Is the Effect of the COVID-19 Vaccine on Heart Rate Variability Permanent?

Background and Objectives: The risk of autonomic dysfunction with COVID-19 vaccines used worldwide in the COVID-19 pandemic remains a topic of debate. Heart rate variability has a number of parameters that can be used to assess autonomic nervous system dynamics. The aim of this study was to investigate the effect of a COVID-19 vaccine (Pfizer-BioNTech) on heart rate variability and autonomic nervous system parameters, and the duration of the effect. Materials and Methods: A total of 75 healthy individuals who visited an outpatient clinic to receive the COVID-19 vaccination were included in this prospective observational study. Heart rate variability parameters were measured before vaccination and on days 2 and 10 after vaccination. SDNN, rMSSD and pNN50 values were evaluated for time series analyses, and LF, HF, and LF/HV values for frequency-dependent analyses. Results: The SDNN and rMSDD values declined significantly on day 2 after vaccination, while the pNN50 and LF/HF values increased significantly on day 10. The values at pre-vaccination and at day 10 were comparable. The pNN50 and LF/HF values declined significantly on day 2 and increased significantly on day 10. The values at pre-vaccination and at day 10 were comparable. Conclusions: This study showed that the decline in HRV observed with COVID-19 vaccination was temporary, and that the Pfizer-BioNTech COVID-19 vaccination did not cause permanent autonomic dysfunction.

Efficacy of BNT162b2 and CoronaVac in patients diagnosed with COVID-19.

This retrospective observational study is aimed to determine the efficacy of BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccines against symptomatic or severe disease in COVID-19-diagnosed patients. The secondary aim was to define the differences between vaccinated and un-vaccinated patients in terms of age, comorbidities and course of the disease, and to determine the survival rates. Of the 1463 PCR-positive patients, 55.3 % were vaccinated, and 44.7 % were unvaccinated. While 959 patients had mild-moderate symptoms, 504 patients had severe-critical symptoms and were treated in the intensive care unit. There was a statistically significant difference in the distribution of the type and doses of vaccines between the patient groups (p = 0.021). The rate of receiving 2 doses of Biontech was 18.9 % in the mild-moderate patient group but lower in the severe patient group (12.6 %). The rate of two doses of Sinovac and two doses of Biontech vaccine (four doses of vaccine) was 5 % in the mild-moderate patient group and 1.9 % in the severe patient group. The mortality rates were statistically significantly different (p < 0.001) between the patient groups: 65.3 % in the severe patient group and 1 % in the mild-moderate patient group. The multivariate model showed that the mortality risk of the unvaccinated patients was 1.5 times higher than the vaccinated ones (p = 0.042). In addition to being unvaccinated, advanced age, coronary artery disease (CAD), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), and obesity were found to be associated with higher mortality risk. Besides, the reduction in mortality rate was more evident in individuals vaccinated with at least 2 doses of the BNT162b2 (Pfizer-BioNTech) vaccine than in CoronaVac group.

Selection Effects and COVID-19 Mortality Risk after Pfizer vs. Moderna Vaccination: Evidence from Linked Mortality and Vaccination Records.

Prior research generally finds that the Pfizer-BioNTech (BNT162b2) and Moderna (mRNA1273) COVID-19 vaccines provide similar protection against mortality, sometimes with a Moderna advantage due to slower waning. However, most comparisons do not address selection effects for those who are vaccinated and with which vaccine. We report evidence on large selection effects, and use a novel method to control for these effects. Instead of directly studying COVID-19 mortality, we study the COVID-19 excess mortality percentage (CEMP), defined as the COVID-19 deaths divided by non-COVID-19 natural deaths for the same population, converted to a percentage. The CEMP measure uses non-COVID-19 natural deaths to proxy for population health and control for selection effects. We report the relative mortality risk (RMR) for each vaccine relative to the unvaccinated population and to the other vaccine, using linked mortality and vaccination records for all adults in Milwaukee County, Wisconsin, from 1 April 2021 through 30 June 2022. For two-dose vaccinees aged 60+, RMRs for Pfizer vaccinees were consistently over twice those for Moderna, and averaged 248% of Moderna (95% CI = 175%,353%). In the Omicron period, Pfizer RMR was 57% versus 23% for Moderna. Both vaccines demonstrated waning of two-dose effectiveness over time, especially for ages 60+. For booster recipients, the Pfizer-Moderna gap is much smaller and statistically insignificant. A possible explanation for the Moderna advantage for older persons is the higher Moderna dose of 100 µg, versus 30 µg for Pfizer. Younger persons (aged 18-59) were well-protected against death by two doses of either vaccine, and highly protected by three doses (no deaths among over 100,000 vaccinees). These results support the importance of a booster dose for ages 60+, especially for Pfizer recipients. They suggest, but do not prove, that a larger vaccine dose may be appropriate for older persons than for younger persons.

