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Azargoonjahromi A. Immunotherapy in Alzheimer's disease: focusing on the efficacy of gantenerumab on amyloid-β clearance and cognitive decline. J Pharm Pharmacol 2024; 76:1115-1131. [PMID: 38767981 DOI: 10.1093/jpp/rgae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
Gantenerumab, a human monoclonal antibody (mAb), has been thought of as a potential agent to treat Alzheimer's disease (AD) by specifically targeting regions of the amyloid-β (Aβ) peptide sequence. Aβ protein accumulation in the brain leads to amyloid plaques, causing neuroinflammation, oxidative stress, neuronal damage, and neurotransmitter dysfunction, thereby causing cognitive decline in AD. Gantenerumab involves disrupting Aβ aggregation and promoting the breakdown of larger Aβ aggregates into smaller fragments, which facilitates the action of Aβ-degrading enzymes in the brain, thus slowing down the progression of AD. Moreover, Gantenerumab acts as an opsonin, coating Aβ plaques and enhancing their recognition by immune cells, which, combined with its ability to improve the activity of microglia, makes it an intriguing candidate for promoting Aβ plaque clearance. Indeed, the multifaceted effects of Gantenerumab, including Aβ disaggregation, enhanced immune recognition, and improved microglia activity, may position it as a promising therapeutic approach for AD. Of note, reports suggest that Gantenerumab, albeit its capacity to reduce or eliminate Aβ, has not demonstrated effectiveness in reducing cognitive decline. This review, after providing an overview of immunotherapy approaches that target Aβ in AD, explores the efficacy of Gantenerumab in reducing Aβ levels and cognitive decline.
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Abdirakhman T, Balay-Odao EM, Aljofan M, Cruz JP. Highly Educated Mother's Perception of Childhood Vaccination Hesitancy in Kazakhstan: A Thematic Analysis. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2024; 12:86-97. [PMID: 38650958 PMCID: PMC11032417 DOI: 10.30476/ijcbnm.2024.100940.2393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/15/2024] [Accepted: 03/10/2024] [Indexed: 04/25/2024]
Abstract
Background Vaccine hesitancy among parents directly affects the child's vaccination status since they are the legal decision-makers regarding vaccinating their children. The study aimed to describe the perceptions of highly educated Kazakhstani mothers about childhood vaccination hesitancy. Methods The study utilized a thematic analysis to explore the mothers' perceptions. A sample of 95 participants comprehensively answered the free-text questions in an online questionnaire from January to February 2023. The analysis of the free-text responses followed a semantic thematic analysis approach. The data were coded manually. Results From the in-depth analysis of the data, 285 initial codes were extracted. The combination of similar meanings and concept codes led to 14 sub-themes and finally yielded four significant themes: misconceptions about childhood vaccination, fear of the effect of vaccine on children, distrust of the healthcare system, and social learning factors. Conclusion The perceptions of Kazakh mothers about childhood vaccination hesitancy may lead to behaviors of delaying and refusing some or all childhood vaccines. Therefore, motivational and educational strategies can be used by healthcare providers to instill trust in parents about childhood vaccines and their safety and effectiveness.
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Affiliation(s)
- Togzhan Abdirakhman
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | | | - Mohamad Aljofan
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Jonas Preposi Cruz
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
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3
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Willison AG, Pawlitzki M, Lunn MP, Willison HJ, Hartung HP, Meuth SG. SARS-CoV-2 Vaccination and Neuroimmunological Disease: A Review. JAMA Neurol 2024; 81:179-186. [PMID: 38227318 DOI: 10.1001/jamaneurol.2023.5208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Importance The temporal association between the occurrence of neurological diseases, many autoimmune diseases, and vaccination against SARS-CoV-2 has been topically interesting and remains hotly debated both in the medical literature and the clinic. Given the very low incidences of these events both naturally occurring and in relation to vaccination, it is challenging to determine with certainty whether there is any causative association and most certainly what the pathophysiology of that causation could be. Observations Data from international cohorts including millions of vaccinated individuals suggest that there is a probable association between the adenovirus-vectored vaccines and Guillain-Barré syndrome (GBS). Further associations between other SARS-CoV-2 vaccines and GBS or Bell palsy have not been clearly demonstrated in large cohort studies, but the possible rare occurrence of Bell palsy following messenger RNA vaccination is a topic of interest. It is also yet to be clearly demonstrated that any other neurological diseases, such as central nervous system demyelinating disease or myasthenia gravis, have any causative association with vaccination against SARS-CoV-2 using any vaccine type, although it is possible that vaccination may rarely trigger a relapse or worsen symptoms or first presentation in already-diagnosed or susceptible individuals. Conclusions and Relevance The associated risk between SARS-CoV-2 vaccination and GBS, and possibly Bell palsy, is slight, and this should not change the recommendation for individuals to be vaccinated. The same advice should be given to those with preexisting neurological autoimmune disease.
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Affiliation(s)
- Alice Grizzel Willison
- Department of Neurology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Marc Pawlitzki
- Department of Neurology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Michael Peter Lunn
- Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
- Department of Neuromuscular Disease, Institute of Neurology, University College London, London, United Kingdom
| | - Hugh John Willison
- College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Hans-Peter Hartung
- Department of Neurology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Brain and Mind Center, University of Sydney, Sydney, Australia
- Department of Neurology, Palacky University, Olomouc, Czech Republic
| | - Sven Günther Meuth
- Department of Neurology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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Kim HJ, Jeong S, Song J, Park SJ, Oh YH, Jung J, Choi NK, Park SM. Risk of Bell's palsy following SARS-CoV-2 infection: a nationwide cohort study. Clin Microbiol Infect 2023; 29:1581-1586. [PMID: 37611865 DOI: 10.1016/j.cmi.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES Despite some evidence of an increased risk of neurologic symptoms following viral vector COVID-19 vaccine administration, it is unclear whether SARS-CoV-2 infection is associated with Bell's palsy (BP), especially over a long enough follow-up period. METHODS The study population of this nationwide population-based study was derived from the South Korean population, including 11 593 365 and 36 565 099 participants with and without COVID-19, respectively. The Fine and Gray's regression model was utilized to calculate the adjusted subdistribution hazard ratio (aSHR), considering death as a competing risk, to assess the association between SARS-CoV-2 infection and the risk of BP. All participants were followed up from 1 December 2021, until the incident BP, SARS-CoV-2 infection, death, or 31 March 2022. Subgroup analyses were conducted based on participants' vaccination status (completion of the primary series vs. unvaccinated). RESULTS COVID-19 was associated with an increased risk of BP in all participants (aSHR, 1.24; CI, 1.19-1.29). However, the size of the COVID-19-related BP risk was significantly lower among those who completed the primary series of the COVID-19 vaccine (aSHR, 1.20; 95% CI, 1.15-1.25) compared to those who were unvaccinated (aSHR, 1.84; 95% CI, 1.59-2.12; p for interaction: <0.001). The severity of COVID-19 exhibited a gradual escalation in BP risk for both vaccinated and unvaccinated individuals. DISCUSSION While both unvaccinated individuals and those who completed the primary series of the COVID-19 vaccine may be at an increased risk of developing BP due to COVID-19, the risk appears to be lower among those who completed the vaccination.
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Affiliation(s)
- Hye Jun Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam, South Korea
| | - Jihun Song
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - Sun Jae Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, South Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Nam-Kyong Choi
- Department of Health Convergence College of Science and Industry Convergence, Ewha Womans University, Seoul, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea; Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea.
