ABSTRACT
Almost all vaccines have been reported to be associated with ocular inflammation, which has caused some concern regarding global mass COVID-19 vaccination efforts. Vogt-Koyanagi-Harada disease (VKHD) is a granulomatous inflammation caused by an autoimmune response against antigens in melanocytes, including those in the eyes. The mechanism by which COVID-19 vaccines are associated with VKHD is still unclear. Here, we report two cases of VKHD following COVID-19 vaccination. The first is a case of probable VKHD that presented with bilateral vision loss after administration of the adenovirus-vectored vaccine ChAdOx1 nCoV-19 (AstraZeneca). The condition improved after intravenous methylprednisolone 1g daily for 3days, followed by oral methotrexate and a slow taper of oral corticosteroids. The second case is a patient with an established diagnosis of well-controlled VKHD who developed a reactivation of the disease after receiving the mRNA-based vaccine (mRNA-1273, Moderna). VKHD is a potential ocular event that could follow COVID-19 vaccination. Awareness of this association is key to early detection and treatment to prevent loss of vision.
Subject(s)
COVID-19 , Uveomeningoencephalitic Syndrome , Humans , Uveomeningoencephalitic Syndrome/diagnosis , Uveomeningoencephalitic Syndrome/etiology , ChAdOx1 nCoV-19 , 2019-nCoV Vaccine mRNA-1273 , COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , COVID-19/complications , Vaccination/adverse effects , Inflammation/complicationsABSTRACT
Vaccination recommendations for the prevention of herpes zoster (HZ) aim to reactivate specific cell-mediated immunity towards the varicella/zoster virus. This specific immunity naturally declines with age but there are many factors that can accelerate this decline, including, most recently, the immune response induced by SARS-CoV-2. Two vaccines are available to date. A live attenuated vaccine (Zostavax®) licensed in 2006 and more recently a recombinant vaccine (Shingrix®). We present data on the efficacy of these two vaccines as well as on the relevant precautions and safety of use. © 2023 Elsevier Masson SAS Les recommandations vaccinales en matière de prévention du zona ont pour objectif de réactiver l'immunité à médiation cellulaire spécifique contre le virus varicelle-zona. Cette immunité spécifique décline naturellement avec l'âge mais nombreux sont les facteurs qui peuvent accélérer ce déclin dont récemment la réponse immunitaire induite par le SARS-CoV-2. Deux vaccins sont disponibles à ce jour : un vaccin vivant atténué (Zostavax®) homologué en 2006 et plus récemment un vaccin recombinant (Shingrix®). Nous présentons des données d'efficacité de ces deux vaccins ainsi que celles concernant leurs précautions d'emploi et la sécurité de leur utilisation. © 2023 Elsevier Masson SAS
ABSTRACT
Résumé Les recommandations vaccinales en matière de prévention du zona ont pour objectif de réactiver l'immunité à médiation cellulaire spécifique contre le virus varicelle-zona. Cette immunité spécifique décline naturellement avec l'âge mais nombreux sont les facteurs qui peuvent accélérer ce déclin dont récemment la réponse immunitaire induite par le SARS-CoV-2. Deux vaccins sont disponibles à ce jour : un vaccin vivant atténué (Zostavax®) homologué en 2006 et plus récemment un vaccin recombinant (Shingrix®). Nous présentons des données d'efficacité de ces deux vaccins ainsi que celles concernant leurs précautions d'emploi et la sécurité de leur utilisation. Summary Vaccination recommendations for the prevention of herpes zoster (HZ) aim to reactivate specific cell-mediated immunity towards the varicella/zoster virus. This specific immunity naturally declines with age but there are many factors that can accelerate this decline, including, most recently, the immune response induced by SARS-CoV-2. Two vaccines are available to date. A live attenuated vaccine (Zostavax®) licensed in 2006 and more recently a recombinant vaccine (Shingrix®). We present data on the efficacy of these two vaccines as well as on the relevant precautions and safety of use.