Changes within the P681 residue of spike dictate cell fusion and syncytia formation of Delta and Omicron variants of SARS-CoV-2 with no effects on neutralization or infectivity.

The rapid spread and dominance of the Omicron SARS-CoV-2 lineages have posed severe health challenges worldwide. While extensive research on the role of the Receptor Binding Domain (RBD) in promoting viral infectivity and vaccine sensitivity has been well documented, the functional significance of the 681PRRAR/SV687 polybasic motif of the viral spike is less clear. In this work, we monitored the infectivity levels and neutralization potential of the wild-type human coronavirus 2019 (hCoV-19), Delta, and Omicron SARS-CoV-2 pseudoviruses against sera samples drawn four months post administration of a third dose of the BNT162b2 mRNA vaccine. Our findings show that in comparison to hCoV-19 and Delta SARS-CoV-2, Omicron lineages BA.1 and BA.2 exhibit enhanced infectivity and a sharp decline in their sensitivity to vaccine-induced neutralizing antibodies. Interestingly, P681 mutations within the viral spike do not play a role in the neutralization potential or infectivity of SARS Cov-2 pseudoviruses carrying mutations in this position. The P681 residue however, dictates the ability of the spike protein to promote fusion and syncytia formation between infected cells. While spike from hCoV-19 (P681) and Omicron (H681) promote only modest cell fusion and formation of syncytia between cells that express the spike-protein, Delta spike (R681) displays enhanced fusogenic activity and promotes syncytia formation. Additional analysis shows that a single P681R mutation within the hCoV-19 spike, or H681R within the Omicron spike, restores fusion potential to similar levels observed for the Delta R681 spike. Conversely, R681P point mutation within the spike of Delta pseudovirus abolishes efficient fusion and syncytia formation. Our investigation also demonstrates that spike proteins from hCoV-19 and Delta SARS-CoV-2 are efficiently incorporated into viral particles relative to the spike of Omicron lineages. We conclude that the third dose of the Pfizer-BNT162b2 provides appreciable protection against the newly emerged Omicron sub-lineages. However, the neutralization sensitivity of these new variants is diminished relative to that of the hCoV-19 or Delta SARS-CoV-2. We further show that the P681 residue within spike dictates cell fusion and syncytia formation with no effects on the infectivity of the specific viral variant and on its sensitivity to vaccine-mediated neutralization.

BNT162b2 immunization-related myocarditis in adolescents and consequent hospitalization: Report from a medical center.

BACKGROUND: To investigate Pfizer-BioNTech 162b2 mRNA COVID-19 vaccine (BNT162b2) immunization-related myocarditis and describe the risk factors for consequent hospitalization in the pediatric intensive care unit (PICU) in children between 12 and 18 years. METHODS: Children and adolescents 12 years of age and older who presented with discomfort after BNT162b2 immunization (BNTI) and visited pediatric emergency room (PER) at Chang Gung Memorial Hospital from September 22, 2021 to March 21, 2022, were included for analysis. RESULTS: 681 children presented with discomfort after BNTI and visited our PER. The mean age was 15.1 ± 1.7 years. Three hundred and ninety-four (57.9%) and 287 (42.1%) events were after 1st and 2nd dose, respectively. 58.4% (n = 398) were male. The most common complaints were chest pain (46.7%) and chest tightness (27.0%). The median (interquartile range [IQR]) interval of discomfort after BNTI was 3.0 (1.0-12.0) days. BNTI-related pericarditis, myocarditis and myopericarditis were diagnosed in 15 (2.2%), 12 (1.8%) and 2 (0.3%) patients, respectively. Eleven (1.6%) needed hospitalization in PICU. The median (IQR) hospital stay was 4.0 (3.0-6.0) days. There was no mortality. More patients were diagnosed myocarditis (p = 0.004) after 2nd dose BNTI. PICU admission occurred more commonly after 2nd dose BNTI (p = 0.007). Risk factors associated with hospitalization in PICU were abnormal EKG findings (p = 0.047) and abnormal serum troponin levels (p = 0.003) at PER. CONCLUSION: Myocarditis in children aged 12-18 years occurred more commonly following 2nd dose BNTI. Most cases were of mild or intermediate severity without death. Factors predicting BNTI-related myocarditis and consequent hospitalization in PICU were abnormal EKG findings and abnormal serum troponin levels at PER in this study.