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Sadat Larijani M, Doroud D, Banifazl M, Karami A, Bavand A, Ashrafian F, Ramezani A. A landscape on disorders following different COVID-19 vaccination: a systematic review of Iranian case reports. Eur J Med Res 2023; 28:542. [PMID: 38008729 PMCID: PMC10676592 DOI: 10.1186/s40001-023-01531-7] [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: 04/28/2023] [Accepted: 11/16/2023] [Indexed: 11/28/2023] Open
Abstract
There have been massive studies to develop an effective vaccine against SARS-CoV-2 which fortunately led to manage the recent pandemic, COVID-19. According to the quite rapidly developed vaccines in a fast window time, large investigations to assess the probable vaccine-related adverse events are crucially required. COVID-19 vaccines are available of different platforms and the primary clinical trials results presented acceptable safety profile of the approved vaccines. Nevertheless, the long-term assessment of the adverse events or rare conditions need to be investigated. The present systematic review, aimed at classification of probable vaccine-related unsolicited adverse events in Iranian population through the data collection of the published case report studies.The related published case reports were explored via PubMed, Web of Science and Google scholar according to the available published data up to 14th Dec, 2022 using PRISMA guideline. Out of 437 explored studies, the relevant data were fully investigated which totally led to 40 studies, including 64 case reports with a new onset of a problem post-vaccination. The cases were then classified according to the various items, such as the type of adverse event and COVID-19 vaccines.The reported COVID-19 vaccines in the studied cases included BBIBP-CorV, ChAdOx1-S, Sputnik V and COVAXIN. The results showed that the adverse events presented in 8 different categories, including cutaneous involvements in 43.7% (n = 28), neurologic problems (n = 16), blood/vessel involvement (n = 6), cardiovascular involvement (n = 5), ocular disorders (n = 4), liver disorder/failure (n = 2), graft rejection (n = 2) and one metabolic disorder. Notably, almost 60% of the cases had no comorbidities. Moreover, the obtained data revealed nearly half of the incidences occurred after the first dose of injection and the median duration of improvement after the symptom was 10 days (range: 2-120). In addition, 73% of all the cases were either significantly improved or fully recovered. Liver failure following ChAdOx1-S vaccination was the most serious vaccine adverse event which led to death in two individuals with no related medical history.Although the advantages of COVID-19 vaccination is undoubtedly significant, individuals including with a history of serious disease, comorbidities and immunodeficiency conditions should be vaccinated with the utmost caution. This study provides a comprehensive overview and clinical implications of possible vaccine-related adverse events which should be considered in further vaccination strategies. Nevertheless, there might be a bias regarding potential under-reporting and missing data of the case reports included in the present study. Although the reported data are not proven to be the direct vaccination outcomes and could be a possible immune response over stimulation, the people the population with a medium/high risk should be monitored after getting vaccinated against COVID-19 of any platforms. This could be achieved by a carefull attention to the subjects ' medical history and also through consulting with healthcare providers before vaccination.
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Affiliation(s)
- Mona Sadat Larijani
- Clinical Research Department, Pasteur Institute of Iran, No: 69, Pasteur Ave, Tehran, 1316943551, Iran
| | - Delaram Doroud
- Quality Control Department, Production and Research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Banifazl
- Iranian Society for Support of Patients With Infectious Disease, Tehran, Iran
| | - Afsaneh Karami
- Department of Infectious Disease, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Anahita Bavand
- Clinical Research Department, Pasteur Institute of Iran, No: 69, Pasteur Ave, Tehran, 1316943551, Iran
| | - Fatemeh Ashrafian
- Clinical Research Department, Pasteur Institute of Iran, No: 69, Pasteur Ave, Tehran, 1316943551, Iran
| | - Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, No: 69, Pasteur Ave, Tehran, 1316943551, Iran.
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Lin JY, Bai BX. SAPHO syndrome after COVID-19 vaccination complicated with thyroid function abnormalities: a case report and literature review. Immunol Res 2023; 71:781-784. [PMID: 37079220 PMCID: PMC10117263 DOI: 10.1007/s12026-023-09381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/01/2023] [Indexed: 04/21/2023]
Affiliation(s)
- Jia-Ying Lin
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang, Harbin, 150000, China
| | - Bing-Xue Bai
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang, Harbin, 150000, China.
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7
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Pujol FH, Toyé RM, Loureiro CL, Jaspe RC, Chemin I. Hepatitis B eradication: vaccine as a key player. Am J Transl Res 2023; 15:4971-4983. [PMID: 37692960 PMCID: PMC10492071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Despite the availability of a highly effective and safe vaccine against hepatitis B virus (HBV) infection for 40 years, still almost 300 million persons are estimated to be chronically infected by this virus worldwide. The World Health Organization (WHO) has proposed a plan for hepatitis elimination by 2030. However, several factors, such as the reduction and limitation in vaccination campaigns or vaccine hesitancy (VH) in some regions of the World, might have played a role in limiting the worldwide coverage of hepatitis B prophylaxis. This review aims to describe which factors, such as VH, may be hampering the WHO 2030 goal for hepatitis B eradication. METHODS The review describes the development and characteristics of the HBV vaccine, from the first plasma-derived to the recombinant one. Eventual limitations in its effectiveness and particularly VH were reviewed. RESULTS The apparent pitfalls of the HBV vaccine, such as long-term effectiveness, vaccine-escape mutants, and adverse effects, were proven not to be a concern for this vaccine. However, VH persists and was even intensified by the COVID-19 pandemic. CONCLUSIONS Many barriers still exist, such as vaccine availability, lack of awareness of the benefits of HBV vaccination, and VH. HBV VH seems to be eventually overcome in many settings with active education campaigns and information, stressing the importance of developing these strategies to achieve the 2030 goal of the WHO.
