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Guillain-Barré syndrome (GBS) is a rare but serious immune-mediated neurological condition characterized by damage to the peripheral nervous system. Two-thirds of cases of GBS are diagnosed following infection; however, vaccination has also been linked to GBS pathogenesis. The aim of this systematic review and meta-analysis was to establish the prevalence of GBS following vaccination against the SARS-CoV-2 virus, which causes COVID-19, describe the clinical and neurophysiological characteristics, and identify potential determinants. A systematic review of the literature regarding post-vaccination GBS was conducted using the PubMed database. Seventy papers were included. The pooled prevalence of GBS after vaccination against COVID-19 per has been established to be 8.1 (95% CI 30-220) per 1,000,000 vaccinations. Vaccination with vector vaccines - but not mRNA - has been associated with an increased risk of GBS. More than 80% of the patients developed GBS within 21 days following the first dose of the vaccination. The interval between the vaccination and GBS was shorter in patients who were vaccinated with mRNA versus vector vaccines (9.7±6.7 days versus 14.2±6.6 days). Epidemiological findings regarding post-vaccination GBS revealed a higher prevalence in males and people between the ages of 40 and 60 years, with a mean age of 56.8±16.1 years. The most common type was the acute inflammatory demyelinating polyneuropathy type. Most cases responded well to treatment. In conclusion, vaccination against COVID-19 with vector vaccines seems to increase the risk of GBS. GBS occurring following vaccination does differ in characteristics from GBS during the pre-COVID-19 era.
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Background and aim: Patients with cancer are at an increased risk for morbidity and mortality from coronavirus disease 2019 (COVID-19). Although cancer patients should have the priority for vaccination against SARS-CoV-2, data on vaccine immunogenicity and safety against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are scarce. The aim of this prospective study was to investigate the safety and efficacy of Pfizer-BioNTech's COVID-19 vaccine (BNT162b2) in solid cancer patients receiving active chemotherapy. Methods: We evaluated the safety and immunogenicity of BNT162b2 vaccine in 51 solid cancer patients undergoing active therapy in Azadi Hematology -- Oncology center in Duhok city. The serum IgG antibody titer for S1 protein was measured by using VIDAS at pre-vaccination and 14-30 days after the second dose. The adverse events of vaccine were collected by a standardized questionnaire. Results: From 51 patients, most were metastatic (35, 68.63%), stage IV (28,54.90%). Females were more than males (36, 70.59%), (15, 29.41%) respectively. The most common types of cancer were breast (16, 31.37%), colon (8, 15.69%). Anti-S1 antibody level was significantly high. Fifty patients were seropositive (98.04%). Vaccine showed high safety profile;most of the adverse effects were mild to moderate. Most of the side effects recovered over 1-3 days. Injection site reactions were the most frequent local adverse effects after first and second doses, 17.6% and 52.9, respectively. On the other hand, most prevalent systemic adverse effects were fever (17.65%, 44.00%), headache (16.00%, 21.57%), and myalgia (35.29%, 5.88%) after first and second doses, respectively. Conclusion: the COVID-19 vaccine acceptance rate was high (89.36%). The seropositivity, following BNT162b2 vaccine, was extremely high (98.04) among cancer patient on active chemotherapy. The vaccine showed good tolerance and an excellent safety profile. Hence, it should be strongly recommended for such a risky vulnerable group to SARSCoV- 2. Breast cancer showed significantly higher seropositivity in comparison to colon cancer, which may be attributed to chemotherapy regimen, degree of immunosuppression, and gender factors. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: Renal complications have previously been reported with various vaccinations, including those for influenza and hepatitis. On a similar note, a spectrum of nephrological complications, both de novo, and flare-ups, were reported after immunization with various coronavirus disease 2019 (COVID-19) vaccines, causing concerns among patients as well as physicians. Materials and Methods: A systematic search of the literature published on renal complications seen post-COVID-19 vaccination was performed up to April 2022 using electronic databases such as PubMed and Google Scholar. Result: Immunoglobulin A (IgA) nephropathy, minimal change disease, glomerulonephritis, acute kidney injury, nephrotic syndrome, and anti-neutrophil cytoplasmic antibody-associated vasculitis were some of the renal complications reported upon administration of COVID-19 vaccines. The causality and underlying pathogenic mechanisms linking these complications and COVID-19 vaccination remain unclear. Nonetheless, a temporal relationship has been established with dysregulated T-cell response, transient systemic pro-inflammatory cytokine response, molecular mimicry, delayed hypersensitivity reaction to the vaccine, and other mechanisms such as hyperresponsive IgA, dysregulation of neutrophil extracellular traps were hypothesized as the possible mechanisms linking renal complications and COVID-19 vaccination. Conclusion: This review emphasizes the need for rigorous surveillance and reporting of the adverse events following COVID-19 vaccination and explores the underlying mechanisms instigating these renal complications in individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