Intracranial Hemorrhage After Pfizer-BioNTech (BNT162b2) mRNA COVID-19 Vaccination: A Case Report.

The Coronavirus 2019 (COVID-19) pandemic has affected over 700 million people worldwide and caused nearly 7 million deaths. Vaccines currently developed or in development are the most effective tools for curbing the pandemic and mitigating its impacts. In Turkey, inoculation with the Pfizer-BioNTech COVID-19 vaccine (BNT162b2, also known as tozinameran) has been approved. We report a 56-year-old female patient with underlying essential hypertension who experienced intracranial hemorrhage after receiving her first dose of tozinameran. The patient underwent immediate surgical evacuation of the hematoma, during which a left middle cerebral artery bifurcation aneurysm was macroscopically identified and clipped. The patient was pronounced deceased on the second postoperative day. This is the second case of intracranial hemorrhage following tozinameran administration caused by a ruptured middle cerebral artery bifurcation aneurysm. Upon analyzing the case, there might be a connection between the vaccine's potential immune-triggering effect on hemodynamic patterns and the rupture of the previously unknown cerebral aneurysm. However, these severe complications do not justify avoiding vaccines; further studies are needed. This study emphasizes the need for increased vigilance in patients with underlying systemic comorbidities who have recently been vaccinated and to share our insights into the potential relationship between tozinameran and intracranial hemorrhage.

Comparing health consumer search behavior and scientific research productivity related to COVID-19 vaccines in the USA: an infodemiology study

PurposeWhile vaccines are an effective preventative measure to defend against the spread and harmful symptoms of COVID-19, information about COVID vaccines can be difficult to find and conflicting in its coverage of vaccines' benefits and risks. This study aims to examine the extent to which Americans are searching for information about the three major vaccine producers (Pfizer-BioNTech, Moderna and Johnson & Johnson's Janssen) in relation to the amount of reliable scholarly information that has been produced about each one.Design/methodology/approachData were retrieved from Google Trends for the US Web users alongside scientific research output of the US scientists toward three Centers for Disease Control and Prevention (CDC)-authorized COVID-19 vaccines in Web of Science, Scopus and PubMed. The authors searched for descriptive statistical analyses to detect coronavirus-seeking behavior versus coronavirus releases in the USA from May 1, 2020, to April 30, 2021.FindingsOf the three COVID-19 vaccines, Pfizer has attracted more attention from the US population. However, the greatest number of articles about COVID-19 vaccines published by the US scholars belonged to Moderna (M = 8.17), with Pfizer (M = 7.75) having slightly less, and Janssen (M = 0.83) well behind. A positive association was found between COVID-19 vaccine information-seeking behavior (ISB) on Google and the amount of research produced about that vaccine (P <0.001).Research limitations/implicationsAs the researchers use the single search engine, Google, to retrieve data from the USA, thus, selection bias will be existing as Google only gathers the data of people who chose to get the information by using this search engine.Practical implicationsIf the policymakers in the US Department of Health and Human Services or the US CDC desire to improve the country's health ISB and the scientific publication behavior (SPB) of the US researchers regarding COVID-19 vaccines studies, they should reference the results of such a study.Originality/valueFrom an infodemiological viewpoint, these findings may support the health policymakers, as well as researchers who work on COVID-19 vaccines in the USA.