ABSTRACT
Introduction Les patients ayant une sclérose en plaques (SEP) ont parfois des réticences concernant la vaccination, notamment en raison d'idées fausses qui ont été largement diffusées concernant la vaccination de l'hépatite B. Objectifs Étudier l'association entre la vaccination COVID-19 et le risque de survenue de poussées de SEP. Méthodes Les données du Système national des données de santé (SNDS, 68 millions de Français couverts) ont été utilisées pour identifier tous les patients présentant une SEP, et un algorithme a permis d'identifier toutes les poussées ayant nécessité un traitement par corticoïdes à fortes doses. Une méthode de type « self-controlled case series » a été utilisée pour comparer les périodes exposées à la vaccination à celles non exposées, globalement et dans des sous-groupes d'intérêt. Résultats Au total, 124 545 patients SEP ont été identifiés, dont plus de 80 % ont reçu au moins une dose vaccinale. Les patients ne présentaient aucune majoration du risque de poussée, que la période d'analyse porte sur les 6 ou les 12 semaines après la vaccination. Ces données étaient les mêmes après la deuxième dose vaccinale. Il existait même une légère diminution du risque de poussée pendant quelques semaines, dans les suites de chaque vaccination. Discussion Cette étude de grande ampleur, portant sur la France entière, et utilisant une méthodologie adaptée autocontrôlée (chaque patient étant son propre témoin), ne montre pas d'augmentation du risque de poussée de SEP après une vaccination contre le COVID, là où de nombreuses séries de cas de petit effectif avaient montré l'existence de poussées inflammatoires dans les suites de la vaccination. Conclusion Ces données très rassurantes permettent de poursuivre l'incitation vaccinale chez nos patients SEP, en particulier chez ceux ayant des facteurs de risque d'infection grave (âge, handicap, obésité, traitement par anti-CD20…).
ABSTRACT
OBJECTIVE: SARS-CoV-2 is more likely to cause severe cases in pregnant women. They were part of the priority groups since April 2021 to benefit from SARS-CoV-2 vaccination before its extent to general population. This contribution aims to evaluate, in the postpartum period, the achievement of COVID-19 vaccination and factors associated in women during their pregnancy. MATERIAL AND METHOD: Multicenter cross-sectional survey study conducted from September to December 2021 with online self-questionnaire. All postpartum patients hospitalized in one of the 6 participating maternity hospitals were invited to answer. The questionnaire asked patients about their demographic characteristics, vaccination modalities, vaccine tolerance, and their general perception of vaccination. RESULTS: Of the 371 women who responded, the vaccination rate was 65.7% (IC95% [60.8-70.4]), whom 98.8% entirely during pregnancy. Associated factors with vaccination during pregnancy were older age, higher socio-professional category, and prior information provided by health professionals. Factors that appear to motivate vaccination were personal protection and protection of the newborn. Finally, main factors negatively influencing the vaccination process were the fear of vaccine side effects and the negative perception of vaccines in general. DISCUSSION: Acceptability and information about the vaccine by health professionals is in constant improvement. Information campaigns should be continued to improve the acceptability of vaccination, in light of the accumulating data.
ABSTRACT
The pandemic subsequent to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus resulted, for the French institutional pharmacovigilance, in a "health crisis" in 2 phases: the coronavirus disease 2019 - "COVID-19" phase during which the missions of the Regional Pharmacovigilance Centres (RPVC) were to detect a possible impact of drugs on this disease, as whether existed a possible aggravating role of certain drugs, or the safety profile of drugs used for the management of COVID-19 could evolve. The second phase followed the availability of COVID-19 vaccines, during which the RPVCs' missions were to detect as early as possible any new serious adverse effect, source of a potential signal that would modify the benefit/risk ratio of a vaccine and require the implementation of health safety measures. During these two periods, signal detection remained the core business of the RPVCs. The RPVCs had to organize themselves to handle an historical surge of declarations and requests for advice, whereas the RPVCs in charge of monitoring vaccines had to deal with an extraordinary dense activity over a long period of time, in order to produce in real time and on a weekly basis, a summary of all the declarations and an analysis of safety signals. The national organization put in place made it possible to meet the challenge of real-time pharmacovigilance monitoring of 4 vaccines with conditional marketing authorizations. Short-circuit efficient exchanges with the French Regional Pharmacovigilance Centres Network was paramount for the French National Agency for medicines and health products (Agence nationale de sécurité du médicament et des produits de santé) to develop an optimal collaborative partnership. The RPVC network has shown agility and flexibility, has been able to adapt swiftly and demonstrated its effectiveness in the early detection of safety signals. This crisis confirmed the superiority of manual/human signal detection as the most effective and powerful tool to date, to rapidly detect a new adverse drug reaction and enable to elaborate rapid measures of risk reduction. In order to maintain the performance of French RPVCs in signal detection and to monitor all drugs as they should and as expected by our fellow citizens, a new funding model correcting the inadequacy of RPVCs' expertise resources in relation to the volume of reports should be considered.