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Affiliation(s)
- Flor Helene Pujol
- Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular (CMBC), Instituto Venezolano de Investigaciones Científicas (IVIC)1020A Caracas, Venezuela
- Collegium de Lyon, Institut d’Etudes Avancées, Université Lyon 269003 Lyon, France
| | - Rayana Maryse Toyé
- Institut National de la Santé et de la Recherche Médicale (Inserm) U1052, Centre de Recherche en Cancérologie de Lyon (CRCL)151 Cours Albert Thomas, 69003 Lyon, France
| | - Carmen Luisa Loureiro
- Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular (CMBC), Instituto Venezolano de Investigaciones Científicas (IVIC)1020A Caracas, Venezuela
| | - Rossana Celeste Jaspe
- Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular (CMBC), Instituto Venezolano de Investigaciones Científicas (IVIC)1020A Caracas, Venezuela
| | - Isabelle Chemin
- Institut National de la Santé et de la Recherche Médicale (Inserm) U1052, Centre de Recherche en Cancérologie de Lyon (CRCL)151 Cours Albert Thomas, 69003 Lyon, France
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8
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Hu C, Wei KC, Wang WH, Chang YC, Huang YT. Association of Influenza Vaccination With Risk of Bell Palsy Among Older Adults in Taiwan. JAMA Otolaryngol Head Neck Surg 2023; 149:726-734. [PMID: 37347468 PMCID: PMC10288376 DOI: 10.1001/jamaoto.2023.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/28/2023] [Indexed: 06/23/2023]
Abstract
Importance Annual administration of the influenza vaccine (fluVc) is currently the most effective method of preventing the influenza virus in older adults. However, half of adults older than 65 years remain unvaccinated in Taiwan, possibly because of concern about adverse events, such as Bell palsy (BP). Currently, studies on the association between fluVc and risk of BP are inconsistent. Objective To determine whether the incidence of BP increases following fluVc in older adults. Design, Setting, and Participants A self-controlled case series study design was used. Days 1 through 7, days 8 through 14, days 15 through 30, and days 31 through 60 following fluVc were identified as risk intervals, and days 61 through 180 were considered the control interval. A total of 4367 vaccinated individuals aged 65 years or older who developed BP within 6 months following fluVc were enrolled. Population-based retrospective claims data were obtained between 2010 and 2017; data were analyzed from April 2022 through September 2022. Exposure Government-funded seasonal fluVc. Main Outcomes and Measures The outcome of interest was BP onset in risk intervals compared with control intervals. Three or more consecutive diagnoses of BP within 60 days following fluVc were used as the definition of a patient with BP. Poisson regression was used to analyze the incidence rate ratio (IRR) of risk intervals compared with control intervals. Results In total, 13 261 521 patients who received the fluVc were extracted from the National Health Insurance Research Database in Taiwan from January 1, 2010, to December 31, 2017. Of those, 7 581 205 patients older than 65 years old met the inclusion criteria. The number of patients with BP diagnosed within 6 months following fluVc enrolled for risk analysis was 4367 (mean [SD] age, 74.19 [5.97] years; 2349 [53.79%] female patients). The incidence rate of BP among all observed fluVc older adults was 57.87 per 100 000 person-years. The IRRs for BP on days 1 through 7, days 8 through 14, and days 15 through 30 were 4.18 (95% CI, 3.82-4.59), 2.73 (95% CI, 2.45-3.05), and 1.67 (95% CI, 1.52-1.84), respectively. However, there was no increase during days 31 through 60 (IRR, 1.06; 95% CI, 0.97-1.16). The postvaccination risk of BP was consistent across all subgroups stratified by sex, age group, and baseline conditions. Conclusions and Relevance The present self-controlled case series indicated that the risk of BP in individuals older than 65 years increased within the first month, especially within the first week, following fluVc. But overall, the adverse event rate of BP was low, and considering the morbidity and mortality of influenza infection, the benefits of fluVc still outweigh the risks.
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Affiliation(s)
- Chin Hu
- Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kai-Che Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Hwa Wang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - Yu-Chia Chang
- Department of Long Term Care, College of Health and Nursing, National Quemoy University, Kinmen County, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Department of Medical Research & Development, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan
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9
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Moezinia C, Harbinson EB, Maweni RM. Concurrent facial and trigeminal nerve palsies in a child following COVID-19 vaccination with the Pfizer vaccine. BMJ Case Rep 2023; 16:16/1/e253302. [PMID: 36717162 PMCID: PMC9887692 DOI: 10.1136/bcr-2022-253302] [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: 01/31/2023] Open
Abstract
We present the case of a teenaged boy who attended our Ear, Nose and Throat Emergency clinic with a left-sided lower motor neuron (LMN) facial nerve paralysis associated with sensory loss in the distribution of the ophthalmic (V1) and maxillary (V2) divisions of the trigeminal nerve. This happened 3 days following a first dose of the Pfizer-BioNTech BNT162b2 vaccine. He had a House-Brackmann grade V facial palsy, with marked inability to close the left eye. He was treated with a 10-day course of oral steroids and referred to ophthalmology for eye care. He had an MRI scan of the head, which revealed no space occupying lesions or other abnormalities. Over the 6-week period of follow-up, the patient's V1 and V2 sensation gradually resolved, along with improvement of his LMN facial nerve palsy to House-Brackmann grade 3. Despite the potential temporal relationship, it is not possible to establish a causal relationship between the patient's symptoms and the Pfizer-BioNTech BNT162b2 vaccine, thus further research is required.
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Affiliation(s)
- Carine Moezinia
- Department of Medicine, Royal Free Hospital, London, UK,Department of Otorhinolaryngology, Wexham Park Hospital, Slough, UK
| | | | - Robert M Maweni
- Department of Otorhinolaryngology, Wexham Park Hospital, Slough, UK
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10
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Lamprinou M, Sachinidis A, Stamoula E, Vavilis T, Papazisis G. COVID-19 vaccines adverse events: potential molecular mechanisms. Immunol Res 2023; 71:356-372. [PMID: 36607502 PMCID: PMC9821369 DOI: 10.1007/s12026-023-09357-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/01/2023] [Indexed: 01/07/2023]
Abstract
COVID-19 is an infectious disease caused by a single-stranded RNA (ssRNA) virus, known as SARS-CoV-2. The disease, since its first outbreak in Wuhan, China, in December 2019, has led to a global pandemic. The pharmaceutical industry has developed several vaccines, of different vector technologies, against the virus. Of note, among these vaccines, seven have been fully approved by WHO. However, despite the benefits of COVID-19 vaccination, some rare adverse effects have been reported and have been associated with the use of the vaccines developed against SARS-CoV-2, especially those based on mRNA and non-replicating viral vector technology. Rare adverse events reported include allergic and anaphylactic reactions, thrombosis and thrombocytopenia, myocarditis, Bell's palsy, transient myelitis, Guillen-Barre syndrome, recurrences of herpes-zoster, autoimmunity flares, epilepsy, and tachycardia. In this review, we discuss the potential molecular mechanisms leading to these rare adverse events of interest and we also attempt an association with the various vaccine components and platforms. A better understanding of the underlying mechanisms, according to which the vaccines cause side effects, in conjunction with the identification of the vaccine components and/or platforms that are responsible for these reactions, in terms of pharmacovigilance, could probably enable the improvement of future vaccines against COVID-19 and/or even other pathological conditions.
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Affiliation(s)
- Malamatenia Lamprinou
- Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124 Greece
| | - Athanasios Sachinidis
- 4th Department of Internal Medicine, School of Medicine, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Stamoula
- Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124 Greece
| | - Theofanis Vavilis
- Laboratory of Medical Biology and Genetics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece ,Department of Dentistry, School of Medicine, European University of Cyprus, Nicosia, Cyprus
| | - Georgios Papazisis
- Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124 Greece ,Clinical Research Unit, Special Unit for Biomedical Research and Education (SUBRE), School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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11
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Mohseni Afshar Z, Sharma A, Babazadeh A, Alizadeh-Khatir A, Sio TT, Taghizadeh Moghadam MA, Tavakolli Pirzaman A, Mojadad A, Hosseinzadeh R, Barary M, Ebrahimpour S. A review of the potential neurological adverse events of COVID-19 vaccines. Acta Neurol Belg 2023; 123:9-44. [PMID: 36385246 PMCID: PMC9668235 DOI: 10.1007/s13760-022-02137-2] [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: 03/17/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022]
Abstract
Despite the advantages of getting access to the coronavirus disease 2019 (COVID-19) vaccines, their potential ability to induce severe adverse events (AEs) has been a significant concern. Neurological complications are significant among the various adverse events following immunization (AEFI) due to their likely durability and debilitating sequelae. Neurological AEs following COVID-19 vaccination can either exacerbate or induce new-onset neuro-immunologic diseases, such as myasthenia gravis (MG) and Guillain-Barre syndrome (GBS). The more severe spectrum of AEs post-COVID19 vaccines has included seizures, reactivation of the varicella-zoster virus, strokes, GBS, Bell's palsy, transverse myelitis (TM), and acute disseminated encephalomyelitis (ADEM). Here, we discuss each of these neurological adverse effects separately.