Investigation of TNF-alpha and IL-4 in Pfizer/BioNTech vaccinated people: A comparative study

Background: The necessity for a vaccine to prevent this disease has been made abundantly clear by the appearance of the new SARS-CoV-2 and COVID-19. The most reliable method of halting the spread of infectious illnesses is vaccination. Since they were first made available to the general public more than 200 years ago, vaccines have saved millions of lives. Method(s): There were eighty-one (81) participants in total in the study. Individuals ranged in age from 18 to 66 and had recently received COVID-19 mRNA Pfizer/BioNTech [BNT162b2] vaccination injections. They were given two injections of the vaccine of 30 g and 0.3 mL, twenty-one (21) days apart. Before the first vaccination, blood samples were collected. This procedure was repeated on days 7-10 after the first vaccination, and on days 7-10 after the second dose. All samples were tested for IL-4, and TNF-alpha using a High Sensitivity Human ELISA Kit corresponding to each marker (Elabscience/United State). Result(s): There was no significant increase in IL-4 levels in all groups, TNF-alpha results showed increased after the first and second doses compared to before vaccination, and the increase after the second dose is greater than the first dose. Conclusion(s): Our research demonstrated that vaccinations caused Th1 biases and prevented Th2 responses in all groups.Copyright © 2023, Codon Publications. All rights reserved.

'Granulomatosis with polyangiitis after Pfizer vaccination': a case report.

The advent of COVID-19, caused by the SARS-CoV-2 virus, has resulted in over 541 million cases with 6.32 million deaths worldwide as of June 2022. The devastating consequences of this global pandemic resulted in the expedited generation of mRNA-based vaccines such as the Pfizer-BioNTech and Moderna vaccines. Although the vaccines have been effective, with recent data indicating greater than 95% effectiveness, rare complications have been reported, including manifestations of autoimmune phenomena. Herein, we report a rare case of Granulomatosis with polyangiitis (GPA) in an active duty military male soon after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine.

A 27-year-old active duty marine was admitted to our hospital after being transferred from Hawaii with concern of new autoimmune disease after receiving the Pfizer vaccine. The patient initially presented to the emergency department with joint pain, fever, chest pain, hemoptysis, and a nose bleed. A comprehensive workup demonstrated elevated inflammatory markers, progressive renal dysfunction, and a positive antibody panel consistent with antineutrophil cytoplasmic antibodies (ANCA) vasculitis. Due to the limited capabilities in his deployed setting, he was transferred to our hospital for a higher level of care. We performed some additional tests to include computed tomography (CT) imaging of his lungs and a renal biopsy which came back consistent with GPA. The patient was started on high-dose prednisone and rituximab, and he achieved remission. He was discharged from the hospital with follow-up arranged with rheumatology and nephrology. He remained in remission on follow-up.

[COVID-19 infections and effectiveness of the vaccination among healthcare workers]. / A COVID­19-fertozés és a védooltások hatásosságának vizsgálata egészségügyi dolgozókon.

INTRODUCTION: New variants of the SARS-CoV-2 coronavirus are constantly appearing, causing the COVID-19 pandemic. From November 2021, most infections were caused by the Omicron coronavirus variant. OBJECTIVE: The aim of this prospective observational cohort study was to estimate the incidence of COVID-19 infections in the high-risk healthcare workers after two BNT162b2 mRNA Pfizer-BioNTech vaccines and the subsequent booster vaccine, as well as the effectiveness, the safety and the humoral immune response of the vaccines. METHOD: We started the two Pfizer-BioNTech ((BNT162b29) vaccinations of healthcare workers of the Polyclinic of the Hospitaller Brothers of St. John between January 07 and March 08, 2021. The choice of the type and timing of the third booster vaccination was voluntary. The workers were followed up between January 07, 2021 and June 29, 2022. The infection rate, adverse events of the vaccination, risk factors to infection and the kinetics of anti-spike (S) antibody and anti-nucleocapsid (N) antibody serum level were evaluated. RESULTS: The data of 294 healthcare workers - 96 medical doctors, 127 nurses and 71 workers in hospital - who had at least three antibody level measurements were analyzed. The third booster vaccine was given to 280 workers, the distribution of the vaccines was the following: Pfizer-BioNTech (BNT162b29) vaccine (n = 210), Moderna COVID-19 (mRNA-1273) vaccine (n = 37), Sinopharm COVID-19 vaccine (n = 21), Janssen COVID-19 (n = 10), AstraZeneca (ChAdOx1 nCoV-19) vaccine (n = 2). Infection occurred in 121 cases (41%) during the observation period. The course of the COVID-19 infections was mostly mild (97%) and recovered within a week. During the observational period, 2 workers died: a 56-year-old woman died after two vaccinations for reason unrelated to COVID-19 infection, and a 58-year-old man died after the booster vaccination, following COVID-19 infection. The incidence of infection did not correlate with age, sex, comorbidities, smoking, occupation and BMI. The median titre of anti-S antibody serum level increased one month after the second vaccination of the basic immunization (1173.0 U/ml) and decreased slowly until the 8th month (678.5-625.8-538.0 U/ml) after the basic vaccination. One month after the booster vaccination, the median titre of anti-S antibody serum level increased significantly (16 535 U/ml), and showed a decreasing trend in the 3rd month after the booster vaccination (9697.7 U/ml). An exceptionally high S antibody serum level increasing after the basic (>10 000 U/mL) and booster (>60 000 U/m) vaccination showed a correlation with prior COVID-19 infection. The median cut-off index (COI) of anti-N antibody was not affected by vaccination, the increasing of the titre is related to the infection. CONCLUSION: The booster vaccination had less effect on the infection caused by Omicron variant, but the course of the infection was milder. Compared to the basic immunisation, the booster vaccination caused a significant increase in the S antibody level. An exceptionally high S antibody level correlated with prior COVID-19 infection. Orv Hetil. 2023; 164(5): 163-171.

