ABSTRACT
BACKGROUND: As COVID-19 became a pandemic, the urgent need to find an effective treatment vaccine has been a major objective. Vaccines contain adjuvants which are not exempt from adverse effects and can trigger the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). There is very little information about autoimmune endocrine disease and the ASIA after the use of mRNA-based SARS-CoV2 vaccination. CASE SERIES: We report three cases and also review the literature showing that the thyroid gland can be involved in the ASIA induced by the mRNA-based SARS-CoV2 vaccination. We present the first case to date of silent thyroiditis described in the context of SARS-CoV2 vaccination with Pfizer/BioNTech. Also, we discuss the first subacute thyroiditis in the context of SARS-CoV2 vaccination with the Moderna's vaccine. Finally, we provide another case to be added to existing evidence on Graves' disease occurring post-vaccination with the Pfizer/BioNTech vaccine. DISCUSSION: Adjuvants play an important role in vaccines. Their ability to increase the immunogenicity of the active ingredient is necessary to achieve the desired immune response. Both the Moderna and the Pfizer/BioNTech vaccines use mRNA coding for the SARS-CoV2 S protein enhanced by adjuvants. In addition, the cross-reactivity between SARS-CoV2 and thyroid antigens has been reported. This would explain, at least, some of the autoimmune/inflammatory reactions produced during and after SARS-CoV2 infection and vaccination. CONCLUSION: The autoimmune/inflammatory syndrome induced by adjuvants involving the thyroid could be an adverse effect of SARS-CoV2 vaccination and could be underdiagnosed.
Subject(s)
COVID-19 Vaccines/adverse effects , Graves Disease/etiology , Thyroid Gland/immunology , Thyroiditis/etiology , Vaccination/adverse effects , Adult , COVID-19 Vaccines/immunology , Female , Graves Disease/immunology , Humans , Male , Thyroiditis/immunologyABSTRACT
The outbreak of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has had a direct impact on the global health system, causing an alarming shortage of Personal Protective Equipment (PPE). Recent studies have shown that a significant number of healthcare professionals have been contaminated by the COVID-19 at their workplace due to the lack of appropriate PPE. Consequently, the PEE requirements have changed, making the use of filtering face-piece respirators (FFR) N95 and NK95 (FFP2 or FFP3, respectively) mandatory in place of the surgical masks previously used by healthcare professionals. Applying individualized face-seal devices in surgical masks, such as a thermoplastic resin ring, may significantly avoid inhalation of unfiltered air. Besides reducing leakage around the mask, which could convert surgical masks into PPE dual masks due to the high percentage of face-seal, it would allow a bidirectional protection for both healthcare professionals and patients, thus becoming a medical device. The polylactic acid (corn starch) thermoplastic resin ring is the device proposed here to be used in order to decrease leakage of potentially contaminated air. The use of poly lactic acid is of particular interest due to the fact that is a material appropriate for sanitary use, reusable and biodegradable. Therefore, healthcare professionals and organizations can maintain clinical activity in a cost-efficient manner whilst improving clinical safety.