Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study

Effect of female coronavirus disease 2019 vaccination on assisted reproductive outcomes: a systematic review and meta-analysis

IMPORTANCE

The effect of coronavirus disease 2019 (COVID-19) vaccination on fertility warrants clarification in women undergoing assisted reproductive treatment.

OBJECTIVE

To study the association between female COVID-19 vaccination and outcomes of assisted reproductive treatment.

DATA SOURCES

PubMed, Embase, the Web of Science, Cochrane Library, and medRxiv and bioRxiv were searched for eligible studies from December 1, 2019, to November 30, 2022, with no language restrictions.

STUDY SELECTION AND SYNTHESIS

Observational studies comparing assisted reproductive outcomes between women with and without COVID-19 vaccination were included. The pooled estimates were calculated using the random-effects models as mean differences (MDs), standardized MDs, or odds ratios with 95% confidence intervals (CIs). Heterogeneity was evaluated using the I² statistic.

MAIN OUTCOMES

The number of oocytes retrieved and clinical pregnancy rate.

RESULTS

Twenty-one cohort studies involving a total of 19,687 treatment cycles were included. In a comparison of the vaccinated vs. unvaccinated groups, the pooled MD for oocyte number was -0.06 (95% CI, -0.51 to 0.39; I² = 0), and the pooled odds ratio for clinical pregnancy was 0.95 (95% CI, 0.85-1.05; I² = 0). Similarly, there were no statistically significant adverse effects identified in other outcomes determined a priori, including 4 cycle characteristics, 6 laboratory parameters, and 3 pregnancy indicators. Most results were consistently unchanged in subgroup and sensitivity analyses, with no evidence of publication bias according to Egger's test.

CONCLUSION AND RELEVANCE

Our work did not find significant differences in assisted reproductive outcomes between vaccinated and unvaccinated women. However, more data are warranted to confirm the safety of COVID-19 vaccination for assisted reproductive treatment and in female fertility in general.

Evaluation of Short-Term Side Effects Following the First Dose of COVID-19 Vaccines Among Physicians and Dentists: A Cross-Sectional Study from India

Background

Efficacy and safety are fundamental for the development of successful COVID-19 vaccines. Vaccine-associated side effects influence vaccine hesitancy. This study investigated the prevalence, severity, and onset of side effects following the first dose of COVID-19 vaccines among physicians and dentists working in various healthcare settings across India.

Methods

A cross-sectional survey collected self-report data from April to June 2021 on side effects following the first dose of the vaccine. An online validated questionnaire using the Google Docs^® platform was circulated via email and social media platforms.

Results

More than 40% of participants experienced at least one side effect after the first dose of vaccination; the most common were mild and resolved within three days after vaccination. More than 91% of respondents received the Covishield (AstraZeneca) vaccine; the most prevalent adverse effects were soreness of the injected arm (78.9%), tiredness (71.1%), and fever (54.9%). Logistic regression showed that women were almost 60% less likely to report side effects.

Conclusion

Findings supported the safety of the first dose of the COVID-19 vaccine based on relatively few self-limiting side effects, mainly soreness of the injected arm and tiredness. Further research is needed to determine the long-term safety of COVID-19 vaccines, especially after booster doses.

Cerebral venous sinus thrombosis after COVID-19 vaccination: a case report and literature review

As COVID-19 vaccines became widely available, there have been reports of neurovascular complications. In this article, we aim to report a case of cerebral venous sinus thrombosis (CVST) induced by COVID-19 vaccination, with a literature review on similar cases as well as the potential pathophysiological mechanisms. Our case is a healthy male who developed headache, vomiting, photophobia and diplopia after receiving the Ad26.COV2.S vaccine. Fundus examination showed papilledema, and magnetic resonance imaging of the brain and cerebral veins showed CVST involving the superior sagittal sinus and right transverse sinus extending into the right jugular vein. Hypercoagulability workup was unremarkable, and the patient received immunotherapy and anticoagulation. Following this treatment, symptoms resolved, and he had no residual neurologic deficits. Developing neurologic manifestations, especially severe headaches with papilledema, after COVID-19 vaccination should warrant neuroimaging. Early recognition and management of CVST are essential for good clinical outcomes.

Frequency of COVID-19 vaccine side effects and its associated factors among the vaccinated population of Pakistan: A cross-sectional study

Background

Coronavirus disease 2019 (COVID-19) vaccine side effects have an important role in the hesitancy of the general population toward vaccine administration. Therefore, this study was conducted to document the COVID-19 vaccine side effects in our population.

Materials and Methods

An online survey-based, cross-sectional study was carried out from September 1, 2021, to October 1, 2021, to document the side effects of the COVID-19 vaccine among the general public. The questionnaire included participants' sociodemographic data, type of vaccine, comorbidities, previous COVID-19 infection, and assessment of side effects reported by them.

Results

The majority of the participants were <20 years of age (62.2%), females (74.9%), belonged to the educational sector (58.1%), residents of Sindh (65.7%), and were previously unaffected by COVID-19 infection (73.3%). Sinovac (38.7%) followed by Sinopharm (30.4%) and Moderna (18.4%) were administered more frequently. Commonly reported side effects were injection site pain (82%), myalgia (55%), headache (46%), fatigue/malaise (45%), and fever (41%). Vaccine side effects were more likely to be reported with the first dose as compared to the second dose. On regression analysis, factors associated with occurrence of side effects included younger age (odds ratio [OR]: 6.000 [2.065-17.431], p < 0.001), female gender (OR: 2.373 [1.146-4.914], p = 0.020), marital status (OR: 0.217 [0.085-0.556], p < 0.001), graduate level of education (OR: 0.353 [0.153-0.816], p = 0.015), and occupation being either retired, freelancers, or social workers (OR: 0.310 [0.106-0.909]), p = 0.033). Previous infection with COVID-19 (p = 0.458) and comorbidities were found unrelated (p = 0.707) to the occurrence of side effects.

Conclusion

The overall prevalence of local side effects was quite higher than the systemic ones. Further large-scale studies on vaccine safety are required to strengthen public confidence in the vaccination drive.

Reduced Neutralization Efficacy against Omicron Variant after Third Boost of BNT162b2 Vaccine among Liver Transplant Recipients

The immune responses of liver transplant (LT) recipients after the third boost of the BNT162b2mRNA vaccine improved. This study evaluates the durability of the immune response of LT recipients after the third boost, its predictors, and the impact of emerging variants. The receptor-binding domain IgG was determined at median times of 22 (first test) and 133 days (second test) after the administration of the third boost. IgG antibody titers > 21.4 BAU/mL were defined as a positive response. The neutralization efficacies of the vaccine against the wild-type, Omicron, and Delta variants were compared in the first test. The 59 LT recipients were of a median age of 61 years (range 25−82); 53.5% were male. Following administration of the third dose, the positive immune response decreased from 81.4% to 76.3% between the first and second tests, respectively, (p < 0.0001). The multivariate analysis identified CNI monotherapy (p = 0.02) and hemoglobin > 12 g/dL (p = 0.02) as independent predictors of a maintained positive immune response 133 days after the third dose. The geometric mean titers of Omicron neutralization were significantly lower than the wild-type and Delta virus (21, 137, 128, respectively; p < 0.0001). The immune response after the third BNT162b2mRNA vaccine dose decreased significantly in LT recipients. Further studies are required to evaluate the efficacy of the fourth vaccine dose and the durability of the immune response.

SARS-CoV-2 Breakthrough Infections in Health Care Workers: An Italian Retrospective Cohort Study on Characteristics, Clinical Course and Outcomes

BACKGROUND

The aim of this study was to determine the characteristics, clinical course and outcomes of COVID-19 breakthrough infections (BIs) among healthcare workers (HCWs) of an Italian University Hospital.

METHODS

A retrospective observational study was conducted on 6111 HCWs, from January 2021 to February 2022. The study population was offered the full vaccination with BNT162b2 mRNA COVID-19 vaccine. To allow return to work after BI, the protocol required one negative nasopharyngeal RT-PCR swab followed by a medical examination to assess the HCW's health status. Laboratory tests, instrumental tests and specialist evaluations were carried out if necessary.

RESULTS

The cases of BIs observed numbered 582 (9.7%). The frequency of BIs was significantly higher in females than in males (67% vs. 33%; p = 0.03), and in nurses than in all other professional categories (p = 0.001). A total of 88% of the HCWs affected by BI were still symptomatic after the negative swab. None of the instrumental tests carried out showed any new findings of pathological significance. All cases showed progressive disappearance of symptoms, such that no cases of long COVID and no hospitalization or deaths were recorded.

CONCLUSIONS

Our results confirm that SARS-CoV-2 infections occur even after a full vaccination course; however, the clinical course is favorable and severe outcomes are reduced.

SARS-CoV-2 Vaccination Safety in Guillain-Barré Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, and Multifocal Motor Neuropathy

BACKGROUND AND OBJECTIVES

There are concerns on the safety of SARS-CoV-2 vaccination in patients with a history of Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). The aim of this study was to determine the risk of recurrence of GBS and exacerbations of CIDP or MMN after SARS-CoV-2 vaccination.