Journal of Population Therapeutics & Clinical Pharmacology

The SARS-CoV-2 virus causes a contagious disease known as Coronavirus Disease 2019 (COVID-19). It began spreading globally in 2019 and is still producing pandemics today. Different COVID-19 vaccinations offer protection against this illness. Pfizer-BioNTech and Sinopharm were the two vaccine manufacturers with the highest usage in Iraq. Both vaccines use a different method to activate the immune system. This study seeks to compare the IL-22, IL-37, and IL-38 levels in those who received either the Sinopharm or the Pfizer-BioNTech COVID-19 vaccination. IL-22, IL-37, IL-38 levels have been shown to be upregulated in COVID-19 patients. In this study, IL-22, IL-37, and IL -38 levels were tested in 80 healthy controls and 100 COVID-19 patients 14-21 days after recovery. Additionally, people who received the Sinopharm or Pfizer-BioNTech vaccine (50 each) were monitored 21 days after the first dosage and 21 days after the second dose. In comparison to controls, serum levels were noticeably higher in recovered patients. Except for the first dosage of Pfizer BioNTech, the first and second doses of Sinopharm and Pfizer BioNTech were linked to considerably higher levels of IL-22, IL-37, and IL-38 compared to controls or recovered patients. where IL-22, IL -37, and IL-38 levels did not show significant differences compared to recovered patients. In conclusion, lower IL-37 and IL-38 molecule levels were linked to recovery from COVID-19, although these levels remained considerably greater in recovered patients compared to uninfected controls. Vaccination with Sinopharm or Pfizer-BioNTech confirmed the up-regulating effects of SARS-CoV-2 on IL-22, IL-37, and IL-38 levels.

Adverse health events experienced by the recipients of COVID-19 vaccines and the associated factors in southwestern Saudi Arabia

Aims: Studying the post-vaccination adverse health events is crucial to determine the confidence and acceptance of the public to the newly-developed COVID-19 vaccines. The present study aimed to investigate the prevalence rates of the adverse health events experienced by the recipients of COVID-19 vaccines in Saudi Arabia. Methodology and results: A cross-sectional study was conducted in October 2021 using a google form of an online self-administered questionnaire sent via different social media platforms for recruiting participants from southwestern Saudi Arabia. The questionnaire was prepared by medical and public health professionals and then translated into Arabic, pilot-studied and validated. Among the 453 Saudi adults who participated in the study with at least one dose of the COVID-19 vaccine, about (77.9%) were males aged 25.5 +/- 10.6 years. Most of the participants were college students living in the Makkah region. Nearly 68.3% reported post-vaccination adverse events, such as injection site pain/swelling (91.9%), fatigue (67.9%), bone and muscle pain (65.2%) and flu-like symptoms (58%). The type of vaccine was significantly associated with the development of adverse events p=0.002 (OR of Pfizer-BioNTech versus AstraZeneca: 0.33, 95% CI: 0.18-0.61). Additionally, ageing of more than the 3rd decade, male gender and being married were significantly associated with lower rates of reporting post-vaccination adverse events. Conclusion, significance and impact of study: The development of COVID-19 vaccine-related adverse health events had no significant associations with residence, education, occupation, BMI, chronic diseases or smoking. However, age, gender, marital state and vaccine type may be considered significant predictors for developing post-vaccination adverse reactions.