ABSTRACT
The development of a vaccine for COVID-19 presented hope for a way out of the global crisis caused by the virus. However, a potential barrier may be vaccine hesitancy, and identifying the factors that affect it is critical, especially concerning a new vaccine technology. The purpose of this research is to identify the factors that effects vaccine hesitancy by using a holistic view. The data were collected from 504 people in December 2020, 3 days before the vaccine operation started in Israel. The analysis included three categories of determinants: (1) contextual influences;(2) health records;and (3) perceived health attitudes. The results indicate that different sets of variables affect willingness to accept the vaccine among the whole spectrum of the vaccine-hesitant and the undecided subsample. In the full sample, gender, age, income, influenza vaccine, perceived trust, perceived susceptibility, perceived benefits, and perceived barriers affected vaccine acceptance. The perceived level of suffering from COVID-19 was associated with willingness to vaccinate, and when religious beliefs increased, the intention to vaccinate decreased. For the undecided subsample, the factors included gender, influenza vaccine, trust in the vaccine company, and perceived vaccine benefits and barriers. The results suggest that efforts of governments and health institutions should focus on women and highlight the vaccine as an opportunity to "go back to normal" without worries. Those results will help implement vaccine strategy in the following cases: if infant vaccination is pursued and if emergency vaccines or new vaccine technologies emerge for another pandemic as well. Copyright © 2021.
ABSTRACT
The pandemic linked to Covid-19 let the notion of freedom rights arise: freedom of expression, of movement, of vaccination, etc. In this context, this article focuses on the vaccination process. Between pro-vaccination, "anti-vax" and undecided, the question of freedom, of the individual decisional autonomy of the citizen and the collective/societal benefit to be oriented towards a choice arises. The dispensation of information, via the media (television, written, radio) and the multitude of sources available on the Web, may or may not facilitate decision-making. But what about the position of caregivers? Beyond the principle of wanting to care without counting, the Hippocratic oath ("I will respect all persons, their autonomy and their will, without any discrimination according to their condition or their convictions"), is it easy to keep these convictions? Is it legitimate to ask the question "Would it be ethical to prioritize vaccinated patients in intensive care?", a question joined by certain doctors of Wallonia (Belgium) in an approach of ethical debate. A look at the literature tries to understand this questioning, which can be both positive and disturbing. Level of Evidence: NA. Copyright © 2022 Elsevier Masson SAS
ABSTRACT
Introduction: In Tunisia, the Ministry of Health launched an awareness campaign in television spots and different social media platforms and started the vaccination campaign on the 13 March 2021 aiming to have vaccinated half of the Tunisian population by the end of 2021. However, to date, on July 31, 2021, only 1,104,286 people are completely vaccinated Objectives: The aim of the study was to identify Tunisians' mental perceptions and attitudes towards COVID-19 vaccines to examine the predictors of the COVID-19 vaccine hesitancy in the Tunisian population. Method(s): A group of citizens, randomly selected were invited to participate in the study. Data were collected through a focus group using a piloted topic guide. The entire discussion was recorded in audio-visual mode with a total duration of 1 hour. We also collected data on participant gender, age, education, and profession. Result(s): Seven women and four men participated in the study All participants reported having doubts about the efficacy of the vaccines. Two participants reported that their acquaintances died after being vaccinated. They suspected that expired vaccines have caused the reported deaths. "I think these vaccines can be extremely dangerous. They could contain chemicals that are carcinogens or that have a castrating effect", an interlocutor stated, supported by the rest of the group. We found unanimously in our study, attesting to the relevance of religion in the lives of the Tunisian people, which is in agreement with literature Conclusion(s): Construction of multi-component and systematic interventions are required by public health authorities.
ABSTRACT
This special issue contains 7 articles that discuss COVID-19 and vaccination refusal, theories on intention to be vaccinated, culture, health attitudes and behaviour, vaccine rollout management and communication, and risk perception and policy compliance.