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Affiliation(s)
- Zeinab Mohseni Afshar
- grid.412112.50000 0001 2012 5829Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akanksha Sharma
- grid.417468.80000 0000 8875 6339Department of Neurology, Mayo Clinic, Scottsdale, AZ USA
| | - Arefeh Babazadeh
- grid.411495.c0000 0004 0421 4102Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Alizadeh-Khatir
- grid.411495.c0000 0004 0421 4102Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Terence T. Sio
- grid.417468.80000 0000 8875 6339Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ USA
| | | | - Ali Tavakolli Pirzaman
- grid.411495.c0000 0004 0421 4102Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Ahmadreza Mojadad
- grid.411495.c0000 0004 0421 4102Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Rezvan Hosseinzadeh
- grid.411495.c0000 0004 0421 4102Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Barary
- Student Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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12
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Monte G, Pro S, Ursitti F, Ferilli MAN, Moavero R, Papetti L, Sforza G, Bracaglia G, Vigevano F, Palma P, Valeriani M. Case report: A pediatric case of Bickerstaff brainstem encephalitis after COVID-19 vaccination and Mycoplasma pneumoniae infection: Looking for the culprit. Front Immunol 2022; 13:987968. [PMID: 36032138 PMCID: PMC9411636 DOI: 10.3389/fimmu.2022.987968] [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: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 01/17/2023] Open
Abstract
Bickerstaff brainstem encephalitis (BBE) is a rare, immune-mediated disease characterized by the acute onset of external ophthalmoplegia, ataxia, and consciousness disturbance. It has a complex multifactorial etiology, and a preceding infectious illness is seen in the majority of cases. Immune-mediated neurological syndromes following COVID-19 vaccination have been increasingly described. Here we report the case of a child developing BBE 2 weeks after COVID-19 vaccination. Despite nerve conduction studies and CSF analysis showing normal results, BBE was diagnosed on clinical ground and immunotherapy was started early with a complete recovery. Later, diagnosis was confirmed by positive anti-GQ1b IgG in serum. Even if there was a close temporal relationship between disease onset and COVID-19 vaccination, our patient also had evidence of a recent Mycoplasma pneumoniae infection that is associated with BBE. Indeed, the similarity between bacterial glycolipids and human myelin glycolipids, including gangliosides, could lead to an aberrantly immune activation against self-antigens (i.e., molecular mimicry). We considered the recent Mycoplasma pneumoniae infection a more plausible explanation of the disease onset. Our case report suggests that suspect cases of side effects related to COVID-19 vaccines need a careful evaluation in order to rule out well-known associated factors before claiming for a causal relationship.
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Affiliation(s)
- Gabriele Monte
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- *Correspondence: Gabriele Monte,
| | - Stefano Pro
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Fabiana Ursitti
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Michela Ada Noris Ferilli
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Romina Moavero
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Child Neurology and Psychiatry Unit, Department of System Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Laura Papetti
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giorgia Sforza
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giorgia Bracaglia
- Department of Diagnostics and Laboratory Medicine, Medical Laboratory Unit, Unit of Allergy and Autoimmunity, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Federico Vigevano
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Paolo Palma
- Academic Department of Pediatrics (DPUO), Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Chair of Pediatrics, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Massimiliano Valeriani
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Denmark Neurology Unit, Aalborg, Denmark
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13
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Shahsavarinia K, Mahmoodpoor A, Sadeghi-Ghyassi F, Nedayi A, Razzaghi A, Zehi Saadat M, Salehi-Pourmehr H. Bell's Palsy and COVID-19 Vaccination: A Systematic Review. Med J Islam Repub Iran 2022; 36:85. [PMID: 36128311 PMCID: PMC9448503 DOI: 10.47176/mjiri.36.85] [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: 01/27/2022] [Accepted: 07/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Bell's palsy is a rare adverse event reported in COVID-19 vaccines. Given the importance of neurological manifestations, the necessity to highlight and scrutinize the incidence of them following COVID-19 vaccination is needed. This study aimed to systematically review the reported cases of Bell's palsy following vaccination against COVID-19. Methods: This systematic review is conducted based on the Cochrane Collaboration Handbook and PRISMA Statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) and using the Joanna Briggs Institute (JBI) methodology for systematic reviews. The inclusion criteria for the included published studies were patient age ≥18 years, history of Bell's palsy after COVID-19 vaccination and established diagnosis in the patients with COVID-19 vaccination. The exclusion criteria were repeated cases and missing clinical information. The search strategy aimed to find both published and unpublished studies in August 2021 and updated by hand searching in May 2022 using the identified keywords and index terms in Cochrane Library, MEDLINE (PubMed), Web of Science, Scopus, ProQuest, and Google scholar. Finally, the reference lists of all identified reports and articles were searched for additional studies. The JBI critical appraisal tools for case reports or case series were used to assess the risk of bias in the included studies. Results: During the electronic search, hand search, and reference check, we identified 1281 citations, and in hand searching, we detected additional 15 studies. After omitting duplicated citations and assessing the title, abstract, and full text 15 case-report and two case-series studies were included for the critical appraisal process and were included in this study. Pfizer and Moderna vaccines were the most common vaccines among articles that reported the cases of Bell's palsy. Left-sided paralysis was more common than right-sided paralysis. The interval between receiving the vaccine and the onset of facial weakness was between 1 and 48 days. Conclusion: Further studies with larger sample sizes are necessary to assess the association between Bell's palsy and the dose-response of the COVID-19 vaccine.
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Affiliation(s)
- Kavous Shahsavarinia
- Emergency and trauma care research center, Tabriz University of Medical Sciences, Tabriz, Iran,Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ata Mahmoodpoor
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Sadeghi-Ghyassi
- Faculty of Management & Medical Informatics Tabriz University of Medical Science, Tabriz, Iran
| | - Arezou Nedayi
- Emergency and trauma care research center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Razzaghi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Zehi Saadat
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Salehi-Pourmehr
- Research center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding author: Dr Hanieh Salehi-Pourmehr,
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14
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Skovbo Hoffmann S, Thiesson EM, Johansen JD, Hviid A. Risk factors for granulomas in children following immunisation with aluminium adsorbed vaccines: A Danish population-based cohort study. Contact Dermatitis 2022; 87:430-438. [PMID: 35778959 DOI: 10.1111/cod.14180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Aluminium adsorbed vaccines may in some children cause severely itching nodules at the injection site, known as vaccination granulomas. OBJECTIVE To investigate vaccine-, child- and maternal level risk factors for the development of vaccination granulomas following immunisation with aluminium adsorbed vaccines. METHODS A Danish population-based cohort study with 553 932 children born in Denmark from 1 January 2009 to 31 December 2018, vaccinated with an aluminium adsorbed vaccine during the first year of life, followed until 31 December 2020. Poisson regression was used to estimate granuloma rate ratios according to type of adjuvant, accumulated dose of aluminium, timing of vaccination appointments, sex, gestational age, having siblings with granulomas, maternal age, and maternal ethnicity. RESULTS We identified 1 901 vaccination granuloma cases (absolute risk, 0.34%). Among vaccine level factors, revaccination (third vs first vaccination appointment, adjusted rate ratio [RR] 1.26, 95% confidence interval [CI] 1.03-1.55), the specific adjuvant used (aluminium phosphate vs hydroxide, RR 0.58, 95% CI 0.48-0.70) and dosage (≥1.0 mg vs <1.0 mg, RR 1.34, 95% CI 1.19-1.52) were associated with risk of granulomas; the timing of vaccination appointments was not. Among child level factors, female sex (vs males, RR 1.12, 95% CI, 1.02-1.22), prematurity (vs term birth, RR 0.71, 95% CI, 0.54-0.93) and having sibling(s) with granulomas (vs no siblings with granulomas, RR 46.15, 95% CI, 33.67-63.26) were associated with risk of granulomas. Among maternal level factors, non-Danish ethnicity (vs. Danish, RR 0.51, 95% CI, 0.42-0.63) and young maternal age (<20 yrs. vs 20-39 yrs., RR 0.46, 95% CI 0.25-0.83) were associated with risk of granulomas. CONCLUSIONS Several risk factors for vaccination granulomas at both the vaccine, child, and maternal level, was identified. Reducing the dose of aluminium or replacing aluminium hydroxide with aluminium phosphate could reduce the risk of granulomas. However, this must be balanced against the potential for reduced immunogenicity.