Adverse effects of COVID-19 Pfizer-BioNTech vaccine in children aged 5-18 years in Saudi Arabia

Coronavirus disease 2019 (COVID-19) can infect children of all ages. Despite the fact that children have a lower risk of exposure and are tested less frequently than adults, their incidence is similar to that of adults. The most effective way to prevent COVID-19 infection is by vaccination. The study's objective was to document vaccination side effects in children aged 5 to 18 years. This cross-sectional study had 303 participating kids between the ages of 5 and 18 in its sample. During the months of March and April 2022, a validated modified questionnaire was circulated as a Google form to KSA citizens via social networking sites. The questionnaire asked questions about the participant's background, socio-demographic information, vaccination history, the mild and major adverse effects of the Pfizer vaccine and how those symptoms affected the child's health and quality of life. There was a total of 303 responses;all of them received two doses of the Pfizer-BioNTech covid-19 vaccine. They were 163 female children (54 %) and 140 males (46 %). The most frequently reported minor adverse effects were body tiredness (88.2%), moderate fever (76.5%), mild headache (72.3%) and discomfort, redness and swelling at the injection site (90.7%). The most reported severe side effects were severe headache (32.8%) and high fever (21.8%). Only five children (4.2%) required hospitalization for 1-3 days. The most common side effects for the Pfizer Covid-19 were the mild and moderate one including pain, redness and swelling at the injection site, fatigue, fever and headache. Most of the symptoms were not severe to need hospital admission.

N-Gram-Codon and Recurrent Neural Network (RNN) to Update Pfizer-BioNTech mRNA Vaccine

In the fight against SARS-CoV-2, Pfizer BioNTech based on synthetic messenger RNA (mRNA) proved to be quicker and more effective even with a small dose of micrograms per injection. Unfortunately, such a vaccine requires very low temperatures to prevent degradation of mRNA. In this paper, the authors have developed three new models of recurrent neural network (1-simple LSTM 2-BDLSTM 3-BERT) using n-gram-codon technique for the codification of mRNA. The primary aim is to analyse the mRNA sequence and predict the stability/reactivity rates at various codon positions. The results of the predictions will be presented in the form of recommendations to support laboratories in updating Pfizer's BioNTech vaccine. The obtained results were validated by the Stanford OpenVaccine dataset and the evaluation measures recall, precision, f1-score, accuracy, and loss.

A case report of relapse of minimal change disease after the first dose of Pfizer-BioNTech Covid-19 vaccine in King Abdul-Aziz Specialist Hospital, Taif, Saudi Arabia

Background: Documented cases of de novo glomerular disease or relapse of pre-existing glomerular disease was acquired shortly after administration of COVID-19 messenger RNA (mRNA) vaccinations. Objectives: to present a case of a 64-year-old female who received the Pfizer-BioNTech COVID-19 vaccination as a first dose and then experienced a relapse of minimal change disease (MCD) presenting with nephrotic syndrome. Case presentation: The presenting symptom was ankle swelling and frothy urine which started 9 days after the first dose of vaccine. Albumin level was 24 g/L, urine albumin/creatinine ratio was 668 mg/mmol, Creatinine had risen to 1.3 mg/dl, urine analysis showed 3+ protein. light microscopy showed 17 patent glomeruli, one of which was globally sclerosed. There was mild focal increase in mesangial matrix with occasional atrophic tubules with minor interstitial scarring affecting less than 5% of cortical area. There was moderate fibrointimal thickening. In electron microscopy, 100% of podocyte foot process were effaced with microvillation and marked cytoplasmic vacuolation. The findings were consistent with minimal change disease (MCD) with mild chronic renal parenchymal damage. The patient started furosemide 80 mg daily for 21 days after the onset of complaints. prednisolone 1 mg/kg was initiated 1 week and patient's symptoms improved. The patient achieved a complete remission 4 weeks after initiation of prednisolone. Conclusion: For the best management of MCD as a potential side effect following COVID-19 vaccination, more knowledge is required.