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Due to a large number of mutations in the spike protein and immune escape, the Omicron variant (B.1.1.529) has become a predominant variant of concern (VOC) strain. To prevent the disease, we developed a candidate inactivated vaccine (Omicron COVID-19 Vaccine (Vero Cell), Inactivated). To evaluate the safety of the vaccine, we tested the repeat-dose toxicity in Sprague-Dawley (SD) rats. The doses were administered randomly to three groups: physiological saline solution (control), aluminum adjuvant in PBS solution adjuvant (adjuvant group), and low-dose and high-dose omicron vaccines (vaccine group) for 6 weeks. The SD rats were allowed to recover for 4 weeks after withdrawal. We evaluated the physiological condition of the rats, including their ophthalmological condition, body weight, food intake, body temperature, blood biochemistry, urine, neutralizing antibody, inflammation at the injection site, and organs weight. In summary, no dose-dependent adverse toxicological changes were observed, and a recovery trend was obvious, which proved the preclinical safety of the candidate omicron vaccine and provided evidence for clinical trials in humans. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Relevance. During a pandemic, the epidemiological well-being of the population of the whole world depends on the vaccination of each individual person, as cells of the immune layer. Only reliable and open information about adverse events after the use of vaccines, obtained in a timely manner in the process of continuous monitoring, can support the confidence and adherence of the population to vaccination. Aim. To assess the monitoring system for AEFI (Adverse Events Following Immunization) in the Russian Federation and other countries. Materials and methods. A descriptive epidemiological study was conducted with a review of regulatory and methodological documents, forms of federal statistical observation, information from the AIS «DRAID» (Analytical Information System «Department of registration and accounting of infectious diseases» program in Moscow, acts of investigation of post-vaccination complications, which were carried out by specialists from the branches of the Center for Hygiene and Epidemiology in Moscow, sources: eLIBRARU.ru, cyberleninka.ru, information from WHO’s websites, Internet resources for monitoring AEFIs in different countries and websites of manufacturers of COVID-19 vaccines, instructions for vaccines. Conclusion. Thus, it is almost impossible for an epidemiologist working in one of the departments that participates in the monitoring of AEFIs to conduct a full-fledged prospective and retrospective epidemiological analysis and draw unambiguous conclusions about the AEFIs based only on data from open sources and forms of state statistical observation. There is a need for interaction and exchange of information between the subjects of monitoring. © 2022, Numikom. All rights reserved.
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Since the introduction of coronavirus disease 2019 (COVID-19) messenger ribonucleic acid (mRNA) vaccines, there have been multiple reports of post-vaccination myocarditis (mainly affecting young healthy males). We report on four patients with active autoimmune rheumatic diseases (ARDs) and probable or confirmed myocarditis following COVID-19 mRNA vaccination managed at a tertiary hospital in Singapore; we reviewed the literature on post-COVID-19 mRNA vaccination-related myocarditis and ARD flares. Three patients had existing ARD flares (two had systemic lupus erythematosus (SLE), one had eosinophilic granulomatosis polyangiitis (EGPA)), and one had new-onset EGPA. All patients recovered well after receiving immunosuppressants comprising high-dose glucocorticoids, cyclophosphamide, and rituximab. Thus far, only one case of active SLE with myocarditis has been reported post-COVID-19 mRNA vaccination in the literature. In contrast to isolated post-COVID-19 mRNA vaccination myocarditis, our older-aged patients had myocarditis associated with ARD flares post-COVID-19 vaccination (that occurred after one dose of an mRNA vaccine), associated with other features of ARD flares, and required increased immunosuppression to achieve myocarditis resolution. This case series serves to highlight the differences in clinical and therapeutic aspects in ARD patients, heighten the vigilance of rheumatologists for this development, and encourage the adoption of risk reduction strategies in this vulnerable population.
