-Chang Jang
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Montero-Navarro S, Sánchez-Más J, Salar-Andreu C, Molina-Payá FJ, Orts-Ruiz C, Botella-Rico JM, Tuells J, Rodríguez-Blanco N. Impact of the COVID-19 Pandemic on the Work Activity of Spanish Physical Therapists and Their Response to Vaccination. Front Public Health 2022; 10:877232. [PMID: 35646793 PMCID: PMC9133911 DOI: 10.3389/fpubh.2022.877232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022] Open
Abstract
Due to the COVID-19 pandemic, physical therapists have had to adopt a set of specific protection measures, which have had an impact on their clinical activity and economy. The objective was to evaluate the impact of the COVID-19 pandemic on the work of Spanish physical therapists, as well as their attitudes and predisposition to vaccination. An online questionnaire was divided into five sections: (1) demographic and professional data; (2) labor impact; (3) precautions and infection-control measures; (4) economic impact; and (5) vaccine acceptance and adverse effects. Of the 666 participants, 62.1% showed a reduction in their working hours motivated by: fear of infection (p = 0.007), financial issues (p = 0.002) and being in quarantine or isolation (p < 0.001). Of these, 36.4% were forced to close the clinic, 62.7% requested help from the government, but only 12.04% mentioned that it was adequate. The main prevention measures adopted were the use of gels and masks and, in the private sector, disinfection with ozone or ultraviolet light (p < 0.05). The acceptance of the vaccine was high, 87.5%, being lower among the group over 40 years of age, self-employed, widowed or separated. More adverse effects were mentioned after receiving the AstraZeneca-Oxford vaccine, compared to Pfizer-BioNTech or Moderna. In conclusion, this study assessed for the first time that the COVID-19 pandemic in Spain had a negative impact on work and finances of physical therapists. The vaccine was widely accepted, in part by the economic impact that an infection in the work setting could signify.
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Affiliation(s)
- Sergio Montero-Navarro
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - Jesús Sánchez-Más
- Biomedical Sciences Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - Cristina Salar-Andreu
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - Francisco Javier Molina-Payá
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - Cristina Orts-Ruiz
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - José Martin Botella-Rico
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - José Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Noelia Rodríguez-Blanco
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
- Department of Obstetrics and Gynaecology, Marina Baixa University Hospital, Villajoyosa, Spain
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Kiewisz J, Drzyzga D, Rozanska K, Krzynowek E, Lukaszuk K. Blood Antibody Titers and Adverse Reactions after BNT162b2 mRNA Vaccination. Vaccines (Basel) 2022; 10:vaccines10050640. [PMID: 35632396 PMCID: PMC9144155 DOI: 10.3390/vaccines10050640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 02/01/2023] Open
Abstract
This study aimed to measure, considering a prior history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (SCV-negative/positive), antibodies titer using Elecsys Anti-SARS-CoV-2 S immunoassay (Roche Diagnostics, Mannheim, Germany), in a serum of healthcare workers (HCW) who received two doses of BNT162b2 vaccines. The local and systemic adverse reactions occurrence was checked with a self-reported questionnaire. A total of 60 SCV-negative HCW showed lower antibody titers than those presented by SCV-positive subjects (n = 7). The highest antibody level was detected 8 days after the second dose of vaccine administration. At the same time, the titer was higher in the SCV2 -positive than the SCV2-negative group and comparable after the first dose in those who became infected to the level after the second dose of those who did not. The local and systemic effects in the SCV2-negative and SCV2-positive groups appeared independent of the vaccine dose. After the second dose, systemic reactions were reported more often than the local adverse effects. Whether no effect was observed or whether the response was local or systemic, the antibody level in a specific group remains constant. These results can be helpful in the improvement of vaccination programs, controlling the occurrence of adverse and long-term effects of the vaccination.
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Affiliation(s)
- Jolanta Kiewisz
- Department of Human Histology and Embryology, Collegium Medicum, School of Medicine, University of Warmia and Mazury, 10-082 Olsztyn, Poland;
| | - Damian Drzyzga
- INVICTA Research and Development Center, 81-740 Sopot, Poland; (K.R.); (E.K.)
- Correspondence: ; Tel.: +48-58-58-58-800
| | - Karolina Rozanska
- INVICTA Research and Development Center, 81-740 Sopot, Poland; (K.R.); (E.K.)
| | - Emilia Krzynowek
- INVICTA Research and Development Center, 81-740 Sopot, Poland; (K.R.); (E.K.)
| | - Krzysztof Lukaszuk
- INVICTA Research and Development Center, 81-740 Sopot, Poland; (K.R.); (E.K.)
- Department of Obstetrics and Gynecology Nursing, Medical University of Gdansk, 80-210 Gdansk, Poland;
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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: 37] [Impact Index Per Article: 18.5] [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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Seirafianpour F, Pourriyahi H, Mesgarha MG, Pour Mohammad A, Shaka Z, Goodarzi A. A systematic review on mucocutaneous presentations after COVD-19 vaccination and expert recommendations about vaccination of important immune-mediated dermatologic disorders. Dermatol Ther 2022; 35:e15461. [PMID: 35316551 PMCID: PMC9111423 DOI: 10.1111/dth.15461] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent,in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Homa Pourriyahi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | | | - Arash Pour Mohammad
- Student Research Committee, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zoha Shaka
- Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.,Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Focus on Sex and Gender: What We Need to Know in the Management of Rheumatoid Arthritis. J Pers Med 2022; 12:jpm12030499. [PMID: 35330498 PMCID: PMC8948892 DOI: 10.3390/jpm12030499] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/13/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease, affecting mostly women with a female/male ratio of 3:1. It is characterized by symmetrical polyarthritis, leading to progressive joint damage. Sex differences have been reported in terms of disease course and characteristics, influencing patients reported outcome measures (PROMs) and pain perception, ultimately leading to male–female disparities in treatment response. Notwithstanding, sex and gender discrepancies are still under-reported in clinical trials. Therefore, there is a consistent need for a precise reference of sex and gender issues in RA studies to improve treat-to-target achievement. This narrative review explores the above-mentioned aspects of RA disease, discussing the latest core principles of RA recommendations, from safety issues to early arthritis concept and management, treat-to-target and difficult-to-treat notions, up to the most recent debate on vaccination. Our final purpose is to evaluate how sex and gender can impact current management guidelines and how this issue can be integrated for effective disease control.
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