Numerical Simulation for a Hybrid Variable-Order Multi-Vaccination COVID-19 Mathematical Model

In this paper, a hybrid variable-order mathematical model for multi-vaccination COVID-19 is analyzed. The hybrid variable-order derivative is defined as a linear combination of the variable-order integral of Riemann–Liouville and the variable-order Caputo derivative. A symmetry parameter σ is presented in order to be consistent with the physical model problem. The existence, uniqueness, boundedness and positivity of the proposed model are given. Moreover, the stability of the proposed model is discussed. The theta finite difference method with the discretization of the hybrid variable-order operator is developed for solving numerically the model problem. This method can be explicit or fully implicit with a large stability region depending on values of the factor Θ. The convergence and stability analysis of the proposed method are proved. Moreover, the fourth order generalized Runge–Kutta method is also used to study the proposed model. Comparative studies and numerical examples are presented. We found that the proposed model is also more general than the model in the previous study;the results obtained by the proposed method are more stable than previous research in this area.

Effectiveness and adverse effects of astrazeneca and pfizer COVID-19 vaccines among medical students in Oman: A comparative study

Background: Immunization against severe acute respiratory syndrome coronavirus 2 became necessary to control the menace of COVID-19. However, the safety of COVID-19 vaccines must be monitored continuously. The present study aims at comparing the effectiveness and adverse effects of Pfizer and AstraZeneca vaccines among the cohort of medical students. Methods: It was a single-cohort comparative study, and the data were collected using an online survey from participants who took at least two doses of AstraZeneca or Pfizer vaccines. The data included demography, breakthrough infections, and adverse effects following vaccination. Bivariate and logistic regression models were used to find associations between effectiveness and independent variables. Statistical significance was considered at P < 0.05. Results: In total, 115 students who had received Pfizer or AstraZeneca vaccines were included in the study. The mean age of the participants was 21.52. Female (n = 90) participants were more compared to males (n = 25). The majority of them received Pfizer vaccine (95), while AstraZeneca was received by only 20 participants. Overall effectiveness of both AstraZeneca and Pfizer was nearly 85%, while almost 100% protection was observed among those who were vaccinated after contracting the disease. Logistic regression revealed an independent effect of COVID-19 before any vaccination dose offered 66% protection against any subsequent breakthroughs (odds ratio 0.44, 95% confidence interval [CI]: 0.095-2.08). At least one adverse effect was reported by 96 (83.5%) participants (95% CI: 75.4%-89.75%). Pain at the site of injection, fever, generalized weakness, and headache were the most common adverse effects. Fever (P < 0.001), body ache (P < 0.001), generalized weakness (P = 0.002), and joint pain (P = 0.014) were significantly more common in AstraZeneca as compared to Pfizer. Conclusion: Coronavirus vaccines were well tolerated, safe, and induced protection in most participants. Most postvaccine adverse events were mild to moderate, mainly due to induction of immune response by the body for protection. Furthermore, these mild to moderate adverse effects should not be hindrance to vaccination. © The Author(s) 2023.

Covid-19 Vaccines and mRNA Technology: Not as New as Many Believe

When the mRNA COVID-19 vaccines were announced in December 2020 the world was excited that a vaccine was available to combat the coronavirus pandemic. One of the most frequent comments was a desire to wait because the vaccine technology was "so new.” This article will concentrate on the mRNA vaccines not familiar to the public and is intended to explain the developmental timeline before and after the genome of COVID-19 was announced. We discuss Operation Warp Speed and SARS-CoV-2 and specifically the development of Messenger RNA (mRNA) vaccines and concurrent other types of vaccines. Other topics of discussion include COVID-19 variants;effectiveness of mRNA vaccines;and late news about the Pfizer-BioNTech COVID-19 vaccine. The article conclusion discusses implications for nurses as they continue to follow future developments, become competent in communicating viral epidemiology, and educate patients and families about vaccine options © 2022,Online Journal of Issues in Nursing. All Rights Reserved.