METHODS

We conducted a prospective, multicenter cohort study from January 2021 to August 2021. Patients known in 1 of 3 Dutch University Medical Centers with research focus on immune-mediated neuropathy and members of the Dutch Patient Association for Neuromuscular Diseases were invited to participate if they were 18 years or older and diagnosed with GBS, CIDP, or MMN. Participants completed a series of questionnaires at 4 different time points: study baseline (1), within 48 hours before any SARS-CoV-2 vaccination (2 and 3, if applicable), and 6 weeks after their last vaccination (4). Participants unwilling to get vaccinated completed the last questionnaire (4) 4 months after study baseline. We assessed recurrences of GBS, any worsening of CIDP or MMN-related symptoms, treatment alterations, and hospitalization.

RESULTS

Of 1,152 individuals to whom we sent the questionnaires, 674 (59%) signed informed consent. We excluded 153 individuals, most often because they had already received a SARS-CoV-2 vaccination or had had the infection (84%) before study baseline. Of 521 participants included in analyses, 403 (81%) completed the last questionnaire (time point 4). None of 162 participants with a history of GBS had a recurrence after vaccination. Of 188 participants with CIDP, 10 participants (5%) reported a worsening of symptoms within 6 weeks after vaccination. In 5 (3%) of these patients, maintenance treatment was modified. Two of 53 participants with MMN (4%) reported a worsening of symptoms, and treatment modification was reported by 1 participant.

DISCUSSION

We found no increased risk of GBS recurrence and a low to negligible risk of worsening of CIDP or MMN-related symptoms after SARS-CoV-2 vaccination. Based on our data, SARS-CoV-2 vaccination in patients with these immune-mediated neuropathies seems to be safe.

Reactions following Pfizer-BioNTech COVID-19 mRNA vaccination and related healthcare encounters among 7,077 children aged 5-11 years within an integrated healthcare system

BACKGROUND

Studies combining data from digital surveys and electronic health records (EHR) can be used to conduct comprehensive assessments on COVID-19 vaccine safety.

METHODS

We conducted an observational study using data from a digital survey and EHR of children aged 5-11 years vaccinated with Pfizer-BioNTech COVID-19 mRNA vaccine across Kaiser Permanente Southern California during November 4, 2021-February 28, 2022. Parents/guardians who enrolled their children were sent a 14-day survey on reactions. Survey results were combined with EHR, and medical encounters were described for children whose parents or guardians indicated seeking medical care for vaccine-related symptoms. This study describes self-reported reactions (local and systemic) and additional symptoms (chest pain, tachycardia, and pre-syncope).

RESULTS

The study recruited 7,077 participants aged 5-11 years who received the Pfizer-BioNTech COVID-19 mRNA vaccine. Of 6,247 participants with survey responses after dose 1, 2,176 (35 %) reported at least one systemic reaction, and 1,076 (32 %) of 3,401 respondents following dose 2 reported at least one systemic reaction. Local reactions were reported less frequently following dose 2 (1,113, 33 %) than dose 1 (3,140, 50 %). The most frequently reported reactions after dose 1 were pain at the injection site (48 %), fatigue (20 %), headache (12 %), myalgia (9 %) and fever (5 %). The most frequently reported symptoms after dose 2 were also pain at the injection site (30 %), fatigue (19 %), headache (13 %), myalgia (10 %) and fever (9 %). Post-vaccination reactions occurred most frequently-one day following vaccination. Chest pain or tachycardia were reported infrequently (1 %). EHR demonstrated that parents rarely sought care for post-vaccination symptoms, and among those seeking care, the most common symptoms documented in EHR were fever and nausea, comprising <0.5 % of children. No encounters were related to myocarditis.

CONCLUSION

While post-vaccination reactions to the Pfizer-BioNTech COVID-19 mRNA vaccine were common in children aged 5-11 years, our data showed that in most cases they were transient and did not require medical care.

Short-term safety of COVID-19 mRNA vaccines with respect to all-cause mortality in the older population in Norway

BACKGROUND

There have been concerns about COVID-19 vaccination safety among frail older individuals. We investigated the relationship between COVID-19 mRNA vaccination and mortality among individuals aged ≥ 70 years and whether mortality varies across four groups of health services used.

METHODS

In this nationwide cohort study, we included 688,152 individuals aged ≥ 70 years at the start of the Norwegian vaccination campaign (December 27, 2020). We collected individual-level data from theNorwegian Emergency Preparedness Register for COVID-19. Vaccinated and unvaccinated individuals were matched (1:1 ratio) on the date of vaccination based on sociodemographic and clinical characteristics. The main outcome was all-cause mortality during 21 days after first dose of COVID-19 mRNA vaccination. Kaplan-Meier survival functions were estimated for the vaccinated and unvaccinated groups. We used Cox proportional-hazards regression to estimate hazard ratios (HRs) of death between vaccinated and unvaccinated individuals, with associated 95% confidence intervals (CIs), overall and by use of health services (none, home-based, short- and long-term nursing homes) and age group.

RESULTS

Between December 27, 2020, and March 31, 2021, 420,771 older individuals (61.1%) were vaccinated against COVID-19. The Kaplan-Meier estimates based on the matched study sample showed a small absolute risk difference in all-cause mortality between vaccinated and unvaccinated individuals, with a lower mortality in the vaccinated group (overall HR 0.28 [95% CI: 0.24-0.31]). Similar results were obtained in analyses stratified by use of health services and age group.

CONCLUSION

We found no evidence of increased short-term mortality among vaccinated individuals in the older population after matching on sociodemographic and clinical characteristics affecting vaccination and mortality.

Comparison of side effects of the dose-1 of AstraZeneca and Sinopharm vaccines in patients with multiple sclerosis in Kermanshah, Iran (2021)

Background: Coronavirus 2019 (COVID-19) vaccination is recommended for people with multiple sclerosis (MS). This study evaluated the side effects of Sinopharm and AstraZeneca vaccines in MS patients. Methods: In this cross-sectional study among MS patients in Kermanshah province, Iran, who received Sinopharm or AstraZeneca vaccine, sampling was performed through convenience sampling according to the nationwide MS registry of Iran (NMSRI). Demographic and clinical information of the participants and data on the side effects of vaccines were collected by telephone after the first dose. The data were analyzed in SPSS software. Results: 264 vaccinated MS patients (217 with Sinopharm and 47 with AstraZeneca) were studied. In the Sinopharm and AstraZeneca groups, respectively, 58.5% and 73.3% of patients had side effects that were not significantly different between the 2 groups (P = 0.064). In the AstraZeneca group, the severity of side effects and prevalence of taking painkillers were significantly higher (P < 0.050) and the interval between vaccination and side effects onset was significantly shorter (P = 0.013). The most commonly experienced side effects in the Sinopharm group were fatigue (29.0%), myalgia (24.9%), fever (24.0%), and headache (21.7%), and in the AstraZeneca group were fever (59.6%), chills (51.1%), myalgia (40.4%), and fatigue (34.0%). Logistic regression by controlling for confounding variables showed that considering some factors as confounding factors did not show a significant difference between the 2 vaccines in the experience of side effects (P = 0.104). Conclusion: The AstraZeneca vaccine caused more severe side effects in MS patients than the Sinopharm vaccine. Most of the side effects were moderate in severity and transient.

Differences in BNT126b2 and ChAdOx1 Homologous Vaccination Antibody Response among Teachers in Poznan, Poland

Children are among the best vectors to spread respiratory viruses, including emerging variants of SARS-CoV-2 due to the asymptomatic or relatively mild course of infection and simultaneously high titres of pathogens in the respiratory tract. Therefore, individuals who have constant contact with children, e.g., teachers should be vaccinated against COVID-19 as essential workers within the first phases of a vaccination campaign. In Poland, primary and secondary school teachers were vaccinated with ChAdOx1 from February 2021 with a three month interval between the two doses, while lecturers at medical universities, who are simultaneously healthcare workers, received the BNT126b2 vaccine from December 2020 with three weeks between the first and second doses. The aim of this study was to compare the antibody responses at two weeks and three months after vaccination and to estimate the vaccine effectiveness against COVID-19 among infection-naïve teachers vaccinated with mRNA and a vector vaccine. We found that the anti-SARS-CoV-2 spike protein antibodies were significantly higher among the lecturers but antibody waning was slower among the schoolteachers. However, those vaccinated with ChAdOx1 complained significantly more often of vaccine side effects. In addition, during the three months after the second vaccine dose no study participants were infected with SARS-CoV-2. The BNT126b2 vaccine gave higher antibody titres in comparison with ChAdOx1 but protection against COVID-19 in both cases was similar. Moreover, we did not find any anti-SARS-CoV-2 nucleoprotein antibodies at two weeks as well as at three months after vaccination among the study participants, which shows a very high vaccine effectiveness in the occupational group with a high SARS-CoV-2-infection risk.

Side Effects Comparison of Coronavirus Vaccines Among Healthcare Workers in Shoushtar, Iran

Objective

Vaccination is one of the effective ways to fight against COVID-19 disease. Various vaccines have been designed during the coronavirus pandemic. Each of the used vaccines has beneficial effects as well as side effects. Healthcare workers were among the first vaccinated persons against COVID-19 in different countries. The current study aims to compare the side effects of AstraZeneca, Sinopharm, Bharat, and Sputnik V on healthcare workers in Iran.