ABSTRACT
La infección por el SARS-CoV-2 (COVID-19) ha supuesto un importante impacto en la actividad trasplantadora en nuestro país. En su condición de paciente inmunodeprimido y con frecuentes comorbilidades, era esperable que la mortalidad y el riesgo de complicaciones asociadas a la COVID-19 en el receptor de trasplante renal (TR) fueran mayores en comparación con la población general, si bien la información al respecto en los primeros meses de la pandemia era muy limitada. Desde marzo de 2020 hemos mejorado rápidamente nuestro conocimiento acerca de la epidemiología, características clínicas y manejo de la COVID-19 post-trasplante. La presente revisión pretende recopilar la información disponible a julio de 2021 en respuesta a una serie de cuestiones relevantes: ¿cómo se manifiesta clínicamente la infección por SARS-CoV-2 en receptores de TR?, ¿cuáles son sus factores pronósticos?, ¿es más grave la COVID-19 en el contexto del TR respecto a los pacientes inmunocompetentes?, ¿de qué opciones de tratamiento antiviral disponemos actualmente para el receptor de TR?, ¿cuál es la experiencia disponible con los tratamientos inmunomoduladores? y, por último, ¿son eficaces las vacunas frente a la COVID-19 basadas en ARN mensajero en esta población?. A pesar de los avances realizados, aún son varios los aspectos que debemos mejorar en nuestro abordaje de la infección por SARS-CoV-2 en el ámbito específico del TR.Alternate : SARS-CoV-2 infection (COVID-19) has profoundly impacted transplant activity in our country. As immunocompromised hosts with common comorbidities, kidney transplant (KT) recipients were expected to have higher mortality and risk of complications associated to COVID-19 compared to the overall population. The available experience at the beginning of the pandemic, however, was very limited. Since March 2020 our knowledge on the epidemiology, clinical features and management of post-transplant COVID-19 has rapidly evolved. The present review is aimed at summarizing the information generated by July 2021 to answer a number of relevant questions: How does SARS-CoV-2 infection present in KT recipients? What are the prognostic factors? Does COVID-19 entail a worse prognosis in the setting of KT as compared to non-immunocompromised individuals? What are the antiviral agents currently available for KT recipients? What is the experience with the use of immunomodulatory therapies? And lastly, are mRNA-based COVID-19 vaccines effective in this patient population? Despite notable advances achieved, we should still improve various aspects of our approach to SARS-CoV-2 infection in the specific setting of KT.
ABSTRACT
BACKGROUND AND PURPOSE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has accelerated vaccine development. The BNT162b2 messenger RNA (mRNA) vaccine is being administered worldwide. The purpose of this case series is to report a possible association between the BNT162b2 mRNA vaccine and Central serous chorioretinopathy (CSC). Although rare, CSC has been reported following the administration of anthrax, influenza and smallpox vaccines. METHODS: Four individuals who developed CSC following the BNT162b2 mRNA vaccine were examined in our institution using multimodal imaging of the retina, and their demographic data were analyzed and compared to all the similar cases published to date. RESULTS: Four patients (3 males, 1 female) between the ages of 35 and 65 presented with acute CSC (n=3) and relapsed CSC (n=1) within the first week following the administration of the BNT162b2 mRNA vaccine. Three individuals demonstrated hyper-reflective foci in the outer segments of the retina. CONCLUSIONS: The timing of the BNT162b2 mRNA vaccine administration relative to the development of CSC suggests a possible causal relationship. Further research is necessary to explore this possible association.