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COVID-19 vaccinations are an important tool for alleviating the effects of the pandemic. However, many Americans, including many Texans, are hesitant to receive a COVID-19 vaccine. This study examined who, among Texans, is most likely to experience COVID-19 vaccine hesitancy and determined the reasons behind COVID-19 vaccine hesitancy among Texans. To address our objectives, we used six weeks of repeated cross-sectional data from January 6, 2021, through March 29, 2021, from the United States Census Bureau's Household Pulse Survey. An average of 4,145 Texas household responded to the survey each week. We found that 52 percent of Texans who had not yet received a COVID-19 vaccine (as of January - March 2021) reported vaccine hesitancy. Female and black Texans had the highest odds of reporting COVID-19 vaccine hesitancy, while Texans of Asian descent, Texans who have college degrees or higher, and Texans 40 years and older had a lower odds of reporting hesitancy. The most common reasons for vaccine hesitancy among Texans were: they plan to wait and see if the vaccine is safe and they may get it later;they are concerned about possible side effects of a COVID-19 vaccine;and they think other people need the vaccine more than they do at the present moment. Efforts to promote COVID-19 vaccination in Texas may benefit from a focus on black, female, and younger (<40 years) Texans. Additionally, to increase COVID-19 vaccination rates, public health messages could address the two most commonly reported reasons for Texans' vaccine hesitancy: (1) I plan to wait and see if it is safe and may get it later, and (2) I am concerned about possible side effects of a COVID-19 vaccine. [ FROM AUTHOR] Copyright of Texas Public Health Journal is the property of Texas Public Health Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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These articles address the recent advances and future perspectives in the field of neuroinfectious diseases to try and elucidate the pathogenetic mechanisms, and identify effective treatment and preventive measures for each disease. Despite the recent remarkable diagnostic and therapeutic advances, including next-generation sequencing, bioinformatic tools, vaccines, therapeutic antibodies and antibiotics, neurological infections are major causes of permanent neurological disability.1 Although accumulating evidence has suggested the importance of complex microbe-host interactions and host immune response in determining the risk and timing of disease, and technological advances have greatly aided our knowledge of how the immune system influences the nervous system, the precise mechanism of disease pathophysiology is still incompletely understood and the treatment is still unsatisfactory.2 This issue of I Clinical and Experimental Neuroimmunology i focuses on "Neuroimmunology and neuroinfectious diseases", for which leading experts have contributed four review articles on emerging topics, including neuro-COVID-19, human prion disease, HTLV-1-associated myelopathy and Bornavirus infection. Shimohata summarizes the neuromuscular manifestations of the novel coronavirus disease 2019 (COVID-19) and adverse reactions to the COVID-19 vaccines. [Extracted from the article];Copyright of Clinical & Experimental Neuroimmunology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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B Introduction: b In midst of the ongoing coronavirus disease 2019 (COVID-19) surges, immunization remains the primary hope to end this pandemic. B Discussion: b This patient's overwhelming inflammatory response was attributed to COVID-19 vaccination after excluding other etiologies. COVID-19 spike protein IgM/IgG antibodies were reactive but COVID-19 polymerase chain reaction (PCR) was negative. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Vaccination is considered one of the most important achievements of modern medicine and has saved millions of lives. As a result, the age-old fear of severe or fatal infectious diseases has largely been forgotten in society; however, the pandemic triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shows how quickly this fear can return. Also, many people have reservations about medical measures, especially if they are directed against vague dangers. Paradoxically, the success of vaccinations jeopardizes the acceptance. To counteract this development, this article provides information on basic vaccination principles, legal frameworks and components of vaccines. It explains the most important categories, goals, core elements of vaccination programs and the most important recommendations of the Standing Committee on Vaccination at the Robert Koch Institute (STIKO). It explains the current state of knowledge with respect to required resources, assessment of vaccine reactions, complication management and possible vaccine damage.
