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Fusco F, Scognamiglio G, Roma AS, Abbate M, Papaccioli G, Merola A, Palma M, Borrelli N, Barracano R, Correra A, Grimaldi N, Ciriello GD, D'Abbraccio M, Scavone C, Capuano A, Sarubbi B. Mid-term follow-up after COVID-19 vaccination in adults with CHD: a prospective study. Cardiol Young 2023; 33:2574-2580. [PMID: 37038838 DOI: 10.1017/s1047951123000689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND Long-term data on COVID-19 vaccine safety, immunogenicity, and acceptance in adults with CHD are lacking. METHODS This is a prospective study including adults with CHD patients undergoing COVID-19 vaccination from January 2021 to June 2022. Data on adverse events, antispike IgG titre, previous or subsequent COVID-19 infection, booster doses, and patients' attitude towards vaccination were collected. RESULTS Four hundred and ninety CHD patients (36 ± 13 years, 53% male, 94% with moderate/complex defects) were prospectively included: 433 (88%) received a Pfizer-BioNTech mRNA vaccine, 31 (6%) Moderna mRNA vaccine, 23 (5%) AstraZeneca-Oxford ChAdOx1 nCov-19 vaccine, and 3 (0.6%) Janssen Vaccine; 310 (63%) received a booster dose. Median follow-up after vaccination was 1.53 [1.41-1.58] years. No major adverse event was reported. Eighty-two fully vaccinated patients contracted COVID-19 during follow-up after a median of 5.4 [4.3-6.5] months from the last dose. One patient with Ebstein's disease died from severe COVID-19. Symptoms' duration in patients who tested positive after vaccination was significantly shorter than in the group tested positive before vaccination (5.5 [3-8] versus 9 [2.2-15] days, p = 0.04). Median antispike IgG titre measured in 280 individuals (57%) at a median of 1.4 [0.7-3.3] months from the last dose was 2381 [901-8307] BAU/ml. Sixty patients (12%) also showed positive antinucleocapsid antibodies, demonstrating previous SARS-COV2 exposure. Twenty-nine percent appeared to have concerns regarding vaccine safety and 42% reported fearing potential effects of the vaccine on their cardiac disease before discussing with their CHD cardiologist. CONCLUSION COVID-19 vaccines appear safe in the mid-term follow-up in adults with CHD with satisfactory immunogenicity and reduction of symptoms' duration in case of infection.
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Affiliation(s)
- Flavia Fusco
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - Anna Selvaggia Roma
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Massimiliana Abbate
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Giovanni Papaccioli
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Assunta Merola
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Michela Palma
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Nunzia Borrelli
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Rosaria Barracano
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Anna Correra
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Nicola Grimaldi
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - Maurizio D'Abbraccio
- Vaccination Unit for Vulnerable Patients, AO dei Colli - Cotugno Hospital, Naples, Italy
| | - Cristina Scavone
- Section of Pharmacology "L. Donatelli", Department of Experimental Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Annalisa Capuano
- Section of Pharmacology "L. Donatelli", Department of Experimental Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Berardo Sarubbi
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
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Desai S, Kainth T, Yadav G, Kochhar H, Srinivas S, Kamil S, Du W. Role of Psychosomatic Symptoms in COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2023; 11:vaccines11050922. [PMID: 37243026 DOI: 10.3390/vaccines11050922] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Vaccination against COVID-19 is one of the highly effective preventative strategies to reduce morbidity and mortality associated with COVID-19 infection. The rapid approval of COVID-19 vaccination due to the raging pandemic, media coverage, anti-vaccination groups, and concerns about adverse effects associated with vaccination has given rise to COVID-19 vaccine hesitancy. Current evidence suggests that psychosomatic and nocebo-related adverse effects account for a significant proportion of common adverse effects following COVID-19 vaccination. The most common adverse effects are headache, fatigue, and myalgia, which are highly prone to nocebo effects. In our review article, we discuss the role of psychosomatic and nocebo effects in COVID-19 vaccination-related hesitancy, predictors of such effects, and strategies to reduce vaccine hesitancy. General education regarding psychosomatic and nocebo effects and specialized education for at-risk populations may reduce psychosomatic and nocebo-related adverse effects following COVID-19 vaccination, ultimately reducing hesitancy.