COVID-19 Vaccination Status and Post-Vaccination Adverse Effects Among Members of Health Sciences Faculties in Malaysia: A Descriptive Cross-Sectional Study

COVID-19 vaccines are breakthrough to reduce the unprecedented global pandemic;however, misinformation on their efficacy and Adverse Events Following Immunization (AEFI) may impede vaccine uptake. The objective of this study was to evaluate the COVID-19 vaccination compliance rate and AEFI among members of the Health Sciences Faculties (HSF) of our university. An online, cross-sectional, self-administered, structured questionnaire was distributed to the members of the HSF, SEGI University to study the demographic characteristics, history of infection, type of vaccine received, AEFI, duration, and hospitalization. Convenience sampling and descriptive statistics were employed. The Chi-square test was used to compare the postvaccination AEs among the CoronaVac® group, Pfizer-BioNTech group, and AstraZeneca group and a p-value of less than 0.05 was considered statistically significant. About 347 members responded to the survey. Following the first dose, one participant each from the Pfizer-BioNTech and AstraZeneca group tested positive for COVID-19. Following the second dose, two participants from the Pfizer-BioNTech contracted COVID-19 infection. Pain at the injection site (45.2%) and swelling (50.0%) were significantly more common in the Pfizer-BioNTech group, whereas warmth (50.0%) was most experienced by those receiving AstraZeneca. After the second dose, headaches (51.8%), fatigue (50.5%), fever (58.6%), myalgia (51.6%), and chills (65.9%) were found to be the highest among recipients of Pfizer-BioNTech vaccine as compared to the rest. HSF members exhibited a good compliance rate with COVID-19 vaccination. Recipients of AstraZeneca experienced AEFI for a longer duration than the rest. Identification and reporting of the AEFI of COVID-19 vaccines are the need of the hour to encourage compliance to vaccination among members of the public. © 2023,Journal of International Dental and Medical Research. All Rights Reserved.

evaluation of hematological abnormalities in subjects vaccinated with bnt162b2 in a longitudinal cohort of the coRe study

Background: Vaccination is considered the most effective preventive strategy to fight COVID-19. The aim of this study was to evaluate two critical concerns about: 1) the kinetic response of IgG and IgM, and: 2) the hematological abnormalities in a longitudinal cohort of health-care workers (HCW) who had received 2 doses of BNT162b2 mRNA-based vaccine. Method(s): Blood and nasopharyngeal swabs were collected from 46 volunteers' participants, previous written consensus, with presumable no symptoms of COVID-19. Anti-SARS-CoV-2 serum immunoglobulin G (IgG) and M (IgM) and hematological parameters were examined. Multivariable mixed-effects models for repeated measure analysis were adopted to evaluate time changes in IgG, IgM and hematological parameters, and to investigate associations with vaccination response. Result(s): Forty-six subjects (N.=46;31.8% men;68.2% women;mean age near 36 years-old) were enrolled among healthcare workers of IRCCS MultiMedica (Milan, Italy). Overall, increase in serological IgG concentration appeared mainly between 21-28 days after the 1st dose, whereas IgM did not reach positivity in all cases. Mean blood cells counts were in normal range but we observed a significant reduction of total white blood cells and absolute lymphocyte counts after the 1st dose, persisting until the day 28. The increase of monocytes and neutrophils the day after the 1st dose subsequently decayed significantly. Eosinophils concentration showed a tendency to increase over time. Peripheral blood smear showed a growing frequency of atypical lymphocytes (lympho-variants), and of plasmacytoid forms, whereas no difference was found in large granular lymphocytes (LGL), although a decay after the boost was evident. The stratification of subjects, relative to the timing of IgG increase, showed the occurrence of 3 different patterns after vaccination, namely early-responders (R+), late-responders (R-) and pauci-responders (PR) with a peculiar kinetics of hematological parameters. Lymphocytes were significantly associated with total IgG: lower in R+ and PR compared to R- (P=0.0193 and P=00054, respectively). Conclusion(s): In healthy subjects, anti SARS-CoV-2 vaccination induced a variety of non-pathologic abnormalities. The response to vaccination was not equal in the groups examined. In PR group a major difference occurred with respect to R- and R+. This work adds novel insight into the puzzle of changes induced by SARS-CoV-2 virus.Copyright © 2022 EDIZIONI MINERVA MEDICA.