The Side Effects of COVID-19 Vaccines and Its Association With ABO Blood Type Among the General Surgeons in Saudi Arabia

Examination of iatrogenic FDG accumulation after COVID-19 vaccination

PURPOSE

This study aimed to investigate the frequency of COVID-19 vaccine-induced reactive change and potential factors including blood type correlated with increased FDG uptake on positron emission tomography (PET)/computed tomography (CT).

MATERIALS AND METHODS

We evaluated 284 patients who underwent PET/CT between June and September 2021 and had a known history of COVID-19 vaccination. Information on the injection site, vaccine type, and adverse reactions was obtained. We visually assessed the presence or absence of accumulation in the axillary and supraclavicular lymph nodes and the deltoid muscles. We measured the maximum standardized uptake value (SUVmax) using semi-quantitative analysis.

RESULTS

Our study included 158 males and 126 females aged 16-94. The median time between vaccination and PET/CT was 9 and 42 days for patients who had received their first and second doses, respectively. We observed axillary lymph node accumulation, supraclavicular lymph node accumulation, and deltoid muscle accumulation in 98 (SUVmax 1.07-25.1), nine (SUVmax 2.28-14.5), and 33 cases (SUVmax 0.93-7.42), respectively. In cases with axillary lymph node (P = 0.0057) or deltoid muscle (P = 0.047) accumulation, the shorter the time since vaccination, the higher the FDG accumulation. Patients with axillary lymph node accumulation were significantly younger (P < 0.0001) and had a significantly higher frequency of adverse reactions such as fever (P < 0.0001) and myalgia (P = 0.002). No significant relationship was observed between blood type and the frequency of FDG accumulation. Logistic regression analysis also showed that age, gender, days since vaccination, and adverse reactions such as fever and myalgia were important factors for axillary lymph node accumulation.

CONCLUSION

Our study found that FDG accumulation in the axillary lymph nodes and deltoid muscle was higher within a shorter time after vaccination, and axillary lymph node accumulation was higher in young patients, females, and those with adverse reactions of fever and myalgia. No significant relationship was observed between blood type and the frequency of FDG accumulation. Confirming the vaccination status, time since vaccination, and the presence of adverse reactions before PET may reduce false positives.

Investigation of the Side Effects of COVID-19 Vaccines in Southern Iran: A Cross-Sectional Study

The COVID-19 disease is a newly emerging disease, and the COVID-19 vaccine is one of the necessities to prevent this disease. The present study aimed to investigate the side effects of COVID-19 vaccines in southern Iran. We used convenience sampling to conduct this cross-sectional study on 647 people living in cities under coverage in Kerman province, southern Iran. The data collection tool was a researcher-made questionnaire of vaccine symptoms and signs. The results were analyzed using ANOVA and Chi-squared tests by SPSS software (version 24). The mean age of the participants was 40.19±15.20. The results indicated that 431 people (66.6%) reported post-vaccination side effects, with 18.23% of them having severe side effects. We noticed the most severe side effects in AstraZeneca, Sinopharm, Sputnik, and Bharat. Fever, headache, and pain at the injection site were the most common side effects after vaccination in descending order, which had a statistically significant relationship with all types of vaccines (P=0.001). The side effects differed in the types of vaccines, and most of the vaccines had mild to moderate side effects. People with the B blood type showed the most severe side effects, while those with the AB showed the lowest rate of side effects. Therefore, the injection of the AstraZeneca vaccine in blood group B should be done with more caution. More attention should also be paid to blood groups B and A in the injection of COVID-19 vaccines. Moreover, health officials and the government should plan appropriate educational strategies to increase public awareness of the importance of vaccines in eradicating viral infections.

Side effects of COVID-19 vaccines in the middle eastern population

The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine long-term side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects.