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Affiliation(s)
- Saral Desai
- Department of Psychiatry, Tower Health-Phoenixville Hospital, Phoenixville, PA 19460, USA
| | - Tejasvi Kainth
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794, USA
| | - Garima Yadav
- Department of Psychiatry, Bronx Care Health System, Bronx, NY 10456, USA
| | - Hansini Kochhar
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Sushma Srinivas
- Department of Psychiatry, A.J. Institute of Medical Sciences and Research Center, Manglore 575004, India
| | - Saher Kamil
- Department of Pediatrics, Dell Children's Medical Center, Austin, TX 78723, USA
| | - Wei Du
- Academic Affairs, Tower Health, West Reading, PA 19611, USA
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA 19102, USA
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Suthaharan P, Corlett PR. Assumed shared belief about conspiracy theories in social networks protects paranoid individuals against distress. Sci Rep 2023; 13:6084. [PMID: 37055504 PMCID: PMC10100615 DOI: 10.1038/s41598-023-33305-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/10/2023] [Indexed: 04/15/2023] Open
Abstract
Paranoia is the belief that others intend you harm. It is related to conspiracy theories, wherein those others represent an organized faction, coordinating the harm against self and others, and violating societal norms. Current psychological studies of paranoid conspiracy theorizing focus either on the individual or their broader social network. Likewise, theories of belief formation and updating often contain individual level processes as well as broader interpersonal and organizational factors. Here we examine paranoia and conspiracy theorizing in terms of individual behavioral predictors (performance on a probabilistic reversal learning task which assays belief updating) as well as social sensing: we ask participants to report the features of their social network, including whether their friends and acquaintances share their paranoid conspiratorial beliefs. We find that people who believe paranoid conspiracy theories expect more volatility during the task. They also assume that members of their social network share their paranoid beliefs. Critically, those participants with larger social networks and greater assumed shared belief tend to harbor their conspiratorial beliefs with less emotional distress and expect less volatility in the task. This is evidence that, like political and religious beliefs, conspiracy theories may flourish under a sacred canopy of belief consensus. These data suggest that friends and acquaintances may serve as sources of credulity and moving between them may sustain conspiracy beliefs when there is detraction. This hybrid individual/social account may shed light on clinical paranoia and persecutory delusion, wherein disability is defined normatively, and social supports are fewer.
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Affiliation(s)
- Praveen Suthaharan
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Kavli Institute for Neuroscience, Yale University, New Haven, CT, USA
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT, USA
| | - Philip R Corlett
- Kavli Institute for Neuroscience, Yale University, New Haven, CT, USA.
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT, USA.
- Department of Psychology, Yale University, New Haven, CT, USA.
- Wu Tsai Institute, Yale University, New Haven, CT, USA.
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Smith LE, Sim J, Sherman SM, Amlôt R, Cutts M, Dasch H, Sevdalis N, Rubin GJ. Psychological factors associated with reporting side effects following COVID-19 vaccination: A prospective cohort study (CoVAccS - Wave 3). J Psychosom Res 2023; 164:111104. [PMID: 36495757 PMCID: PMC9708101 DOI: 10.1016/j.jpsychores.2022.111104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022]
Abstract
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.
