1
|
Sahli W, Vitte J, Desnues B. Eosinophils and COVID-19: Insights into immune complexity and vaccine safety. Clin Transl Allergy 2025; 15:e70050. [PMID: 40120088 PMCID: PMC11929522 DOI: 10.1002/clt2.70050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 02/23/2025] [Accepted: 03/10/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND COVID-19 exhibits a variety of symptoms and may lead to multi-organ failure and death. This clinical complexity is exacerbated by significant immune dysregulation affecting nearly all cells of the innate and adaptive immune system. Granulocytes, including eosinophils, are affected by SARS-CoV-2. OBJECTIVES Eosinophil responses remain poorly understood despite early recognition of eosinopenia as a hallmark feature of COVID-19 severity. RESULTS The heterogeneous nature of eosinophil responses categorizes them as dual-function cells with contradictory effects. Eosinophil activation can suppress virus-induced inflammation by releasing type 2 cytokines like IL-13 and granular proteins with antiviral action such as eosinophil-derived neurotoxins and eosinophil cationic protein, and also by acting as antigen-presenting cells. In contrast, eosinophil accumulation in the lungs can induce tissue damage triggered by cytokines or hormones like IFN-γ and leptin. Additionally, they can affect adaptive immune functions by interacting with T cells through direct formation of membrane complexes or soluble mediator action. Individuals with allergic disorders who have elevated levels of eosinophils in tissues and blood, such as asthma, do not appear to be at an increased risk of developing severe COVID-19 following SARS-CoV-2 infection. However, the SARS-CoV-2 vaccine appears to be associated with complications and eosinophilic infiltrate-induced immunopathogenicity, which can be mitigated by corticosteroid, anti-histamines and anti-IL-5 therapy and avoided by modifying adjuvants or excipients. CONCLUSION This review highlights the importance of eosinophils in COVID-19 and contributes to a better understanding of their role during natural infection and vaccination.
Collapse
Affiliation(s)
- Wided Sahli
- Aix Marseille UniversityMEPHIMarseilleFrance
- IHU‐Méditerranée InfectionMarseilleFrance
| | - Joana Vitte
- Laboratory of ImmunologyUniversity Hospital of ReimsReimsFrance
- INSERM UMR‐S 1250 P3CELLUniversity of ReimsReimsFrance
| | - Benoit Desnues
- Aix Marseille UniversityMEPHIMarseilleFrance
- IHU‐Méditerranée InfectionMarseilleFrance
| |
Collapse
|
2
|
Jeong YD, Lee K, Park J, Lee J, Kang J, Yeo SG, Smith L, Lee H, Yon DK. Global burden of vaccine-associated angioedema and their related vaccines, 1967-2023: Findings from the global pharmacovigilance database. Allergy 2025; 80:590-594. [PMID: 39212223 DOI: 10.1111/all.16304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 08/15/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Yi Deun Jeong
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Kyeongmin Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Jinseok Lee
- Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea
| | - Jiseung Kang
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Seung Geun Yeo
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Hayeon Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea
| | - Dong Keon Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| |
Collapse
|
3
|
Szklarz M, Gontarz-Nowak K, Kieroński A, Golon K, Górny J, Matuszewski W, Bandurska-Stankiewicz E. The co-occurrence of SAT, hypophysitis, and Schnitzler syndrome after COVID-19 vaccination: the first described case. Hormones (Athens) 2024; 23:735-752. [PMID: 38775985 PMCID: PMC11519144 DOI: 10.1007/s42000-024-00567-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/30/2024] [Indexed: 10/29/2024]
Abstract
Subacute thyroiditis (also known as granulomatous thyroiditis, giant cell thyroiditis, de Quervain's disease, or SAT) is an inflammatory disease of the thyroid gland, usually spontaneously remitting, that lasts for weeks to months. However, recurrent forms sometimes occur which may have a genetic basis. In our paper, we have focused on the pathogenetics, symptoms, and treatment of SAT. We have described the 17-month disease course of a woman with persistent recurrent steroid-resistant SAT. SAT was well established and the patient's symptoms were not only recurrent neck pain with fever, but also recurrent chronic urticaria, which are symptoms that fulfil the criteria for the diagnosis of Schnitzler syndrome. Schnitzler syndrome occurred after vaccination with COVID-19 in the mechanism of ASIA syndrome. In our patient, Schnitzler syndrome involved the thyroid gland, causing persistent subacute thyroiditis, and the pituitary gland, causing transient swelling of the pituitary, which, to our knowledge, is the first reported case in the literature. Also unprecedented, as far as we know, is the fact that we performed thyroidectomy in the above patient, which reduced systemic inflammation and caused SAT to resolve, although only the inclusion of anakinra treatment resulted in resolution of the underlying condition.