Methods

This descriptive study was conducted from July 2021 to January 2022 on 1639 healthcare workers who received the COVID-19 vaccines. Data were collected using a checklist that contained questions related to systemic, local, and severe side effects of the vaccine. The collected data were analyzed using the Kruskal-Wallis, Chi-square, and trend chi-square. P < .05 was regarded as a significant statistical difference.

Results

The most commonly injected vaccines were Sinopharm (41.80%), Sputnik V (36.65%), AstraZeneca (17.75%), and Bharat (3.80%), respectively. At least 37.5% of participants reported one complication. The most common side effects after 72 hours of the first and second doses were as follows: injection site pain, fatigue, fever, myalgia, headache, and chill. Overall complication rates were reported as follows: AstraZeneca (91.4%), Sputnik V (65.9%), Sinopharm (56.8%), and Bharat (98.4%). Bharat showed the highest overall side effects, while Sinopharm had the lowest overall side effects. Also, our results indicated that individuals with a previous history of positive COVID-19 infection had a higher rate of overall complications.

Conclusions

The majority of participants did not show life-threatening side effects after the injection of 1 of the 4 studied vaccines. Since it was well accepted and tolerable by the participants, it can be used widely and safely against SARS-CoV-2.

Reactogenicity and persistence of IgG antibodies against SARS-CoV-2 among recipients of ChAdOx1 nCoV-19 vaccine: A single center experience from Sri Lanka

Objectives

Actual world data on vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are imperative for future immunization decisions. We studied the reactogenicity and IgG response in a cohort dually vaccinated with the ChAdOx1 nCoV-19 vaccine.

Methods

This prospective study recruited 494 ChAdOx1 nCoV-19 vaccine recipients at the University Hospital KDU between January 30 and February 5, 2021, and followed up for 9 months. The two doses of the vaccine were administered 3-month apart, followed by a booster dose with the BNT162b2 (Pfizer-BioNTech) vaccine 6 months later. One-week post-vaccination surveillance ascertained the reactogenicity of the vaccine. Seroprevalence of IgG antibodies before each vaccination dose was determined using a commercially available quantitative ELISA kit (WANTAI SARS-CoV-2 IgG Quantitative ELISA Beijing China). Reactogenicity profiles after vaccination doses were compared. Association of pre-vaccination seropositivity and demographic variables with antibody levels was assessed.

Results

Reactogenicity was reported by 78.5% (329/419) and 25.4% (104/410) participants after the first and second doses, respectively, with a significantly high mean total score of vaccine-related symptoms following the first dose (P = 0.015). Post-first dose seroconversion rate was 97.1%, and the immune response was more robust among pre-vaccination seropositive participants and females. Following the second dose, 100% seroconversion was observed. Subgroup analysis of 196 participants revealed persistent antibodies at nine months with a rise in the previously measured levels among 78.1% compared to 21.9% with declining titers. Antibody waning was significantly associated with pre-vaccination seropositivity (P = 0.015) and female gender (P = 0.022).

Conclusions

High seroconversion rates and longevity of antibody response in the absence of serious concerns regarding reactogenicity suggest that the vaccine is immunogenic and safe. Significant antibody waning among females and pre-vaccination seropositive participants warrant further research.

A prospective observational study to evaluate the safety of COVID-19 mRNA vaccines administered to Qatar Rehabilitation Institute patients

BACKGROUND

The safety of the COVID-19 mRNA vaccine in the outpatient setting has been extensively studied; however, there need to be more reports that specifically assess their safety in the inpatient population. It is hence imperative to explore the adverse drug reaction (ADR) profile in this population and monitor the progression of these ADRs in a hospital setting. This provides a unique opportunity to closely observe patients to ensure no side effects go undiagnosed. This study aims to explore and quantify the incidence and severity of ADRs in patients who have received the COVID-19 vaccine during their stay in the rehabilitation facility.

METHODS

This is a prospective observational study, which included adult patients admitted to the rehabilitation facility who were deemed eligible to receive the COVID-19 vaccine during their hospital stay. Data were collected by the investigators from June 2021 to May 2022 at 24 hours, 48 hours, and 7 days post-vaccination. A piloted data collection tool was utilized.

RESULTS

Thirty-five patients met the inclusion criteria. Pain at the injection site was the most commonly reported local ADR, while headache was the most frequent systemic ADR. The majority of the reported ADRs were mild to moderate in nature, with only one severe reaction detected. Although no statistical significance was noted among the variables, common patterns were identified, such as a higher occurrence of fever at 24 hours after the second dose as opposed to the first dose. Close monitoring of the included study subjects did not reveal any unanticipated ADRs or an increase in ADRs susceptibility and severity compared to the general population.

CONCLUSION

This study supports the initiation of vaccination campaigns in inpatient rehabilitation settings. This approach would offer the advantage of gaining full immunity and reducing the risk of contracting COVID-19 infection and complications once discharged.

Discussion on the Clinical Course of Adverse Effects after COVID-19 Vaccination: A Retrospective Analysis of Case Series in an Outpatient Department

BACKGROUND

A total of 8,303 individuals (4.3%) with adverse reactions (n=191,860) after vaccination developed serious conditions or died. Such health developments could cause people not vaccinated yet or waiting for a booster shot to become fearful of the vaccination.

METHODS

The 3-month (July-September 2021) clinical data of 41 patients from the family medicine department of a single medical center were analyzed retrospectively to determine risk factors and to investigate the clinical course to identify the cause of symptoms in detail.

RESULTS

A significant number of older adults aged over 50 years reported experiencing general weakness (P=0.026) but fewer incidences of fever than patients aged 50 years or younger (P=0.011). Eighteen of the 41 patients were requested to visit more than twice or consult a specialist. In 14 patients, the symptoms were explained by other medical causes.

CONCLUSION

The primary physician has a pivotal role in thoroughly evaluating patients who complain of adverse effects after vaccination, considering the broad multitude of symptoms and medical conditions presented. To thoroughly evaluate and appropriately advise patients with adverse reactions to their chosen vaccine, taking detailed medical history and nutritional counseling are required to identify possible underlying causes, resolve symptoms, and educate them on self-care and regarding vaccines.

Pattern of self-reported adverse events related to COVID-19 vaccines in Saudi Arabia: A nationwide study

Background

Vaccination against coronavirus disease 2019 (COVID-19) is the most effective way to end the pandemic. Any development of adverse events (AEs) from various vaccines should be reported. We therefore aimed to explore major and minor AEs among vaccinated individuals in Saudi Arabia.

Methods

This is a nationwide report based on the Saudi Arabian Ministry of Health (MOH) registry. It included those who received COVID-19 vaccines from 17th December 2020 to 31st December 2021. The study included spontaneous self-reported adverse effects to COVID-19 vaccines where the study participants used a governmental mobile app (Sehhaty) to report their AEs following vaccination using a checklist option that included a selection of side-effects. The primary outcome was to determine AEs reported within 14 days of vaccination which included injection site itching, pain, reaction, redness, swelling, anxiety, dizziness, fever, headache, hoarseness, itchiness, loss of consciousness, nausea, heartburn, sleep disruption, fatigue, seizures, anaphylaxis, shortness of breath, wheezing, swelling of lips, face, and throat, loss of consciousness, and admissions into the intensive care unit (ICU).

Results

The study included a total number of 28,031 individuals who reported 71,480 adverse events (AEs); which were further classified into minor and major adverse events including ICU admissions post vaccination. Of the reported AEs, 38,309 (53. 6%) side-effects were reported following Pfizer-BioNTech, 32,223 (45%) following Oxford-AstraZeneca, and 948 (1.3%) following Moderna. The following reported AEs were statistically significant between the different vaccine types: shortness of breath\difficulty of breathing, dizziness, fever above 39°C, headache, hoarseness, injection site reactions, itchiness, nausea, sleep disruption, fatigue, wheezing, swelling of lips/face and\or throat, and loss of consciousness (p-value < 0.05). Fever and seizure were the only statistically significant AEs amongst the number of vaccine doses received (p-value < 0.05). Ten ICU admissions were reported in the 14 days observation period post-COVID-19 vaccination with the following diagnoses: acute myocardial infarction, pneumonia, atherosclerosis, acute respiratory failure, intracranial hemorrhage, grand mal seizure, Guillain-Barré syndrome, abnormal blood gas levels, and septic shock.

Conclusion

This study demonstrated that the most prevalent SARS-CoV-2 vaccine side-effects among adults in Saudi Arabia were mild in nature. This information will help reduce vaccine hesitancy and encourage further mass vaccination to combat the COVID-19 pandemic, especially as booster doses are now available. Further studies are warranted to obtain a better understanding of the association between risk factors and the experiencing of side-effects post vaccination.