Subject(s)
BNT162 Vaccine , COVID-19 , Central Serous Chorioretinopathy , Adult , Aged , BNT162 Vaccine/adverse effects , COVID-19/prevention & control , Central Serous Chorioretinopathy/chemically induced , Female , Humans , Male , Middle Aged , SARS-CoV-2ABSTRACT
résumé Le développement et l’évaluation accélérés de vaccins efficaces contre le SARS-CoV-2 ont permis de contrôler en partie la pandémie de COVID-19, responsable d'une crise sanitaire sans précédent. En juin 2022, six vaccins ont été autorisés en Europe, onze ont été reconnus par l'Organisation mondiale de la santé (OMS), et plus de 160 candidats vaccins sont en développement clinique. La remarquable efficacité de ces vaccins, démontrée lors des études pivots, a été confirmée dans les essais en vie réelle. Les données d'efficacité contre le variant Omicron montrent une protection limitée de la primovaccination vis-à-vis des formes symptomatiques, mais qui reste élevée contre les formes graves. L'efficacité n'est qu'en partie restaurée par l'administration d'une ou deux doses de rappel. Les données d'immunogénicité et de sécurité des schémas hétérologues et la possible interchangeabilité entre les vaccins à ARNm sont autant d'outils précieux pour faciliter l'intensification des campagnes de vaccination et envisager de nouvelles stratégies vaccinales. The rapid development and accelerated evaluation of effective vaccines against SARS-CoV-2 have made it possible to partially control the COVID-19 pandemic, responsible for an unprecedented health crisis. In June 2022, six vaccines are authorized in Europe, eleven are recognized by the World Health Organization and more than 160 candidate vaccines are in clinical development. The remarkable efficacy of these vaccines assessed in pivotal trials has been confirmed effectiveness trials. Current efficacy data against the Omicron variant show limited protection conferred by primary vaccination against symptomatic forms, but which remains significant against severe forms. Vaccine efficacy is partially restored by administration of a booster dose. The reassuring data on immunogenicity and safety of heterologous regimens, the possible interchangeability between mRNA vaccines are all valuable tools to facilitate the intensification of vaccination campaigns and consider new vaccine strategies.
ABSTRACT
We present a case of acute bilateral multifocal CSCR in a young healthy Caucasian female occurring 3 days after receiving the first dose of the Pfizer-BioNTech BNT162b2 COVID-19 mRNA vaccine. The true incidence of this adverse reaction might be underreported in asymptomatic unilateral or paracentral cases. We believe that the post-COVID-19 vaccination occurrence of CSCR is not a sufficient reason to withhold the second dose of the vaccine. Further studies are required to ascertain the best way to prevent and manage this complication.
Subject(s)
BNT162 Vaccine , COVID-19 , Central Serous Chorioretinopathy , BNT162 Vaccine/adverse effects , COVID-19/prevention & control , Central Serous Chorioretinopathy/chemically induced , Female , HumansABSTRACT
SARS-CoV-2 vaccines are being administered worldwide. Most side effects are mild and self-limiting with few reported cases of severe reactions. We report a case of leukocytoclastic vasculitis with acute kidney failure following aninactivated SARS-CoV-2 vaccine, unique for its dramatic visual presentation and its rapid response to treatment. This is the case of a 58years-old man presenting with fever, arthralgias and vascular purpura on his limbs associated with acute kidney failure requiring hemodialysis nine days after anti-COVID-19 vaccination. Skin biopsy revealed a leukocytoclastic vasculitis and a renal biopsy showed an acute tubulointerstitial nephritis. The vascular purpura resolved 7days after initiating treatment with prednisone but the patient remains in chronic renal failure. The analysis and investigation of the complications and adverse events induced by anti-COVID-19 vaccines could increase our understanding of the underlying pathogenesis.
Subject(s)
Acute Kidney Injury , COVID-19 Vaccines , COVID-19 , Acute Kidney Injury/etiology , COVID-19/complications , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , IgA Vasculitis , Male , SARS-CoV-2 , Vasculitis, Leukocytoclastic, CutaneousSubject(s)
COVID-19 Vaccines , COVID-19 , Adverse Drug Reaction Reporting Systems , Humans , Pharmacovigilance , SARS-CoV-2ABSTRACT
Patients with end stage renal disease, including dialysis and kidney transplantation, have a high risk of severe COVID-19. In these populations, post-COVID-19 humoral response is prolonged until 6 months post-infection. However, post-vaccination humoral responses are frequently weak even when positive, notably in kidney transplant patients treated with belatacept. Actually, after 2 injectionos of mRNA vaccines, humoral response rates are 80-95% in dialysis patients, 30-50% in transplant patients, and about 5% in transplant patients treated with belatacept. These results have led to propose a 3rd injection of mRNA vaccine in dialysis and transplant patients in France. Numerous questions, regarding cellular responses, durability of response and clinical efficacy of vaccines remain in these high risk populations.