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Affiliation(s)
- Stine Skovbo Hoffmann
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | | | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Anders Hviid
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Pharmacovigilance Research Centre, Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
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15
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Ameratunga R. SARS-CoV-2 the ASIA virus (autoimmune/autoinflammatory syndrome induced by adjuvants), the risk of infertility and vaccine hesitancy. Expert Rev Vaccines 2022; 21:1177-1184. [PMID: 35695410 DOI: 10.1080/14760584.2022.2089120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION COVID-19 has had a calamitous impact on the global community. The current death toll far exceeds 6 million and large numbers of patients are experiencing long-term medical and psychiatric morbidity from the infection. The immunopathology of severe COVID-19 is now better understood. In severely affected patients, there is a chaotic, destructive immune response triggered by SARS-CoV-2, where autoimmunity features prominently. AREAS COVERED COVID-19 vaccines ensure a coordinated, balanced immune response to future SARS-CoV-2 infection. The rapid global deployment of effective COVID-19 vaccines has been hindered by financial, logistical and political barriers. Of concern is increasing vaccine hesitancy caused by unfounded conspiracy theories of vaccine adverse effects, often fueled by misinformation and disinformation on social media. EXPERT OPINION This perspective discusses the potential impact of the so-called autoimmune/autoinflammatory syndrome caused by adjuvants (ASIA) on COVID-19 vaccine uptake. Proponents of the ASIA syndrome have inappropriately linked infertility to HPV vaccines and have recently suggested antigenic cross-reactivity between SARS-CoV-2 and ovarian follicles. COVID-19 vaccines have also been linked to ASIA and unfounded fear of infertility is a leading cause of vaccine hesitancy. Vaccine hesitancy caused by spurious disorders such as ASIA are likely to harm individuals and delay global vaccination efforts leading to emergence of vaccine and monoclonal antibody resistant mutants, thereby prolonging the COVID-19 pandemic.
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Affiliation(s)
- Rohan Ameratunga
- Department of Clinical immunology, Auckland Hospital, Park Rd, Grafton, Auckland 1010, New Zealand.,Department of Virology and Immunology, Auckland Hospital, Park Rd, Grafton, Auckland 1010, New Zealand.,Department of Molecular Medicine and Pathology, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland
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16
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Bell's palsy as a possible complication of mRNA-1273 (Moderna) vaccine against COVID-19. Ann Med Surg (Lond) 2022; 78:103897. [PMID: 35663122 PMCID: PMC9151463 DOI: 10.1016/j.amsu.2022.103897] [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] [Received: 04/19/2022] [Revised: 05/25/2022] [Accepted: 05/29/2022] [Indexed: 11/20/2022] Open
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17
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Zavari A, Hamidabad NM, Hassanzadeh M. Aseptic meningitis following AZD1222 COVID-19 vaccination. Am J Emerg Med 2022; 55:225.e5-225.e6. [PMID: 34955313 PMCID: PMC8684093 DOI: 10.1016/j.ajem.2021.12.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 01/19/2023] Open
Abstract
The AZD1222 is one of the vaccines used against coronavirus disease 2019 (COVID-19), which is currently being used in many countries worldwide. Some important neurological side effects have been reported in association with this vaccine, but aseptic meningitis has not yet been reported. Herein, we report a case of aseptic meningitis in a 26-year-old health care worker, following the first dose of the AZD1222 vaccine.
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Affiliation(s)
- Arefeh Zavari
- School of Medicine, Department of Internal Medicine, Rasoul-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Negin Mahmoudi Hamidabad
- School of Medicine, Department of Internal Medicine, Rasoul-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; School of Medicine, Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Morteza Hassanzadeh
- School of Medicine, Department of Internal Medicine, Rasoul-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
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18
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Wang MTM, Niederer RL, McGhee CNJ, Danesh-Meyer HV. COVID-19 Vaccination and The Eye. Am J Ophthalmol 2022; 240:79-98. [PMID: 35227700 PMCID: PMC8875854 DOI: 10.1016/j.ajo.2022.02.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 11/18/2022]
Abstract
Purpose To summarize the current evidence on COVID-19 vaccine-associated ocular adverse events. Design Narrative literature review. Methods The literature search was conducted in August 2021 using 4 electronic databases: MEDLINE, EMBASE, PubMed, and the Cochrane Database of Systematic Reviews. Population-based pharmacovigilance surveillance data were retrieved from all governmental agencies participating in the World Health Organization (WHO) Programme for International Drug Monitoring with publicly available online adverse event databases in English. Results A small number of case reports have documented uveitis flares and acute corneal graft rejection occurring within the first 3 weeks following immunization, while isolated cases of optic neuropathies, retinal conditions, scleritis, and herpetic eye disease have also been highlighted. However, data from population-based pharmacovigilance surveillance systems suggest that the prevalence of vaccination-associated ocular adverse events are very rare. Conclusions Vaccination-associated ocular adverse events are rare, and there is currently no substantive evidence to counterweigh the overwhelming benefits of COVID-19 immunization in patients with pre-existing ophthalmic conditions.