COVID-19 vaccines, mobility, and pandemic bureaucracies: Undocumented migrants' perspectives from Italy's Alpine border

While scholars have noted the deeply unequal effects of the pandemic containment, there has been limited attempt to map the socio-political lives of vaccination policies, particularly from the perspective of undocumented persons moving at state margins. This paper explores how undocumented migrants, who were predominantly male travellers attempting to cross Italy's Alpine borders, encountered Covid-19 vaccines and contemporary legislation. Based on ethnographic observations and qualitative interviews with migrants, doctors, and activists at safehouses both on the Italian and French sides of the Alpine border, we trace how mobility centred decisions to accept or reject vaccines were significantly shaped by exclusionary border regimes. We move beyond the exceptional focus of the Covid-19 pandemic to show how centring visions of health connected to viral risk diverted attention from migrants' wider struggles to move to obtain safety. Ultimately, we argue for a recognition of how health crises are not merely unequally experienced, but may result in the reconfiguration of violent governance practices at state borders.

Statins: Beneficial Effects in Treatment of COVID-19

The recent viral disease COVID-19 has attracted much attention. The disease is caused by SARS-CoV-19 virus which has different variants and mutations. The mortality rate of SARS-CoV-19 is high and efforts to establish proper therapeutic solutions are still ongoing. Inflammation plays a substantial part in the pathogenesis of this disease causing mainly lung tissue destruction and eventually death. Therefore, anti-inflammatory drugs or treatments that can inhibit inflammation are important options. Various inflammatory pathways such as nuclear factor Kappa B (NF-κB), signal transducer of activators of transcription (STAT), nod-like receptor family protein 3 (NLRP), toll-like receptors (TLRs), mitogen-activated protein kinase (MAPK), and mammalian target of rapamycin (mTOR) pathways and mediators, such as interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), and interferon-γ (INF-γ), cause cell apoptosis, reduce respiratory capacity and oxygen supply, eventually inducing respiratory system failure and death. Statins are well known for controlling hypercholesterolemia and may serve to treat COVID-19 due to their pleiotropic effects among which are anti-inflammatory in nature. In this chapter, the anti-inflammatory effects of statins and their possible beneficial effects in COVID-19 treatment are discussed. Data were collected from experimental and clinical studies in English (1998-October 2022) from Google Scholar, PubMed, Scopus, and the Cochrane Library.

Psychological factors associated with reporting side effects following COVID-19 vaccination: A prospective cohort study (CoVAccS - Wave 3)

OBJECTIVE

To investigate symptom reporting following the first and second COVID-19 vaccine doses, attribution of symptoms to the vaccine, and factors associated with symptom reporting.

METHODS

Prospective cohort study (T1: 13-15 January 2021, T2: 4-15 October 2021). Participants were aged 18 years or older, living in the UK. Personal, clinical, and psychological factors were investigated at T1. Symptoms were reported at T2. We used logistic regression analyses to investigate associations.

RESULTS

After the first COVID-19 vaccine dose, 74.1% (95% CI 71.4% to 76.7%, n = 762/1028) of participants reported at least one injection-site symptom, while 65.0% (95% CI 62.0% to 67.9%, n = 669/1029) reported at least one other (non-injection-site) symptom. Symptom reporting was associated with being a woman and younger. After the second dose, 52.9% (95% CI 49.8% to 56.0%, n = 532/1005) of participants reported at least one injection-site symptom and 43.7% (95% CI 40.7% to 46.8%, n = 440/1006) reported at least one other (non-injection-site) symptom. Symptom reporting was associated with having reported symptoms after the first dose, having an illness that put one at higher risk of COVID-19 (non-injection-site symptoms only), and not believing that one had enough information about COVID-19 to make an informed decision about vaccination (injection-site symptoms only).

CONCLUSIONS

Women and younger people were more likely to report symptoms from vaccination. People who had reported symptoms from previous doses were also more likely to report symptoms subsequently, although symptom reporting following the second vaccine was lower than following the first vaccine. Few psychological factors were associated with symptom reporting.

[Neurological complications after covid-19 vaccination]

The aim of our work was to study the relevance and incidence of neurological post-vaccination complications during the COVID-19 pandemic. Based on the results of a systematic literature search of several databases, the current review describes the diagnosed complications, including neurological, that occurred after the administration of the COVID-19 vaccine during the pandemic period. To fully establish the pathophysiological mechanisms of the development of a causal relationship of neurological complications with vaccines against COVID-19, it becomes necessary to continue long-term studies. This will make it possible to carry out a pharmacological correction of the quality of vaccine safety.

Effects of Biological Sex and Pregnancy on SARS-CoV-2 Pathogenesis and Vaccine Outcomes

SARS-CoV-2 is the causative agent of COVID-19 in humans and has resulted in the death of millions of people worldwide. Similar numbers of infections have been documented in males and females; males, however, are more likely than females to be hospitalized, require intensive care unit, or die from COVID-19. The mechanisms that account for this are multi-factorial and are likely to include differential expression of ACE2 and TMPRSS2 molecules that are required for viral entry into hosts cells and sex differences in the immune response, which are due to modulation of cellular functions by sex hormones and differences in chromosomal gene expression. Furthermore, as comorbidities are also associated with poorer outcomes to SARS-CoV-2 infection and several comorbidities are overrepresented in males, these are also likely to contribute to the observed sex differences. Despite their relative better prognosis following infection with SARS-CoV-2, females do have poorer outcomes during pregnancy. This is likely to be due to pregnancy-induced changes in the immune system that adversely affect viral immunity and disruption of the renin-angiotensin system. Importantly, vaccination reduces the severity of disease in males and females, including pregnant females, and there is no evidence that vaccination has any adverse effects on the outcomes of pregnancy.

Post-Vaccine SARS-CoV-2 Reinfection and Associated Factors Among Health Care Providers in Addis Ababa Public Hospitals, Addis Ababa, 2022: A Cross-Sectional Study

Background of the study

The protection against Coronavirus variants 2019 by pre-existing antibodies due to the current vaccination or natural infection is a global concern. In Ethiopia, case reports show that a significant number of health professionals are reported to get re-infected after vaccination. There are also more studies that revealed the symptomatic SARS-COV-2 re-infection, in particular, among healthcare providers actively engaged in Addis Ababa public health facilities.

Objective

This study has aimed at assessing the magnitude of post-vaccine reinfection of SARS-COV-2 and associated factors among health care providers in Addis Ababa public hospitals, Addis Ababa, 2022 G.C.

Methods

A facility-based cross-sectional study was conducted from July 11 to July 30, 2022. A total of 422 health professionals were included. A simple random sampling method was employed to select 40% of the total hospitals. Then the total sample size was equally allocated to each selected hospital, and then each individual was selected purposefully. The data was collected using a structured, self-administered questionnaire. The analysis was done using SPSS version 26.0, and for data entry, EPi Info version 7.1 was used. Both bivariable and multivariable logistic regression analyses were used to determine the p-value.

Results

Overall, 418 healthcare providers were enrolled in this study, making the response rate 99.05%. The magnitude of SARS-COV-2 reinfection was 60 (14.4%) (95% CI 10.8-17.9). Healthcare professionals who took infection prevention (IP) training on COVID-19 (AOR = 7.177: CI = 4.761-9.698) were associated with SARS-COV-2 reinfection; those with a history of chronic respiratory diseases (AOR = 3.029: CI = 2.406-9.133) were associated with SARS-COV-2 reinfection; health professionals who took the third dose of SARS-COV-2 vaccine (AOR = 1.75: CI = 1.14-2.68) and being a midwife were statistically significant.

Conclusion and Recommendation

This study showed the prevalence of SARS-COV-2 reinfection among vaccinated healthcare providers with a pre-vaccination infection history was high; IP training on COVID-19 was needed; educational status, profession, type of vaccine taken in the first dose, chronic respiratory diseases, and number of vaccinations were significantly associated with SARS-COV-2 reinfection after vaccination. Giving IP training, encouraging taking the vaccine as protocol, and using proper personal protective equipment are recommended.

Side Effects Associated With Homologous and Heterologous COVID-19 Vaccines: A Cross-Sectional Study in Saudi Arabia

BACKGROUND

Numerous studies on coronavirus disease 2019 (COVID-19) vaccination safety have been conducted in Saudi Arabia. Even though there is less evidence comparing the side effects of different vaccines and a few of them studied the side effects of mixing different platforms of vaccines.

OBJECTIVES

This study aimed to evaluate the type and severity of adverse effects following COVID-19 vaccination based on the type and platform of received vaccine and to determine factors that contribute to the occurrence of these side effects.

METHODS

This cross-sectional comparative study was conducted in Saudi Arabia from January to the end of February 2022 among COVID-19 vaccine recipients through an online survey. Based on the type of vaccines received, we categorized our participants into two groups - those who received two doses of either the Pfizer or the AstraZeneca COVID-19 vaccines, and those who received mixed vaccination regimen (one dose of Pfizer and one dose of AstraZeneca).

RESULTS

The study included 1,340 participants, of which 56.3% received two doses of the Pfizer vaccine while (7%) received two doses of the AstraZeneca vaccine, and 8.8% received mixed vaccines (one dose of the Pfizer vaccine and one dose of the AstraZeneca vaccine). Pain at the injection site was the most frequent local symptom (37.9%) followed by swelling±redness (27.6%). The local adverse reactions were nearly equal in AstraZeneca and Pfizer vaccines, whereas these were significantly lower in those who received mixed doses (p<0.001). Fever was significantly higher in mixed vaccination regimens compared to other types (p<0.001). The male gender who received the Pfizer vaccine were at higher risk of developing an adverse reaction following vaccination. Unusual side effects (sleep disorders, menstrual irregularities, and symptoms suggestive of diabetic neuropathy) were also reported.