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Affiliation(s)
- Louise E. Smith
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Weston Education Centre, King’s College London, London SE5 9RJ, UK,NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King’s College London, London SE5 9RJ, UK,Corresponding author at: Department of Psychological Medicine, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK
| | - Julius Sim
- School of Medicine, David Weatherall Building, University Road, Keele University, Staffordshire, ST5 5BG, UK
| | - Susan M. Sherman
- School of Psychology, Dorothy Hodgkin Building, Keele University, Staffordshire, ST5 5BG, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King’s College London, London SE5 9RJ, UK,UK Health Security Agency, Chief Scientific Officer’s Group, 17 Smith Square, London, SW1P 3HX, UK
| | - Megan Cutts
- School of Psychology, Dorothy Hodgkin Building, Keele University, Staffordshire, ST5 5BG, UK
| | - Hannah Dasch
- Centre for Implementation Science, NIHR ARC South London, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Nick Sevdalis
- Centre for Implementation Science, NIHR ARC South London, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - G. James Rubin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Weston Education Centre, King’s College London, London SE5 9RJ, UK,NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King’s College London, London SE5 9RJ, UK
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Loosen SH, Bohlken J, Weber K, Konrad M, Luedde T, Roderburg C, Kostev K. Factors Associated with Non-Severe Adverse Reactions after Vaccination against SARS-CoV-2: A Cohort Study of 908,869 Outpatient Vaccinations in Germany. Vaccines (Basel) 2022; 10:vaccines10040566. [PMID: 35455315 PMCID: PMC9032707 DOI: 10.3390/vaccines10040566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 01/04/2023] Open
Abstract
Background: Vaccination against SARS-CoV-2 significantly reduces the transmissibility of the virus and the likelihood of a severe course of COVID-19, and is thus a critical component in overcoming the current pandemic. The factors associated with adverse reactions after vaccination against SARS-CoV-2 have not yet been sufficiently evaluated. Methods: We used the Disease Analyzer database (IQVIA) to identify 531,468 individuals who received a total of 908,869 SARS-CoV-2 vaccinations in 827 general practices in Germany between April and September 2021. Cox regression models were used to analyze the frequency of vaccination-related side effects reported within 14 days after SARS-CoV-2 vaccination, as well as subjects’ demographic characteristics and comorbidities. Results: The total number of side effects documented was 28,287 (3.1% of all vaccinations). Pain in the limb (24.3%), fatigue (21.0%), dizziness (17.9%), joint pain (15.7%), fever (9.5%), nausea (7.5%), and myalgia (6.4%) were the most common side effects documented among the 12,575 vaccinations with definite side effects. In the multivariate regression analysis, young age was associated with much higher odds of reported side effects (OR18–30 years: 4.45, OR31–40 years: 3.50, OR41–50 years: 2.89). In addition, pre-existing comorbidities such as dementia (OR: 1.54), somatoform disorder (OR: 1.53), anxiety disorder (OR: 1.43), depression (OR: 1.37), chronic respiratory tract disease (OR: 1.27), hypertension (OR: 1.20), and obesity (1.14) significantly increased the odds of side effects. Finally, the male sex was associated with increased odds of reported side effects (OR: 1.17). Conclusion: Our study, based on a large outpatient database from Germany, identified young age, male sex, and pre-existing comorbidities such as dementia, somatoform disorders, anxiety disorders, and depression as factors associated with vaccine-related adverse events diagnosed in GP practices. These data could help to identify subgroups needing particular advice and care in the context of SARS-CoV-2 vaccinations.
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Affiliation(s)
- Sven H. Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany;
- Correspondence: (S.H.L.); (C.R.)
| | - Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany;
| | | | - Marcel Konrad
- Health & Social, FOM University of Applied Sciences for Economics and Management, 60549 Frankfurt, Germany;
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany;
| | - Christoph Roderburg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany;
- Correspondence: (S.H.L.); (C.R.)
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Garces KN, Cocores AN, Goadsby PJ, Monteith TS. Headache After Vaccination: An Update on Recent Clinical Trials and Real-World Reporting. Curr Pain Headache Rep 2022; 26:895-918. [PMID: 36418848 PMCID: PMC9685066 DOI: 10.1007/s11916-022-01094-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to characterize headache as a vaccine adverse event (VAE) in clinical trials. RECENT FINDINGS Of the recent phase III vaccine RCTs (non-COVID-19), 53 studies reported on headache (13 infectious agents). The median rate (interquartile range) of headache was 15.6% (IQR: 9.6-37.6%). Of these, 24.5% of the RCTs reported headache greater in the vaccine group compared to the placebo/control group. In the herpes zoster vaccination trials, headache was more common in all active groups: median rate 33.9% (IQR: 29.7-40.5%) as compared to placebo: median rate 17.7% (IQR: 15.4-23.8%). Influenza and HPV vaccination trials were the 2nd and 3rd most common to have headache as a VAE. Of the 6 widely distributed COVID-19 vaccinations, median rate of post-vaccination headache was 39% (IQR: 28-50%). Headache is a common VAE in vaccine trials. Standardized grading methods, predictors of persistence, and treatment regimens are warranted.
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Affiliation(s)
- Kimberly N. Garces
- Division of Headache, Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL USA
| | - Alexandra N. Cocores
- Division of Headache, Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL USA
| | - Peter J. Goadsby
- NIHR King’s Clinical Research Facility & Headache Group-Wolfson CARD, King’s College London, London, UK ,Department of Neurology, University of California, Los Angeles, Los Angeles, CA USA
| | - Teshamae S. Monteith
- Division of Headache, Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL USA
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