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Affiliation(s)
- Michael T M Wang
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Rachael L Niederer
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Charles N J McGhee
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Helen V Danesh-Meyer
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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19
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Russo R, Gasparini G, Cozzani E, D’Agostino F, Parodi A. Absolving COVID-19 Vaccination of Autoimmune Bullous Disease Onset. Front Immunol 2022; 13:834316. [PMID: 35251024 PMCID: PMC8895245 DOI: 10.3389/fimmu.2022.834316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/24/2022] [Indexed: 01/14/2023] Open
Affiliation(s)
- Roberto Russo
- Dipartimento di Scienze della Salute (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy
- Department of Dermatology, San Martino Polyclinic Hospital, Genoa, Italy
| | - Giulia Gasparini
- Dipartimento di Scienze della Salute (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy
- Department of Dermatology, San Martino Polyclinic Hospital, Genoa, Italy
| | - Emanuele Cozzani
- Dipartimento di Scienze della Salute (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy
- Department of Dermatology, San Martino Polyclinic Hospital, Genoa, Italy
| | - Federica D’Agostino
- Dipartimento di Scienze della Salute (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy
- Department of Dermatology, San Martino Polyclinic Hospital, Genoa, Italy
| | - Aurora Parodi
- Dipartimento di Scienze della Salute (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy
- Department of Dermatology, San Martino Polyclinic Hospital, Genoa, Italy
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20
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Herpes zoster related hospitalization after inactivated (CoronaVac) and mRNA (BNT162b2) SARS-CoV-2 vaccination: A self-controlled case series and nested case-control study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 21:100393. [PMID: 35128500 PMCID: PMC8808060 DOI: 10.1016/j.lanwpc.2022.100393] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Stimulation of immunity by vaccination may elicit adverse events. There is currently inconclusive evidence on the relationship between herpes zoster related hospitalization and COVID-19 vaccination. This study aimed to evaluate the effect of inactivated virus (CoronaVac, Sinovac) and mRNA (BNT162b2, BioNTech/Fosun Pharma) COVID-19 vaccine on the risk of herpes zoster related hospitalization. Methods Self-controlled case series (SCCS) analysis was conducted using the data from the electronic health records in Hospital Authority and COVID-19 vaccination records in the Department of Health in Hong Kong. We conducted the SCCS analysis including patients with a first primary diagnosis of herpes zoster in the hospital inpatient setting between February 23 and July 31, 2021. A confirmatory analysis by nested case-control method was also conducted. Each herpes zoster case was randomly matched with ten controls according to sex, age, Charlson comorbidity index, and date of hospital admission. Conditional Poisson regression and logistic regression models were used to assess the potential excess rates of herpes zoster after vaccination. Findings From February 23 to July 31, 2021, a total of 16 and 27 patients were identified with a first primary hospital diagnosis of herpes zoster within 28 days after CoronaVac and BNT162b2 vaccinations. The incidence of herpes zoster was 7.9 (95% Confidence interval [CI]: 5.2-11.5) for CoronaVac and 7.1 (95% CI: 4.1-11.5) for BNT162b2 per 1,000,000 doses administered. In SCCS analysis, CoronaVac vaccination was associated with significantly higher risk of herpes zoster within 14 days after first dose (adjusted incidence rate ratio [aIRR]=2.67, 95% CI: 1.08-6.59) but not in other periods afterwards compared to the baseline period. Regarding BNT162b2 vaccination, a significantly increased risk of herpes zoster was observed after first dose up to 14 days after second dose (0-13 days after first dose: aIRR=5.23, 95% CI: 1.61-17.03; 14-27 days after first dose: aIRR=5.82, 95% CI: 1.62-20.91; 0-13 days after second dose: aIRR=5.14, 95% CI: 1.29-20.47). Using these relative rates, we estimated that there has been an excess of approximately 5 and 7 cases of hospitalization as a result of herpes zoster after every 1,000,000 doses of CoronaVac and BNT162b2 vaccination, respectively. The findings in the nested case control analysis showed similar results. Interpretation We identified an increased risk of herpes zoster related hospitalization after CoronaVac and BNT162b2 vaccinations. However, the absolute risks of such adverse event after CoronaVac and BNT162b2 vaccinations were very low. In locations where COVID-19 is prevalent, the protective effects on COVID-19 from vaccinations will greatly outweigh the potential side effects of vaccination. Funding The project was funded by Research Grant from the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region (Ref. No.COVID19F01). FTTL (Francisco Tsz Tsun Lai) and ICKW (Ian Chi Kei Wong)'s posts were partly funded by D24H; hence this work was partly supported by AIR@InnoHK administered by Innovation and Technology Commission.
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21
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Mirmosayyeb O, Barzegar M, Rezaei M, Baharlouie N, Shaygannejad V. Bell's palsy after Sputnik V COVID-19 (Gam-COVID-Vac) vaccination. Clin Case Rep 2022; 10:e05468. [PMID: 35228880 PMCID: PMC8867017 DOI: 10.1002/ccr3.5468] [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: 10/05/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/22/2022] Open
Abstract
A possible association between Bell's palsy and COVID-19 vaccination has been suggested previously. Here, we report two cases of facial nerve hemiparalysis following the Sputnik V COVID-19 vaccination in a 27-year-old female patient and a 58-year-old male patient who were both clinically diagnosed with Bell's palsy.
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Affiliation(s)
- Omid Mirmosayyeb
- Department of NeurologySchool of MedicineIsfahan University of Medical SciencesIsfahanIran
- Isfahan Neurosciences Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Mahdi Barzegar
- Department of NeurologySchool of MedicineIsfahan University of Medical SciencesIsfahanIran
- Isfahan Neurosciences Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Mina Rezaei
- Isfahan Neurosciences Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Negar Baharlouie
- Dental Student Research CenterSchool of DentistryIsfahan University of Medical SciencesIsfahanIran
| | - Vahid Shaygannejad
- Department of NeurologySchool of MedicineIsfahan University of Medical SciencesIsfahanIran
- Isfahan Neurosciences Research CenterIsfahan University of Medical SciencesIsfahanIran
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22
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Cabral G, Gonçalves C, Serrazina F, Sá F. MRI Negative Myelitis Induced by Pfizer-BioNTech COVID-19 Vaccine. J Clin Neurol 2022; 18:120-122. [PMID: 35021291 PMCID: PMC8762507 DOI: 10.3988/jcn.2022.18.1.120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Gonçalo Cabral
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
| | - Carolina Gonçalves
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - Filipa Serrazina
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - Francisca Sá
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
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23
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Berrú-Villalobos S, Otiniano-Sifuentes R, Castro-Suárez S, Osorio-Marcatinco V, Guevara-Silva E, Meza-Vega M, Caparó-Zamalloa C. Autoimmune/Inflammatory syndrome induced by adjuvants (ASIA): Neuromyelitis optica spectrum disorder after BBIBP-Cor-V vaccine, case report. NEUROIMMUNOLOGY REPORTS 2022. [PMCID: PMC9188454 DOI: 10.1016/j.nerep.2022.100107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Recently the term Autoimmune/Inflammatory Syndrome induced by Adjuvants has been proposed to describe different clinical conditions, among them post-vaccinal phenomena like demyelinating diseases. Objective We aim to add knowledge on the possible association of vaccines and the development of demyelinating diseases. Case report We present the case of a 38-year-old female that developed a brainstem syndrome after vaccination with COVID-19 BBIBP-CorV Sinopharm Vaccine. The final diagnosis after extensive work-out was Neuromyelitis Optica spectrum disorder with positive Aquaporin 4 positive antibodies; and long-term treatment with Rituximab was initiated. Conclusion Since we are facing a large-scale vaccination, professionals should be aware of the presence of demyelinating diseases as adverse events for COVID-19 vaccine.