CONCLUSION

The results suggest the overall safety of Pfizer and AstraZeneca vaccines as well as the mixed vaccination protocol. A heterologous regimen was associated with fewer side effects compared to homologous vaccines. Further studies are needed to assess the long-term side effects.

Personalized predictions of adverse side effects of the COVID-19 vaccines

Background

Misconceptions about adverse side effects are thought to influence public acceptance of the Coronavirus disease 2019 (COVID-19) vaccines negatively. To address such perceived disadvantages of vaccines, a novel machine learning (ML) approach was designed to generate personalized predictions of the most common adverse side effects following injection of six different COVID-19 vaccines based on personal and health-related characteristics.

Methods

Prospective data of adverse side effects following COVID-19 vaccination in 19943 participants from Iran and Switzerland was utilized. Six vaccines were studied: The AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2, and the mRNA-1273 vaccine. The eight side effects were considered as the model output: fever, fatigue, headache, nausea, chills, joint pain, muscle pain, and injection site reactions. The total input parameters for the first and second dose predictions were 46 and 54 features, respectively, including age, gender, lifestyle variables, and medical history. The performances of multiple ML models were compared using Area Under the Receiver Operating Characteristic Curve (ROC-AUC).

Results

The total number of people receiving the first dose of the AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2, and mRNA-1273 were 6022, 7290, 5279, 802, 277, and 273, respectively. For the second dose, the numbers were 2851, 5587, 3841, 599, 242 and 228. The Logistic Regression model for predicting different side effects of the first dose achieved ROC-AUCs of 0.620-0.686, 0.685-0.716, 0.632-0.727, 0.527-0.598, 0.548-0.655, 0.545-0.712 for the AZD1222, Sputnik V, BBIBP-CorV, COVAXIN, BNT162b2 and mRNA-1273 vaccines, respectively. The second dose models yielded ROC-AUCs of 0.777-0.867, 0.795-0.848, 0.857-0.906, 0.788-0.875, 0.683-0.850, and 0.486-0.680, respectively.

Conclusions

Using a large cohort of recipients vaccinated with COVID-19 vaccines, a novel and personalized strategy was established to predict the occurrence of the most common adverse side effects with high accuracy. This technique can serve as a tool to inform COVID-19 vaccine selection and generate personalized factsheets to curb concerns about adverse side effects.

A postmortem study of patients vaccinated for SARS-CoV-2 in Colombia

INTRODUCTION AND OBJECTIVE

A new coronavirus produces a disease designated as coronavirus disease 2019 (COVID-19). Vaccination against COVID-19 has resulted in decreased mortality. Postmortems of vaccinated patients play an important part in the forensic analysis of adverse effects after vaccination, which is essential for determining its efficacy and security. The main objective of this study was to describe the results of autopsies of patients vaccinated for SARS-CoV-2 carried out in two major centers in Colombia.

MATERIALS AND METHODS

A descriptive cross-sectional study of 121 autopsies was performed following Colombian regulations in two main hospitals in Bogotá, Colombia, between March 1st and April 31st, 2021.

RESULTS

118 of the 121 patients (97.52%) had been vaccinated with CoronaVac (Sinovac); only 3 had received other vaccines. Sudden cardiac death was the leading cause of death, with pulmonary embolism another critical finding. No relation between the cause of death and vaccination against SARS-CoV-2 was found.

CONCLUSIONS

A clinical autopsy is a vital for an accurate post-mortem diagnosis. Any relation between the SARS-CoV-2 vaccine and the cause of death should be carefully studied in order to provide the general public with evidence-based information about the safety of the vaccination.

Expert review of global real-world data on COVID-19 vaccine booster effectiveness and safety during the omicron-dominant phase of the pandemic

INTRODUCTION

COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. However, the emergence of the Omicron variant and subvariants as the globally dominant strains have raised doubts about the effectiveness of currently available vaccines and prompted debate about potential future vaccination strategies.

AREAS COVERED

Using the publicly available IVAC VIEW-hub platform, we reviewed 52 studies on vaccine effectiveness (VE) after booster vaccinations. VE were reported for SARS-CoV-2 symptomatic infection, severe disease and death and stratified by vaccine schedule and age. In addition, a non-systematic literature review of safety was performed to identify single or multi-country studies investigating adverse event rates for at least two of the currently available COVID-19 vaccines.

EXPERT OPINION

Booster shots of the current COVID-19 vaccines provide consistently high protection against Omicron-related severe disease and death. Additionally, this protection appears to be conserved for at least 3 months, with a small but significant waning after that. The positive risk-benefit ratio of these vaccines is well established, giving us confidence to administer additional doses as required. Future vaccination strategies will likely include a combination of schedules based on risk profile, as overly frequent boosting may be neither beneficial nor sustainable for the general population.

COVID-19 vaccination in peritoneal dialysis patients

BACKGROUND

COVID-19 vaccine is recommended in Peritoneal dialysis (PD) patients, but a paucity of data is available regarding vaccine-related adverse effects among PD patients.

METHOD

A cross-sectional study was conducted in a single center between October and November 2021. PD patients were provided with the online survey link to participate in the study.

RESULTS

A total of 107 PD patients responded to the survey (55%: male, 79%: Chinese, 40%: > 65 years old). Of these, 95% received the COVID-19 vaccine (77% received two doses and 22% received three doses). Most participants (91%) received Pfizer vaccine. The main source of vaccine information was from the government (48%). The most common reason to receive and refuse vaccines were the perception of the seriousness of COVID-19 infection (63%) and concern about vaccine safety (60%), respectively. After the first dose, 25% of patients developed one or more vaccine-related adverse effects. Common local adverse effect was pain at the injection site (21%), and systemic adverse effects were muscle pain (15%), fatigue (13%). Similar adverse effects were observed with subsequent doses. None of them required hospitalization for vaccine-related adverse effects. Female patients had a higher risk of developing adverse effects than male patients after the first dose (odds ratio: 3.37; 95% confidence interval: 1.25 - 9.08). No such difference was observed in the subsequent dose. Age, race, employment status and history of drug allergy were not associated with the risk of adverse effects.

CONCLUSIONS

The COVID-19 vaccine was well-tolerated by most PD patients, but few experienced non-severe adverse effects. All PD patients should be vaccinated against SAR-COV-2 infection.

mRNA vaccine-a desirable therapeutic strategy for surmounting COVID-19 pandemic

As an acute respiratory infectious disease, COVID-19 threatens the safety of global public health. Given the current lack of specific treatment against this disease, research and development of vaccines have become sharp weapons for overcoming the pandemic. mRNA vaccines have become the lead in COVID-19 vaccination strategies due to their advantages, such as rapid industrial production and efficacy. A total of 137 COVID-19 vaccines have entered the clinical trial stage, among which 23 are mRNA vaccines, accounting for 17% of the total vaccines. Herein, we summarize the research and developmental processes of mRNA vaccines as well as the approach for protecting the human body against infection. Focusing on the latest clinical trial data of two COVID-19 mRNA vaccines from Pfizer and Modena, we discuss their effectiveness and safety. Finally, we analyze the challenges and problems that mRNA vaccines face in controlling the COVID-19 pandemic.

An empirical assessment of the factors influencing acceptance of COVID-19 vaccine uptake between Kenyan and Hungarian residing populations: A cross-sectional study

The development of effective, safe, and acceptable vaccines is a long process. COVID-19 vaccine hesitancy continues to elicit mixed reactions among different quarters despite numerous evidence of their effectiveness. This study aimed to determine the availability and acceptance rates of SARS-CoV-2 vaccines, among Kenyan and Hungarian residing populations and the underlying reasons contributing to the hesitancy of uptake. A non-probability, snowball sampling design was employed, and a survey questionnaire tool link was expeditiously disseminated. Data were carefully analyzed descriptively. Demographic variables, COVID-19 awareness, possible exposure, reasons associated with hesitancy in taking up a vaccine, choice of a vaccine, and availability of vaccines among other important variables were tested to explore their associations with vaccine acceptance rates between the two distinct countries. A total of 1960 participants were successfully enrolled in the research study, while 67 participants were excluded based on the inclusion criterion set. There was, however, no significant difference in COVID-19 public awareness between the Kenyan and Hungarian-residing participants, p = 0.300. Of the respondents, 62.4% were willing and ready to receive vaccines against COVID-19 disease. There was a significant difference (p = 0.014) between the Kenyan and Hungarian-residing respondents concerning vaccine uptake and acceptance rates. The vaccine acceptance rates in Hungary were higher than in Kenya, with mean = 0.27, SD = 0.446, S. E = 0.045 for the Hungarian population sample and mean = 0.40, SD = 0.492, S. E = 0.026, for the Kenyan sample respectively. Concerning gender and vaccine acceptance, there was a notable significant difference between males and females, p = 0.001, where the mean for males and females were 0.29 and 0.46 respectively. Acceptance rates among males were higher than among females. The functions of One-Way ANOVA and Chi-square were used to establish any significant differences and associations between means and variables respectively. Concerns regarding the safety, efficacy, and accuracy of information about the developed vaccines are significant factors that must be promptly addressed, to arrest crises revolving around COVID-19 vaccine hesitancy, especially in Kenya and among females in both populations, where acceptance rates were lower. Expansion of the screening program to incorporate antibody (serology) tests, is also highly recommended in the present circumstance. Equitable distribution of vaccines globally should be encouraged and promoted to adequately cover low- and middle-income countries. To enhance effective combat on vaccination hesitancy and apprehension in different countries, mitigation techniques unique to those countries must be adopted.