Collapse
Affiliation(s)
- Michał Szklarz
- Clinic of Endocrinology, Diabetology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957, Olsztyn, Poland.
| | - Katarzyna Gontarz-Nowak
- Clinic of Endocrinology, Diabetology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957, Olsztyn, Poland
| | - Aleksander Kieroński
- Department of Nuclear Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957, Olsztyn, Poland
| | - Krystian Golon
- Department of Pathomorphology and Forensic Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957, Olsztyn, Poland
| | - Jan Górny
- Clinic of Endocrinology, Diabetology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957, Olsztyn, Poland
| | - Wojciech Matuszewski
- Clinic of Endocrinology, Diabetology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957, Olsztyn, Poland
| | - Elżbieta Bandurska-Stankiewicz
- Clinic of Endocrinology, Diabetology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957, Olsztyn, Poland
| |
Collapse
|
4
|
Ye YM. Can Vaccinations Trigger or Exacerbate Chronic Urticaria? ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2024; 16:567-570. [PMID: 39622682 PMCID: PMC11621475 DOI: 10.4168/aair.2024.16.6.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 10/31/2024] [Indexed: 12/08/2024]
Affiliation(s)
- Young-Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
| |
Collapse
|
5
|
Jęśkowiak-Kossakowska I, Nowotarska P, Grosman-Dziewiszek P, Szeląg A, Wiatrak B. Impact of Comorbidities and Skin Diseases on Post-Vaccination Reactions: A Study on COVID-19 Vaccinations in Poland. J Clin Med 2024; 13:6173. [PMID: 39458123 PMCID: PMC11508506 DOI: 10.3390/jcm13206173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Revised: 09/30/2024] [Accepted: 10/10/2024] [Indexed: 10/28/2024] Open
Abstract
Background: The COVID-19 pandemic necessitated rapid and widespread vaccination efforts, which proved critical in reducing the severity and mortality of the virus. However, the interplay between vaccinations, pre-existing skin conditions, and other comorbidities still needs to be explored. This study investigated the occurrence and severity of adverse events following immunization (AEFIs) with COVID-19 vaccines in individuals with chronic skin diseases and comorbidities within a Central European cohort. Methods: An anonymous online survey was conducted between May 2022 and February 2023, targeting students and employees of universities in Wrocław, Poland. A total of 513 respondents were analyzed, focusing on AEFIs following the first, second, and third doses of COVID-19 vaccines and the effects of COVID-19 on conditions such as atopic dermatitis, psoriasis, vitiligo, acne vulgaris, rosacea, and various comorbidities. Results: COVID-19 vaccination effectively protected against severe disease across all doses. The analysis revealed no significant impact of either COVID-19 infection or vaccination on the course of selected skin diseases and comorbidities. The reporting of AEFIs to the Sanitary Inspection was notably low. The Moderna and Pfizer mRNA-based vaccines were associated with a higher reported number of AEFIs, particularly after the second and third doses, compared to AstraZeneca, which exhibited fewer adverse events after subsequent doses. Conclusions: COVID-19 vaccination is both safe and effective, even in patients with pre-existing skin conditions and comorbidities. Vaccine selection may benefit from considering individual health profiles, and better reporting of AEFIs is needed to enhance vaccine safety monitoring.