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24
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Wan EYF, Chui CSL, Lai FTT, Chan EWY, Li X, Yan VKC, Gao L, Yu Q, Lam ICH, Chun RKC, Cowling BJ, Fong WC, Lau AYL, Mok VCT, Chan FLF, Lee CK, Chan LST, Lo D, Lau KK, Hung IFN, Leung GM, Wong ICK. Bell's palsy following vaccination with mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines: a case series and nested case-control study. THE LANCET. INFECTIOUS DISEASES 2022; 22:64-72. [PMID: 34411532 PMCID: PMC8367195 DOI: 10.1016/s1473-3099(21)00451-5] [Citation(s) in RCA: 143] [Impact Index Per Article: 71.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Bell's palsy is a rare adverse event reported in clinical trials of COVID-19 vaccines. However, to our knowledge no population-based study has assessed the association between the inactivated SARS-CoV-2 vaccines and Bell's palsy. The aim of this study was to evaluate the risk of Bell's palsy after BNT162b2 and CoronaVac vaccination. METHODS In this case series and nested case-control study done in Hong Kong, we assessed the risk of Bell's palsy within 42 days following vaccination with BNT162b2 (Fosun-BioNTech [equivalent to Pfizer-BioNTech]) or CoronaVac (from Sinovac Biotech, Hong Kong) using data from voluntary surveillance reporting with the Hospital Authority, the COVID-19 Vaccine Adverse Event Online Reporting system for all health-care professionals, and the Hospital Authority's territory-wide electronic health records from the Clinical Data Analysis and Reporting System. We described reported cases of Bell's palsy among vaccine recipients (aged 18-110 years for CoronaVac and aged 16-110 years for BNT162b2). We compared the estimated age-standardised incidence of clinically confirmed cases among individuals who had received the CoronaVac or BNT162b2 vaccination (up to 42 days before presentation) with the background incidence in the population. A nested case-control study was also done using conditional logistic regression to estimate the odds ratio (OR) for risk of Bell's palsy and vaccination. Cases and controls were matched (1:4) by age, sex, admission setting, and admission date. FINDINGS Between February 23 and May 4, 2021, 451 939 individuals received the first dose of CoronaVac and 537 205 individuals received the first dose of BNT162b2. 28 clinically confirmed cases of Bell's palsy were reported following CoronaVac and 16 cases were reported following BNT162b2. The age-standardised incidence of clinically confirmed Bell's palsy was 66·9 cases per 100 000 person-years (95% CI 37·2 to 96·6) following CoronaVac vaccination and 42·8 per 100 000 person-years (19·4 to 66·1) for BNT162b2 vaccination. The age-standardised difference for the incidence compared with the background population was 41·5 (95% CI 11·7 to 71·4) for CoronaVac and 17·0 (-6·6 to 40·6) for BNT162b2, equivalent to an additional 4·8 cases per 100 000 people vaccinated for CoronaVac and 2·0 cases per 100 000 people vaccinated for BNT162b2. In the nested case-control analysis, 298 cases were matched to 1181 controls, and the adjusted ORs were 2·385 (95% CI 1·415 to 4·022) for CoronaVac and 1·755 (0·886 to 3·477) for BNT162b2. INTERPRETATION Our findings suggest an overall increased risk of Bell's palsy after CoronaVac vaccination. However, the beneficial and protective effects of the inactivated COVID-19 vaccine far outweigh the risk of this generally self-limiting adverse event. Additional studies are needed in other regions to confirm our findings. FUNDING The Food and Health Bureau of the Government of the Hong Kong Special Administrative Region, China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Eric Yuk Fai Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China
| | - Celine Sze Ling Chui
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China
| | - Francisco Tsz Tsun Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China
| | - Xue Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China
| | - Vincent Ka Chun Yan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Le Gao
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Qiuyan Yu
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ivan Chun Hang Lam
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Raccoon Ka Cheong Chun
- Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Benjamin John Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China
| | - Wing Chi Fong
- Department of Medicine, Queen Elizabeth Hospital, Hospital Authority, Hong Kong Special Administrative Region, China; Expert Committee on Clinical Events Assessment Following COVID-19 Immunization, Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Alexander Yuk Lun Lau
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Vincent Chung Tong Mok
- Expert Committee on Clinical Events Assessment Following COVID-19 Immunization, Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Frank Ling Fung Chan
- Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Cheuk Kwong Lee
- Expert Committee on Clinical Events Assessment Following COVID-19 Immunization, Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China; Hong Kong Red Cross Blood Transfusion Service, Hospital Authority, Hong Kong Special Administrative Region, China
| | - Lot Sze Tao Chan
- Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Dawin Lo
- Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Kui Kai Lau
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ivan Fan Ngai Hung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Expert Committee on Clinical Events Assessment Following COVID-19 Immunization, Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Gabriel Matthew Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region, China; Expert Committee on Clinical Events Assessment Following COVID-19 Immunization, Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China; Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
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25
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Safety of Multiple Vaccinations and Durability of Vaccine-Induced Antibodies in an Italian Military Cohort 5 Years after Immunization. Biomedicines 2021; 10:biomedicines10010006. [PMID: 35052686 PMCID: PMC8773007 DOI: 10.3390/biomedicines10010006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/17/2021] [Accepted: 12/16/2021] [Indexed: 01/24/2023] Open
Abstract
We previously examined the safety and immunogenicity of multiple vaccines administered to a military cohort, divided into two groups, the first composed of students at military schools, thus operating inside the national borders for at least 3 years, and the other formed of soldiers periodically engaged in a 9-month-long mission abroad (Lebanon). In the current study, we analyzed 112 individuals of this cohort, 50 pertaining to the first group and 62 to the second group, in order to examine the possible late appearance of side effects and to calculate the half-life of the induced antibodies. Moreover, the possible involvement of B-cell polyclonal activation as a pathogenetic mechanism for long term antibody persistence has even been explored. No late side effects, as far as autoimmunity and/or lymphoproliferation appearance, have been noticed. The long duration of the vaccine induced anti-HAV antibodies has been confirmed, whereas the antibodies induced by tetravalent meningococcal polysaccharide vaccine have been found to persist above the threshold for putative protection for a longer time, and anti-tetanus, diphtheria, and polio 1 and 3 for a shorter time than previously estimated. No signs of polyclonal B-cell activation have been found, as a possible mechanism to understand the long antibody persistence.
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26
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Cellina M, D'Arrigo A, Floridi C, Oliva G, Carrafiello G. Left Bell's palsy following the first dose of mRNA-1273 SARS-CoV-2 vaccine: A case report. Clin Imaging 2021; 82:1-4. [PMID: 34763263 PMCID: PMC8566211 DOI: 10.1016/j.clinimag.2021.10.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/16/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Even though no definitive link has been established, Bell's palsy has been described as a potential side effect of SARS-CoV-2 mRNA vaccines in a few reports, and the US Food and Drug Administration has recommended strict surveillance of its occurrence in the vaccinated general population. We present the case of a previously healthy 35-year-old female patient who developed Bell's palsy 12 h after receiving the first dose of the mRNA-1273 vaccine. Her general practitioner performed the diagnosis, and corticosteroid treatment was initiated, with slow symptoms improvement. The neurologist's evaluation and a contrast-enhanced brain Magnetic Resonance Imaging revealed a subtle enhancement of the left facial nerve, confirming the diagnosis of Bell's palsy.
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Affiliation(s)
- Michaela Cellina
- Department of Radiology, ASST Fatebenefratelli Sacco, Milano, Ospedale Fatebenefratelli, Piazza Principessa Clotilde 3, 20121 Milan, Italy.
| | - Andrea D'Arrigo
- Department of Neurology, ASST Fatebenefratelli Sacco, Milano, Ospedale Fatebenefratelli, Piazza Principessa Clotilde 3, 20121 Milan, Italy
| | - Chiara Floridi
- Department of Radiology, Division of Special and Pediatric Radiology, University Hospital "Umberto I Lancisi Salesi", Via Conca 71, 60126 Ancona, AN, Italy
| | - Giancarlo Oliva
- Department of Radiology, ASST Fatebenefratelli Sacco, Milano, Ospedale Fatebenefratelli, Piazza Principessa Clotilde 3, 20121 Milan, Italy
| | - Gianpaolo Carrafiello
- Department of Radiology, Policlinico di Milano Ospedale Maggiore
- Fondazione IRCCS Ca' Granda, Via Francesco Sforza, 35, 20122 Milano, Italy; Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milano, Italy
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27
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Mirmosayyeb O, Bagherieh S, Shaygannejad V. Acute CNS demyelination in a subject with cerebellar ataxia following the first dose of COVID-19 vaccine; a case report. Hum Vaccin Immunother 2021; 17:4099-4101. [PMID: 34714721 PMCID: PMC8567291 DOI: 10.1080/21645515.2021.1971920] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccination-induced demyelination is a rare, unusual side effect of certain vaccines which can cause significant damage to patient's sensory-motor abilities within days. Although COVID-19 vaccines go through rigorous clinical trials before they are injected to the general population, certain unexpected side effects remain inevitable. We herein describe a case of a 42-year-old woman who experienced acute demyelination 10 days after the Oxford-AstraZeneca vaccination. To the best of our knowledge, this is the first case of such nature and severity described regarding COVID-19 vaccines' side effects.