Adverse Effects of COVID-19 Vaccination: Machine Learning and Statistical Approach to Identify and Classify Incidences of Morbidity and Postvaccination Reactogenicity

Good vaccine safety and reliability are essential for successfully countering infectious disease spread. A small but significant number of adverse reactions to COVID-19 vaccines have been reported. Here, we aim to identify possible common factors in such adverse reactions to enable strategies that reduce the incidence of such reactions by using patient data to classify and characterise those at risk. We examined patient medical histories and data documenting postvaccination effects and outcomes. The data analyses were conducted using a range of statistical approaches followed by a series of machine learning classification algorithms. In most cases, a group of similar features was significantly associated with poor patient reactions. These included patient prior illnesses, admission to hospitals and SARS-CoV-2 reinfection. The analyses indicated that patient age, gender, taking other medications, type-2 diabetes, hypertension, allergic history and heart disease are the most significant pre-existing factors associated with the risk of poor outcome. In addition, long duration of hospital treatments, dyspnoea, various kinds of pain, headache, cough, asthenia, and physical disability were the most significant clinical predictors. The machine learning classifiers that are trained with medical history were also able to predict patients with complication-free vaccination and have an accuracy score above 90%. Our study identifies profiles of individuals that may need extra monitoring and care (e.g., vaccination at a location with access to comprehensive clinical support) to reduce negative outcomes through classification approaches.

Short-term Side Effects of COVID-19 Vaccines (Astrazeneca, Sputnik-V, and Sinopharm) in Health Care Workers: A Cross-Sectional Study in Iran

Background: The occurrence of side effects of vaccines plays an important role in their acceptance by people. Therefore, the aim of this study was to evaluate the side effects of COVID-19 vaccines (Sputnik-V, AstraZeneca, and Sinopharm) in Neyshabur health care workers (HCWs). Methods: A cross-sectional study was performed to evaluate the side effects of COVID-19 vaccines among the HCWs of the Neyshabur University of Medical Sciences from July 31, 2021, to September 6, 2021, by using a self-report checklist. We sent our checklist via an internet link to collect data such as demographic data of participants, previous COVID-19 infection (PCR+), vaccine information and side effects of vaccines. Mean, median and standard deviation were used to determine descriptive statistics and a logistic regression model was also used to determine the relationship between the type of vaccine and its side effects. Results: 317 participants filled out the checklist; among them 47% (N= 149), 21.14% (N= 67), and 31.86% (N= 101) have been vaccinated with Sputnik-V, AstraZeneca, and Sinopharm, respectively. The percentage of side effects after the first dose was 62.15% (N= 197). The Percentage of local side effects was 76% (N= 241) and systemic side effects were 29.36% (N= 95). The most common side effects in all three vaccines were injection site pain (75.08%, N= 240), muscle pain (62.46%, N=198) and headache (52.05%, N=165). Also, the odds ratio of injection site pain, chill and sweating in those who received the AstraZeneca vaccine was 3.9(95% CI, 1.7-9.3), 3.7 (95% CI, 1.8-7.3), and 3.2 (95% CI, 1.7-63), of those who received the Sputnik V vaccine (p ≤ 0.001). Conclusion: The most common side effects among our participants were injection site pain, muscle pain, and headache. Most of the post-vaccination side effects are mild to moderate in severity and self-limited. Reported side effects were more common in recipients with AstraZeneca than in those with Sputnik-V and Sinopharm.

Menstrual cycle changes: A cross-sectional study of Saudi females following SARS-CoV-2 infection

Temporary changes in the menstrual cycle have recently been reported following SARS-CoV-2 vaccination. In the current study, we aimed to screen menstrual cycle changes following SARS-CoV-2 infection in Saudi Arabia. The type and duration of these changes have been screened in relation to the severity of coronavirus disease symptoms and vaccination status. In total, 956 individuals responded: sixty-nine did not get the COVID-19 vaccine, while the remaining were vaccinated with either a single dose of ChAdOx1 vaccine (n:45) or BNT162b2 vaccine (n: 142) or two doses of the vaccine (n:700) using BNT162b2 (n:477), ChAdOx1 (n:89) or ChAdOx1/ BNT162b2 (n:134). Approximately 26.1% (18/69) of the subjects who did not receive the SARS-CoV-2 vaccine and 15.3% (29/188) and 26.4% (185/700) of the subjects who received single and double doses of the vaccines, respectively, reported menstrual cycle changes. The persistence of menstrual cycle changes for more than six months was reported by 6.4% (61/956) of the participants. These changes were significantly correlated with the severity of COVID-19 infection. We concluded that menstrual cycle changes, associated with COVID-19 infection, increase due to the severity of COVID-19 infection. Thus, menstrual cycle changes are among the long-term effects associated with COVID-19 infection.

Efficacy and Short-Term Safety of COVID-19 Vaccines: A Cross-Sectional Study on Vaccinated People in the UAE

BACKGROUND

The emergence of COVID-19 has been a major challenge to public health and the world economy. During a wave of COVID-19, the usage of widespread vaccination procedures and broader coverage to the whole of humanity will be made possible if the general population has access. An intended effect of vaccination is to provide "herd immunity," which protects those who have not been vaccinated along with those who have been. However, some concerns regarding the safety and efficacy of COVID-19 vaccines were raised.

AIM

This study aims to provide evidence on the short-term safety and efficacy of four types of vaccines that are officially approved by the Ministry of Health in the United Arab Emirates (UAE). These include Sinopharm, Sputnik V, Pfizer, and AstraZeneca.

METHOD

This study utilized a cross-sectional descriptive design. Data on the efficacy and short-term protection of COVID-19 vaccines on vaccinated citizens and residents (n = 764) of the UAE were collected between February and April 2021. Participants were conveniently approached using a Google Forms survey, where they responded to a semi-structured questionnaire pertaining to socio-demographic questions and in-depth questions related to COVID-19, including whether they suffer from any comorbidities, the most commonly encountered post-vaccination side effects, and the severity of their symptoms, using a 5-point Likert scale. Results were analyzed using SPSS version 24, calculations of p-values and descriptive statistics were used for data differentiation.

RESULTS

The majority of the participants (n = 612 or 94.4%) stated that they did not become reinfected after receiving two doses of COVID-19 vaccine. In addition, the incidence of being hospitalized after vaccination was negligible. In terms of adverse effects, the most common individually reported side effects, regardless of the vaccination type, included "pain at the site of injection", followed by "general fatigue", then "lethargy". Moreover, most of these side effects occurred after the second dose of the vaccine, irrespective of the type of vaccine. Females were found to be more susceptible to the adversities of COVID-19 vaccination. The occurrence of side effects was not found to be related to the nationality/ethnicity of the vaccine recipient. Furthermore, none of the vaccines affected sleep pattern, since a significant number of respondents reported a regular sleep pattern after being vaccinated. The majority respondents who received two doses of vaccination (n = 585 or 76.6%) reported that they did not become infected post vaccination, regardless the type of vaccine received, whereas only (n = 11 or 1.9%) were reinfected with COVID-19 after 2-4 weeks.

CONCLUSION

The findings of this study suggest that vaccines can offer short-term protection against COVID-19 reinfection. Moreover, both the first- and second-vaccination side effects were described as very mild to moderate, which indicates tolerability. These data may strengthen the public confidence in receiving vaccinations.

From trial to practice: incidence and severity of COVID-19 vaccine side effects in a medically at-risk and vaccine-hesitant community

Background

The rapid authorization and widespread rollout of COVID-19 vaccines in the United States demonstrated a need for additional data on vaccine side effects, both to provide insight into the range and severity of side effects that might be expected in medically-diverse populations as well as to inform decision-making and combat vaccine hesitancy going forward. Here we report the results of a survey of 4825 individuals from southcentral Kentucky who received two doses of either the Pfizer-BioNTech (BNT162b2) or Moderna (mRNA-1273) vaccine between December 14, 2020 and May 1, 2021. As new versions of the vaccine are rolled-out, local initiatives such as this may offer a means to combat vaccine hesitancy in reference to COVID-19, but are also important as we face new viral threats that will necessitate a rapid vaccine rollout, and to combat a growing public distrust of vaccines in general.

Methods

Individuals that received two doses of either BNT162b2 or mRNA-1273 between December 14, 2020 and May 1, 2021 were sent a survey, created by the research team. Respondents were asked to rate the incidence and severity of 15 potential side effects and two related outcomes following each of their two doses of the vaccine. All statistical analyses were carried out using SYSTAT, version 13. The data were analyzed utilizing a range of statistical tests, including chi-square tests of association, Cohen’s h, Kruskal-Wallis test one-way nonparametric ANOVA, least-squares regression, and Wilcoxon signed-ranks test. Significance was assessed using Bonferroni-adjusted criteria within families of tests.