Collapse
Affiliation(s)
- Izabela Jęśkowiak-Kossakowska
- Department of Pharmacology, Faculty of Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 2, 50-345 Wroclaw, Poland; (P.G.-D.); (A.S.)
| | - Paulina Nowotarska
- Department of Biostructure and Animal Physiology, Wroclaw University of Environmental and Life Sciences, Norwida 25/27, 50-375 Wroclaw, Poland;
| | - Patrycja Grosman-Dziewiszek
- Department of Pharmacology, Faculty of Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 2, 50-345 Wroclaw, Poland; (P.G.-D.); (A.S.)
| | - Adam Szeląg
- Department of Pharmacology, Faculty of Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 2, 50-345 Wroclaw, Poland; (P.G.-D.); (A.S.)
| | - Benita Wiatrak
- Department of Pharmacology, Faculty of Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 2, 50-345 Wroclaw, Poland; (P.G.-D.); (A.S.)
| |
Collapse
|
6
|
Monadhel H, Abbas A, Mohammed A. COVID-19 vaccinations and their side effects: a scoping systematic review. F1000Res 2024; 12:604. [PMID: 39512911 PMCID: PMC11541072 DOI: 10.12688/f1000research.134171.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2024] [Indexed: 11/15/2024] Open
Abstract
Introduction: The COVID-19 virus has impacted people worldwide, causing significant changes in their lifestyles. Since the emergence of the epidemic, attempts have begun to prepare a vaccine that can eliminate the virus and restore balance to life in the entire world. Over the past two years, countries and specialized companies have competed to obtain a license from the World Health Organization for the vaccines that were discovered. After the appearance of vaccines in the health community, comparisons and fears of their side effects began, but people don't get an answer to the question of which is the best vaccine. Methods: IEEE Xplore, ScienceDirect, the New England Journal of Medicine, Google Scholar, and PubMed databases were searched for literature on the COVID-19 vaccine and its side effects. we surveyed the literature on the COVID-19 vaccine's side effects and the sorts of side effects observed after vaccination. Depending on data from the literature, we compared these vaccines in terms of side effects, then we analyzed the gaps and obstacles of previous studies and made proposals to process these gaps in future studies. Results: Overall, 17 studies were included in this scoping systematic review as they fulfilled the criteria specified, the majority of which were cross-sectional and retrospective cross-sectional studies. Most of the side effects were mild, self-limiting, and common. Thus, they usually resolve within 1-3 days after vaccination. Factors associated with higher side effects included advanced age, allergic conditions, those taking other medications (particularly immunosuppressive ones), those with a history of type II diabetes, heart disease, hypertension, COVID-19 infection, and female sex. Our meta-analyses also found that mRNA vaccines looked to be more effective, while inactivated vaccinations had fewer side effects. Conclusion: This review shows that the COVID-19 vaccine is safe to administer and induces protection.
Collapse
Affiliation(s)
- Hind Monadhel
- Computer Science, University of Technology-Iraq, Baghdad, 10053, Iraq
| | - Ayad Abbas
- Computer Science, University of Technology-Iraq, Baghdad, 10053, Iraq
| | - Athraa Mohammed
- Computer Science, University of Technology-Iraq, Baghdad, 10053, Iraq
| |
Collapse
|
7
|
Ferrari F, Sodi F, Madotto F, Carlesso E, Florio G, Pelliccia MR, Laquintana D, Bisesti A, Piatti A, Letzgus M, Tiwana N, Jachetti A, Mancarella M, Cereda D, Leoni O, Borriello CR, Chiappa L, Sottocorno M, Costantino G, Zanella A, Grasselli G. Medical occurrence and safety of SARS-CoV-2 vaccination outside of the hospital setting. Intern Emerg Med 2024; 19:1593-1604. [PMID: 39042210 DOI: 10.1007/s11739-024-03641-4] [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] [Received: 03/02/2024] [Accepted: 05/08/2024] [Indexed: 07/24/2024]
Abstract
During COVID-19 pandemic, vaccination has been strongly recommended and advocated to prevent COVID-19 infection and adverse outcomes, particularly among at-risk populations. The vaccination against SARS-CoV-2 (COVAC) occurred at off-site locations capable of accommodating large crowds, distinct from the hospital setting, where a team of intensivists, emergency physicians, and nurses, ensuring prompt medical attention (medical occurrences, MO) in cases of adverse event following immunization. Our aims were to estimate the incidence of MO, and to assess its association with demographics, and vaccine characteristics. Our retrospective cohort study included all subject aged 12 years and older who received vaccinations at two large out-of-hospital vaccination hubs (Fiera Milano City, Palazzo delle Scintille), between April 12th and August 31st, 2021. Nine hundred and ninety-five thousand and twenty-eight vaccinations were administrated. MOs incidence rate was 278/100,000 doses (95% confidence interval (CI) 268-289). Most MOs were mild (86.27%) and mainly observed in subjects who received the Comirnaty vaccine; 92 MOs (3.32%) were severe and mostly occurred in recipients of the Vaxzeria vaccine. The incidence rate for hospital transfers following vaccination was 4.7/100,000 doses (95% CI 3.5-6.2) and any level of anaphylaxis occurred in 0.4 cases per 100,000 administrated doses (95% CI 0.3.-0.7). Sex, age, type of vaccine and first dose were associated with incidence of MO. Our results showed a low incidence rate in MOs after COVAC, mainly mild and support the feasibility, effectiveness and safety of vaccinations administered in hubs with a dedicated SEU located outside of the hospital setting.