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Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Bagherieh
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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28
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García-Grimshaw M, Michel-Chávez A, Vera-Zertuche JM, Galnares-Olalde JA, Hernández-Vanegas LE, Figueroa-Cucurachi M, Paredes-Ceballos O, Reyes-Terán G, Carbajal-Sandoval G, Ceballos-Liceaga SE, Arauz A, Valdés-Ferrer SI. Guillain-Barré syndrome is infrequent among recipients of the BNT162b2 mRNA COVID-19 vaccine. Clin Immunol 2021; 230:108818. [PMID: 34358692 PMCID: PMC8332675 DOI: 10.1016/j.clim.2021.108818] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/19/2021] [Accepted: 07/31/2021] [Indexed: 02/07/2023]
Abstract
Vaccines are the most effective strategy to mitigate the global impact of COVID-19. However, vaccine hesitancy is common, particularly among minorities. Guillain-Barré syndrome (GBS) is the most common autoimmune illness of the peripheral nervous system, occurring at an incidence of 1.1/100,000 worldwide. A causal link between mRNA vaccines and GBS has not been previously evaluated. We analyzed a cohort of 3,890,250 Hispanic/Latinx recipients of the BNT162b2 mRNA vaccine (613,780 of whom had already received both doses) for incident GBS occurring within 30 days from vaccine administration. Seven cases of GBS were detected among first-dose recipients, for an observed incidence of 0.18/100,000 administered doses during the prespecified timeframe of 30 days. No cases were reported after second-dose administration. Our data suggest that, among recipients of the BNT162b2 mRNA vaccine, GBS may occur at the expected community-based rate; however, this should be taken with caution as the current incidence of GBS among the unvaccinated population against COVID-19 is still undetermined. We hope that this preliminary data will increase the public perception of safety toward mRNA-based vaccines and reduce vaccine hesitancy.
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Affiliation(s)
- Miguel García-Grimshaw
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Anaclara Michel-Chávez
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Juan Mauricio Vera-Zertuche
- Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Laura E Hernández-Vanegas
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | | | | | | | | | | | - Antonio Arauz
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Sergio Iván Valdés-Ferrer
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Feinstein Institutes for Medical Research, Manhasset, NY, USA.
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29
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Shemer A, Pras E, Einan-Lifshitz A, Dubinsky-Pertzov B, Hecht I. Association of COVID-19 Vaccination and Facial Nerve Palsy: A Case-Control Study. JAMA Otolaryngol Head Neck Surg 2021; 147:739-743. [PMID: 34165512 DOI: 10.1001/jamaoto.2021.1259] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Peripheral facial nerve (Bell) palsy has been reported and widely suggested as a possible adverse effect of the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine. Israel is currently the leading country in vaccination rates per capita, exclusively using the BNT162b2 vaccine, and all residents of Israel are obligatory members of a national digital health registry system. These factors enable early analysis of adverse events. Objective To examine whether the BNT162b2 vaccine is associated with an increased risk of acute-onset peripheral facial nerve palsy. Design, Setting, and Participants This case-control study was performed from January 1 to February 28, 2021, at the emergency department of a tertiary referral center in central Israel. Patients admitted for facial nerve palsy were matched by age, sex, and date of admission with control patients admitted for other reasons. Exposures Recent vaccination with the BNT162b2 vaccine. Main Outcomes and Measures Adjusted odds ratio for recent exposure to the BNT162b2 vaccine among patients with acute-onset peripheral facial nerve palsy. The proportion of patients with Bell palsy exposed to the BNT162b2 vaccine was compared between groups, and raw and adjusted odds ratios for exposure to the vaccine were calculated. A secondary comparison with the overall number of patients with facial nerve palsy in preceding years was performed. Results Thirty-seven patients were admitted for facial nerve palsy during the study period, 22 (59.5%) of whom were male, and their mean (SD) age was 50.9 (20.2) years. Among recently vaccinated patients (21 [56.7%]), the mean (SD) time from vaccination to occurrence of palsy was 9.3 (4.2 [range, 3-14]) days from the first dose and 14.0 (12.6 [range, 1-23]) days from the second dose. Among 74 matched controls (2:1 ratio) with identical age, sex, and admittance date, a similar proportion were vaccinated recently (44 [59.5%]). The adjusted odds ratio for exposure was 0.84 (95% CI, 0.37-1.90; P = .67). Furthermore, analysis of the number of admissions for facial nerve palsy during the same period in preceding years (2015-2020) revealed a relatively stable trend (mean [SD], 26.8 [5.8]; median, 27.5 [range, 17-35]). Conclusions and Relevance In this case-control analysis, no association was found between recent vaccination with the BNT162b2 vaccine and risk of facial nerve palsy.
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Affiliation(s)
- Asaf Shemer
- Department of Ophthalmology, Shamir Medical Center, Be'er Ya'akov, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Pras
- Department of Ophthalmology, Shamir Medical Center, Be'er Ya'akov, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center, Be'er Ya'akov, Israel
| | - Adi Einan-Lifshitz
- Department of Ophthalmology, Shamir Medical Center, Be'er Ya'akov, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Biana Dubinsky-Pertzov
- Department of Ophthalmology, Shamir Medical Center, Be'er Ya'akov, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idan Hecht
- Department of Ophthalmology, Shamir Medical Center, Be'er Ya'akov, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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30
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Obermann M, Krasniqi M, Ewers N, Fayad J, Haeberle U. Bell's palsy following COVID-19 vaccination with high CSF antibody response. Neurol Sci 2021; 42:4397-4399. [PMID: 34322761 PMCID: PMC8318623 DOI: 10.1007/s10072-021-05496-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Mark Obermann
- Department of Neurology, Hospital Weser-Egge, Brenkhäuser Str. 71, 37671, Höxter, Germany.
| | - Maliqe Krasniqi
- Department of Neurology, Hospital Weser-Egge, Brenkhäuser Str. 71, 37671, Höxter, Germany
| | | | - Jaber Fayad
- Department of Neurology, Hospital Weser-Egge, Brenkhäuser Str. 71, 37671, Höxter, Germany
| | - Uta Haeberle
- Department of Neurology, Hospital Weser-Egge, Brenkhäuser Str. 71, 37671, Höxter, Germany
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31
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Ozonoff A, Nanishi E, Levy O. Bell's palsy and SARS-CoV-2 vaccines. THE LANCET. INFECTIOUS DISEASES 2021; 21:450-452. [PMID: 33639103 PMCID: PMC7906673 DOI: 10.1016/s1473-3099(21)00076-1] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Al Ozonoff
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA
| | - Etsuro Nanishi
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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