Results

In general, the pattern and severity in side effects was similar to both clinical trial data as well as other published studies. Responses to the mRNA-1273 vaccine were more severe than to BNT162b2, though all were generally in the mild to moderate category. Individuals who reported having previously tested positive for COVID-19 reported stronger responses following the first dose of either vaccine relative to COVID-naïve individuals. The reported severity to the COVID-19 vaccine was positively correlated with self-reported responses to other vaccines.

Conclusions

Our findings allow broad-scale estimates of the nature and severity of reactions one might expect following vaccination within a clinically-diverse community, and provide a context for addressing vaccine hesitancy in communities such as ours, where locally-generated data and communication may be more influential than national trends and statistics in convincing individuals to become vaccinated. Further, we argue this community-based approach could be important in the future in three key ways: 1) as new boosters and modified vaccines re-volatilize vaccine hesitancy, 2) as new vaccines receive similar testing and rapid authorization, and 3) to combat vaccine hesitancy in other arenas (e.g., annual vaccines, childhood vaccines).

Determinants of the Level of Anti-SARS-CoV-2 IgG ANTibodiEs after Vaccination (DANTE-SIRIO 7) Study in a Large Cohort of Healthcare Workers

The aim of this study was to determine anti-SARS-CoV-2 IgG concentrations and their major determinants in healthcare workers (HCWs) after full vaccination with the BNT162b2 vaccine. We recruited 847 individuals vaccinated with two doses of the BNT162b2 vaccine, who completed the questionnaire, and whose antibody concentrations were tested after 3 and 6 months after full vaccination. Anti-SARS-CoV-2 IgG levels were measured on the routinely employed Siemens Atellica system. The cutoff for positivity was ≥21.8 BAU/mL. Three and 6 months after vaccination, the majority of participants were seropositive. Median concentrations of anti-SARS-CoV-2 IgG significantly decreased from 1145 BAU/mL (IQR: 543-2095) to 225 BAU/mL (IQR: 100-510). Major positive determinants of antibody levels were fever after both doses of vaccine, prior-COVID-19 exposure, and muscle pain after the first dose. Lack of symptoms after the second dose and time since vaccination were significant negative determinants of anti-SARS-CoV-2 IgG concentrations. No other factors, including age and gender, or underlying comorbidities had a significant effect on antibody levels in HCWs. The anti-SARS-CoV-2 response after two doses of BNT162b2 vaccine was independently associated with prior-COVID-19 exposure, time since vaccination, and the occurrence of symptoms after either dose of vaccine. Easily reportable adverse reactions may facilitate the identification of immune response in HCWs.

Association between history of SARS-CoV-2 infection and severe systemic adverse events after mRNA COVID-19 vaccination among U.S. adults

BACKGROUND

Risk of experiencing a systemic adverse event (AE) after mRNA coronavirus disease 2019 (COVID-19) vaccination may be greater among persons with a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; data on serious events are limited. We assessed if adults reporting systemic AEs resulting in emergency department visits or hospitalizations during days 0-7 after mRNA COVID-19 vaccine dose 1 were more likely to have a history of prior SARS-CoV-2 infection compared with persons who reported no or non-severe systemic AEs.

METHODS

We conducted a nested case-control study using v-safe surveillance data. Participants were ≥ 18 years and received dose 1 during December 14, 2020─May 9, 2021. Cases reported severe systemic AEs 0-7 days after vaccination. Three controls were frequency matched per case by age, vaccination date, and days since vaccination. Follow-up surveys collected SARS-CoV-2 histories.

RESULTS

Follow-up survey response rates were 38.6 % (potential cases) and 56.8 % (potential controls). In multivariable analyses including 3,862 case-patients and 11,586 controls, the odds of experiencing a severe systemic AE were 2.4 (Moderna, mRNA-1273; 95 % confidence interval [CI]: 1.89, 3.09) and 1.5 (Pfizer-BioNTech, BNT162b2; 95 % CI: 1.17, 2.02) times higher among participants with pre-vaccination SARS-CoV-2 histories compared with those without. Medical attention of any kind for symptoms during days 0-7 following dose 2 was not common among case-patients or controls.

CONCLUSIONS

History of SARS-CoV-2 infection was significantly associated with severe systemic AEs following dose 1 of mRNA COVID-19 vaccine; the effect varied by vaccine received. Most participants who experienced severe systemic AEs following dose 1 did not require medical attention of any kind for symptoms following dose 2. Vaccine providers can use these findings to counsel patients who had pre-vaccination SARS-CoV-2 infection histories, experienced severe systemic AEs following dose 1, and are considering not receiving additional mRNA COVID-19 vaccine doses.

Adverse Events of COVID-19 Vaccination among the Saudi Population: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to synthesize the evidence on the adverse events (AEs) of coronavirus disease 2019 (COVID-19) vaccinations in Saudi Arabia. A computerized search in MEDLINE via PubMed and OVID, Scopus, CENTRAL, and Web of Science was conducted using relevant keywords. The NIH tools were used for the quality assessment. A total of 14 studies (16 reports) were included. The pooled analysis showed that the incidence of AEs post-COVID-19 vaccination was 40.4% (95% CI:6.4% to 87%). Compared to the AstraZeneca vaccine, the Pfizer-BioNTech vaccine was associated with a lower risk ratio (RR) of wheezing (RR = 0.04), fever (RR = 0.32), chills (RR = 0.41), headache (RR = 0.47), dizziness (RR = 0.49), and joint pain (RR = 0.51). The Pfizer-BioNTech vaccine was associated with significantly higher RR of general allergic reactions (RR = 1.62), dyspnea (RR = 1.68), upper respiratory tract symptoms (RR = 1.71), and lymphadenopathy (RR = 8.32). The current evidence suggests that the incidence of AEs following COVID-19 vaccines is 40%; however, most of these AEs were mild and for a short time. The overall number of participants with AEs was higher in the Pfizer group compared to the AstraZeneca group; however, the AstraZeneca vaccine was associated with a higher RR of several AEs.

Signs, Symptoms, and Side-Effects Presented by Different Types of COVID-19 Vaccines: A Prospective Cohort Study

The concern about post-COVID-19 vaccine complications still remains. In addition, the evidence on Sinopharm, Sputnik V, Covaxin, and, in particular, COVIran Barekat, as well as comparisons between them by dosage after post-vaccination, is scarce. This study aimed to investigate and compare the prevalence of self-reported post-vaccination signs and symptoms following the first and second doses of different types of COVID-19 vaccines. Research design and methods: This prospective cohort study was conducted on more than 1500 health professionals who had received at least one dose of any type of Sputnik V, Sinopharm, Oxford AstraZeneca, Covaxin, and COVIran Barekat vaccines in Iran. The survey questionnaire was sent to participants online, 28 days after receiving each dose of the vaccine. Results: About 73% of health professionals reported at least one post-vaccination sign or symptom, developing mostly within the first 12 h (69.9%) and lasting up to 12 h (59.0%). Pain and tenderness at the injection site, fever, and muscle pain were the most common post-vaccination signs and symptoms in all vaccines, which were significantly higher in the Oxford AstraZeneca vaccine (p < 0.001) for both the first and second doses. The incidence rate of all post-vaccination signs and symptoms was significantly higher in the first dose than in the second dose (p < 0.05). Conclusion: The Oxford AstraZeneca vaccine showed the highest incidence rate, onset, and lasting time of signs and symptoms in both doses; however, they were not life-threatening. The onset time of signs and symptoms was significantly higher for the COVIran Barekat and Oxford AstraZeneca vaccines in both the first and second doses.

Side effects of COVID-19 vaccines and perceptions about COVID-19 and its vaccines in Bangladesh: A Cross-sectional study

•

Significant COVID-19 vaccine hesitancy exists globally, mainly due to safety concerns.

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This study analyzed the side effects of COVID-19 vaccines in Bangladesh.

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Less than half of those who received a COVID-19 vaccine experienced side effects.

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The side effects were mild and regular and lasted 1–3 days only.

•

The findings demonstrate the safety of the COVID-19 vaccines.

Objective

Results

Conclusion

Association between IgG antibody levels and adverse events after first and second Bnt162b2 mRNA vaccine doses

OBJECTIVES

This study sought to correlate the SARS-CoV-2 IgG antibody response level to the BNT162b2 (Pfizer BioNTech) mRNA vaccine after the first and second doses with the reported adverse events.

METHODS

This cohort study examined the adverse events profiles of people vaccinated with BNT162b2 in our institute between late 2020 and May 2021. Adverse events, age, and sex were reported using an electronic questionnaire, and their SARS-CoV-2 IgG antibody levels were retrieved from the hospital database.

RESULTS

Between 20 December 2020 and 31 May 2021, the adverse events questionnaire was completed by 9700 individuals who received the first vaccine dose and 8321 who received the second dose. After the first and second doses, the average antibody levels were 62.34 AU/mL (mean 4-373) and 188.19 AU/mL (mean 20-392), respectively. All of the adverse events, except local pain, were more common after the second vaccine dose. Multivariate analysis showed that after the first vaccine dose, female sex and younger age (but not IgG titres) were associated with a higher probability of adverse events (OR 2.377, 95% CI, 1.607-3.515, p = 0.000; OR 0.959, 95% CI, 0.944-0.977, p £0.000; OR 1.002, 95% CI, 0.995-1.008, p £0.601; respectively); however, all three parameters were associated with the incidence of adverse events after the second dose (OR 2.332, 95% CI, 1.636-3.322, p = 0.000; OR 0.984, 95% CI, 0.970-0.999, p £0.039; OR 1.004, 95% CI, 1.001-1.007, p £0.022; respectively).