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COVID-19 , SARS-CoV-2 , Humans , VaccinationABSTRACT
Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder that results in the formation of thrombi in the small blood vessels throughout the body. The two primary forms of TTP are acquired and familial forms. The acquired form usually presents in late childhood or adulthood. Almost 95% of the cases are due to an autoantibody directed against ADAMTS13, and the remaining 5% are due to drugs like ticlopidine, quinine, cyclosporine, gemcitabine, bevacizumab, and certain recreational drugs like ecstasy and cocaine. The familial forms present in infancy or early childhood, but sometimes they can present later in life. Management for acquired forms includes therapeutic plasma exchange and immunosuppressive agents. While for the hereditary forms, the mainstay of treatment is plasma infusion. We present a case of an 80-year-old male with a known medical history of hypertension, type II diabetes mellitus, hyperlipidemia, gout, iron deficiency anemia, and Pfizer-BioNTech COVID-19 (coronavirus disease-19) vaccine administered two weeks before presentation to the ER for evaluation of generalized weakness and malaise. Laboratory findings showed severe anemia with hemoglobin of 4.8 g/dl, platelet count of 48 x 10^3/mcL, elevated lactate dehydrogenase (LDH), decreased haptoglobin, and peripheral smear showing schistocytes. The serum creatinine, total bilirubin, and troponin were elevated. All these findings were raising concern for presumptive diagnosis of TTP, which was confirmed with ADAMTS13 levels less than 10%. TTP was temporarily resolved in 10 days with plasma exchange therapy and high-dose corticosteroids. It is difficult at this time to differentiate vaccine-induced TTP from coincidental TTP presenting soon after vaccination. Further studies would be needed to understand better if this relationship between vaccination and TTP was coincidental or causal.
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BACKGROUND: Vaccine-induced cerebral venous and sinus thrombosis (VI-CVST) is a rare complication in recipients of the adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccine ChAdOx1 nCov-19 (Vaxzevria®; AstraZeneca). OBJECTIVES: Development of a diagnostic and therapeutic standard. MATERIALS AND METHODS: Analysis of clinical and basic research findings, expert opinions, and experience with our own cases. RESULTS: VI-CVST usually manifests on day 4-24 after vaccination, mostly in individuals aged <â¯60 years, and women. In the majority there is an immune pathogenesis caused by antibodies against platelet factor 4/polyanion complexes, leading to thrombotic thrombocytopenia which can result in severe, sometimes fatal, course. The cardinal symptom is headache worsening within days which, however, also can be of variable intensity. Other possible symptoms are seizures, visual disturbance, focal neurological deficits and signs of increased intracranial pressure. If VI-CVST is suspected, the determination of plasma Ddimer level, platelet count, and screening for heparin-induced thrombocytopenia (HIT-2) are essential for treatment decision-making. Magnetic resonance imaging (MRI) with venous MR-angiography is the neuroimaging modality of choice to confirm or exclude VI-CVST. On T2* susceptibility-weighted MRI, the clot in the sinuses or veins produces marked susceptibility artifacts ("blooming"), which also enables the detection of isolated cortical venous thromboses. MRI/MR-angiography or computed tomography (CT)/CT-angiography usually allow-in combination with clinical and laboratory findings-reliable diagnosis of VI-CVST. CONCLUSIONS: The clinical suspicion of VI-CVST calls for urgent laboratory and neuroimaging workup. In the presence of thrombocytopenia and/or pathogenic antibodies, specific medications for anticoagulation and immunomodulation are recommended.