The role of blood groups, vaccine type and gender in predicting the severity of side effects among university students receiving COVID-19 vaccines

On March 11^th, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) a pandemic. To control the pandemic, billions of vaccine doses have been administered worldwide. Predictors of COVID-19 vaccine-related side effects are inconsistently described in the literature. This study aimed to identify the predictors of side effects' severity after COVID-19 vaccination among young adult students at Taif University (TU) in Saudi Arabia. An online, anonymous questionnaire was used. Descriptive statistics were calculated for numerical and categorical variables. Possible correlations with other characteristics were identified using the chi-square test. The study included 760 young adult participants from TU. Pain at the injection site (54.7%), headache (45.0%), lethargy and fatigue (43.3%), and fever (37.5%) were the most frequently reported COVID-19 vaccine-related side effects after the first dose. The most frequent side effects were reported among the 20-25-year-old age group for all doses of all vaccines. Females experienced remarkably more side effects after the second (p < 0.001) and third doses (p = 0.002). Moreover, ABO blood groups significantly correlated with vaccine-related side effects after the second dose (p = 0.020). The participants' general health status correlated with the side effects after the first and second doses (p < 0.001 and 0.022, respectively). The predictors of COVID-19 vaccine-related side effects in young, vaccinated people were blood group B, female gender, vaccine type, and poor health status.

Sex-disaggregated outcomes of adverse events after COVID-19 vaccination: A Dutch cohort study and review of the literature

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.

Correlation between the severity of COVID-19 vaccine-related adverse events and the blood group of the vaccinees in Saudi Arabia: A web-based survey

Background: Recent epidemiological studies have reported an association between the ABO blood group and the acquisition, symptom severity, and mortality rate of coronavirus disease 2019 (COVID-19). However, the association between the ABO blood group antigens and the type and severity of COVID-19 vaccine-related adverse reactions has not been elucidated. Patients and Methods: We conducted a cross-sectional, questionnaire-based study in Saudi Arabia from February to April 2022. The study cohort included adults who had received or were willing to receive at least two doses of a COVID-19 vaccine of any type. We used Chi-square test to assess the association between the ABO blood groups and vaccine-related adverse reactions. p values of <0.05 were considered significant. Results: Of the 1180 participants, approximately half were aged 18-30 years old, 69.2% were female, and 41.6% reported their blood group as O. The most frequent COVID-19 vaccine-related adverse reactions were fatigue (65%), pain at the injection site (56%), and headache (45.9%). These adverse reactions demonstrated significant correlations with the education level (p = 0.003) and nationality (p = 0.018) of the participants following the first dose, with gender (p < 0.001) following the second dose, and with the general health status (p < 0.001) after all the doses. Remarkably, no correlation was observed between the severity of the vaccine-related adverse reactions and ABO blood groups. Conclusion: Our findings do not support a correlation between the severity of COVID-19 vaccine-related adverse reactions and the ABO blood groups of the vaccinees. The creation of a national database is necessary to account for population differences.

How far are the new wave of mRNA drugs from us? mRNA product current perspective and future development

mRNA products are therapies that are regulated from the post-transcriptional, pre-translational stage of a gene and act upstream of protein synthesis. Compared with traditional small molecule drugs and antibody drugs, mRNA drugs had the advantages of simple design, short development cycle, strong target specificity, wide therapeutic field, and long-lasting effect. mRNA drugs were now widely used in the treatment of genetic diseases, tumors, and viral infections, and are expected to become the third major class of drugs after small molecule drugs and antibody drugs. The delivery system technology was the key to ensuring the efficacy and safety of mRNA drugs, which plays an important role in protecting RNA structure, enhancing targeting ability, reducing the dose of drug delivery, and reducing toxic side effects. Lipid nanoparticles (LNP) were the most common delivery system for mRNA drugs. In recent years, mRNA drugs have seen rapid development, with the number of drugs on the market increasing each year. The success of commercializing mRNA vaccines has driven a wave of nucleic acid drug development. mRNA drugs were clinically used in genetic diseases, oncology, and infectious diseases worldwide, while domestic mRNA clinical development was focused on COVID-19 vaccines, with more scope for future indication expansion.