DISCUSSION

Adverse events are significantly more common after the second BNT162b2 vaccine dose than after the first dose. We found an association between sex, age, and SARS-CoV-2 IgG antibody titre with the incidence of adverse events.

Post COVID-19 vaccination: AusVaxSafety survey participation and adverse events - a community-based regional Queensland study

OBJECTIVE

To describe adverse events following COVID-19 immunisation (AEFI) and participation in AusVaxSafety surveillance in a Queensland regional community.

METHODS

Participants presenting for second dose COVID-19 vaccine at the Hervey Bay Wide Bay Hospital and Health Service (WBHHS) vaccine clinic in July 2021 completed a survey pertaining to their first COVID-19 vaccine. Data collected included participation in AusVaxSafety surveillance, vaccine type (BNT162b2 (Pfizer/BioNTech) or ChAdOx1-S(Oxford/AstraZeneca), AEFI experienced and impact on work/routine activities. Multivariable logistic regression related demographic factors to odds of surveillance participation and AEFI occurrence.

RESULTS

Of 1,148 participants, 37.6% participated in AusVaxSafety surveillance and 44.8% reported an AEFI. Participation in surveillance was higher in older (≥50 vs <50 years: OR 1.36, 95%CI:1.04-1.78) and less-educated participants (university vs. high school/below: OR 0.68, 95%CI:0.48-0.95). Reporting an AEFI was higher in younger (≥50 years vs. <50 years: BNT162b2: OR 0.69, 95%CI:0.51-0.93; ChAdOx1-S: OR 0.42, 95%CI:0.10-1.89), female (female vs. male: BNT162b2: OR 2.28, 95%CI:1.67-3.12; ChAdOx1-S: OR 1.85, 95%CI:1.17-2.94) and more educated participants (university vs. high school/below: BNT162b2:OR 1.63, 95%CI: 1.08-2.45; ChAdOx1-S: OR 3.98, 95%CI:2.03-7.79). Of participants with an AEFI, 15% reported missing work/routine activities.

CONCLUSIONS

Participation in surveillance was modest in this regional population, despite AEFI being frequent, and impacts of absenteeism in this setting warrants further research.

IMPLICATIONS FOR PUBLIC HEALTH

The findings can inform strategies to improve surveillance participation and inform workforce planning in regional areas.

Periprosthetic Hip Joint Infection with Flavonifractor plautii: A Literature Review and Case Report

The purpose of this case report and review of the literature is to provide documentation on periprosthetic hip joint infection with Flavonifractor plautii (formerly known as Eubacterium plautii), a strictly anaerobic bacterium, and to report on a successful pathway for management including staged surgical revisions and extended antibiotic therapy. A systematic review of the literature was conducted, which identified this case as only the fifth documented case of human infection with this organism; as a result, conduct of further research is warranted, based on the paucity of reports in the literature addressing anaerobic periprosthetic joint infection.

A Population-Based Analysis of the Risk of Glomerular Disease Relapse after COVID-19 Vaccination

BACKGROUND

Although case reports have described relapses of glomerular disease after COVID-19 vaccination, evidence of a true association is lacking. In this population-level analysis, we sought to determine relative and absolute risks of glomerular disease relapse after COVID-19 vaccination.

METHODS

In this retrospective population-level cohort study, we used a centralized clinical and pathology registry (2000-2020) to identify 1105 adult patients in British Columbia, Canada, with biopsy-proven glomerular disease that was stable on December 14, 2020 (when COVID-19 vaccines first became available). The primary outcome was disease relapse, on the basis of changes in kidney function, proteinuria, or both. Vaccination was modeled as a 30-day time-varying exposure in extended Cox regression models, stratified on disease type.

RESULTS

During 281 days of follow-up, 134 (12.1%) patients experienced a relapse. Although a first vaccine dose was not associated with relapse risk (hazard ratio [HR]=0.67; 95% confidence interval [95% CI], 0.33 to 1.36), exposure to a second or third dose was associated with a two-fold risk of relapse (HR=2.23; 95% CI, 1.06 to 4.71). The pattern of relative risk was similar across glomerular diseases. The absolute increase in 30-day relapse risk associated with a second or third vaccine dose varied from 1%-2% in ANCA-related glomerulonephritis, minimal change disease, membranous nephropathy, or FSGS to 3%-5% in IgA nephropathy or lupus nephritis. Among 24 patients experiencing a vaccine-associated relapse, 4 (17%) had a change in immunosuppression, and none required a biopsy.

CONCLUSIONS

In a population-level cohort of patients with glomerular disease, a second or third dose of COVID-19 vaccine was associated with higher relative risk but low absolute increased risk of relapse.

Global reports of takotsubo (stress) cardiomyopathy following COVID-19 vaccination: A systematic review and meta-analysis

Concerns have been raised recently about takotsubo cardiomyopathy (TCM) after receiving COVID-19 vaccines, particularly the messenger RNA (mRNA) vaccines. The goal of this study was to compile case reports to provide a comprehensive overview of takotsubo cardiomyopathy (TCM) associated with COVID-19 vaccines. A systematic literature search was conducted in PubMed, Scopus, Embase, Web of Science, and Google Scholar between 2020 and June 1, 2022. The study included individuals who developed cardiac takotsubo cardiomyopathy from receiving COVID-19 vaccinations. Ten studies, including 10 cases, participated in the current systematic review. The mean age was 61.8 years; 90 % were female, while 10 % were male. 80 % of the patients received the mRNA COVID-19 vaccine, while 20 % received other types. In addition, takotsubo cardiomyopathy (TCM) occurred in 50 % of patients receiving the first dose and another 40 % after the second dose of COVID-19 vaccines. Moreover, the mean number of days to the onset of symptoms was 2.62 days. All cases had an elevated troponin test and abnormal ECG findings. The left ventricular ejection fraction (LVEF) was lower than 50 % in 90 % of patients. In terms of the average length of hospital stay, 50 % stayed for 10.2 days, and all cases recovered from their symptoms. In conclusion, takotsubo (stress) cardiomyopathy (TCM) complications associated with COVID-19 vaccination are rare but can be life-threatening. Chest pain should be considered an alarming symptom, especially in those who have received the first and second doses of the COVID-19 vaccine.

Evaluation and comparison of post-vaccination adverse effects among Janssen and Oxford-AstraZeneca vaccinated adult individuals in Debre Tabor Town: A cross- sectional survey in Northwest Ethiopia

COVID 19 vaccination has recently been launched globally to halt the pandemic. But COVID 19 vaccines have some adverse effects that raise concerns in the global community. This study aimed to evaluate and compare the adverse effects of Janssen and Oxford-AstraZeneca vaccinated adults. A community-based cross-sectional study was conducted from March 15 to 30, 2022 among 421 (211 Janssen and 210 Astra Zeneca vaccinated) adults recruited by a convenience sampling technique in Debre Tabor Town, Northwest Ethiopia. Data were collected via face-to-face interviews and by reviewing the immunization card. Chi-square test, independent t-test, and Mann-Whitney test were used to compare the adverse symptoms and related parameters between the two vaccines. A linear regression model was also used to identify predictors of the number of post-vaccination symptoms. The majority (75.8%) of participants reported at least one side effect after vaccination. Adverse symptoms had a significantly greater occurrence (p < .05) among recipients of the AstraZeneca vaccine (84.8%) than receivers of the Janssen vaccine (66.8%). The main adverse symptoms were injection site pain, fever, fatigue, arthralgia, and myalgia in both vaccines. Significant variations (p < .05) between the receipts of the two vaccines were shown in injection site pain, fever, and arthralgia. The total number of symptoms was significantly higher (p < .05) in participants with female sex, younger age, BMI <25 kg/m2, no prior COVID 19, and those who had received AstraZeneca vaccine. Thus, the authors advise that they should receive vaccines with no hesitation, while continuous tracking of vaccine safety is kept in place.

Need of booster vaccine doses to counteract the emergence of SARS-CoV-2 variants in the context of the Omicron variant and increasing COVID-19 cases: An update

The emergence of different variants of SARS-CoV-2, including the Omicron (B.1.1.529) variant in November 2021, has resulted in a continuous major health concern at a global scale. Presently, the Omicron variant has spread very rapidly worldwide within a short time period. As the most mutated variant of SARS-CoV-2, Omicron has instilled serious uncertainties on the effectiveness of humoral adaptive immunity generated by COVID-19 vaccination or an active viral infection as well as the protection provided by antibody-based immunotherapies. Amidst such high public health concerns, the need to carry out booster vaccination has been emphasized. Current evidence reveals the importance of incorporating booster vaccination using several vaccine platforms, such as viral vector- and mRNA-based vaccines, as well as other platforms that are under explorative investigations. Further research is being conducted to assess the effectiveness and durability of protection provided by booster COVID-19 vaccination against Omicron and other SARS-CoV-2 variants.