Collapse
Affiliation(s)
- Fiorenza Ferrari
- Dipartimento Area Emergenza-Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Federico Sodi
- Dipartimento Area Emergenza-Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Padiglione Litta, Milan, Italy
| | - Fabiana Madotto
- Dipartimento Area Emergenza-Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Carlesso
- Department of Pathophysiology and Transplantation, University of Milan, Padiglione Litta, Milan, Italy
| | - Gaetano Florio
- Dipartimento Area Emergenza-Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rosa Pelliccia
- Department of Pathophysiology and Transplantation, University of Milan, Padiglione Litta, Milan, Italy
| | - Dario Laquintana
- Direzione Aziendale Professioni Sanitarie, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Alberto Bisesti
- Direzione Aziendale Professioni Sanitarie, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Piatti
- Direzione Medica di Presidio, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Letzgus
- Direzione Medica di Presidio, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Navpreet Tiwana
- Direzione Medica di Presidio, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Jachetti
- Emergency Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Milan, Italy
| | - Marta Mancarella
- Emergency Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Milan, Italy
| | - Danilo Cereda
- General Directorate for Health, Lombardy Region, Milan, Italy
| | - Olivia Leoni
- General Directorate for Health, Lombardy Region, Milan, Italy
| | | | - Laura Chiappa
- Direzione Sanitaria, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Marcello Sottocorno
- Hospital Pharmacy Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Costantino
- Emergency Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alberto Zanella
- Dipartimento Area Emergenza-Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Padiglione Litta, Milan, Italy.
| | - Giacomo Grasselli
- Dipartimento Area Emergenza-Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Padiglione Litta, Milan, Italy
| |
Collapse
|
8
|
Li Y, Li J, Dang Y, Chen Y, Tao C. Adverse Events of COVID-19 Vaccines in the United States: Temporal and Spatial Analysis. JMIR Public Health Surveill 2024; 10:e51007. [PMID: 39008362 PMCID: PMC11287098 DOI: 10.2196/51007] [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: 07/19/2023] [Revised: 04/07/2024] [Accepted: 05/23/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by SARS-CoV-2, has had a profound impact worldwide, leading to widespread morbidity and mortality. Vaccination against COVID-19 is a critical tool in controlling the spread of the virus and reducing the severity of the disease. However, the rapid development and deployment of COVID-19 vaccines have raised concerns about potential adverse events following immunization (AEFIs). Understanding the temporal and spatial patterns of these AEFIs is crucial for an effective public health response and vaccine safety monitoring. OBJECTIVE This study aimed to analyze the temporal and spatial characteristics of AEFIs associated with COVID-19 vaccines in the United States reported to the Vaccine Adverse Event Reporting System (VAERS), thereby providing insights into the patterns and distributions of the AEFIs, the safety profile of COVID-19 vaccines, and potential risk factors associated with the AEFIs. METHODS We conducted a retrospective analysis of administration data from the Centers for Disease Control and Prevention (n=663,822,575) and reports from the surveillance system VAERS (n=900,522) between 2020 and 2022. To gain a broader understanding of postvaccination AEFIs reported, we categorized them into system organ classes (SOCs) according to the Medical Dictionary for Regulatory Activities. Additionally, we performed temporal analysis to examine the trends of AEFIs in all VAERS reports, those related to Pfizer-BioNTech and Moderna, and the top 10 AEFI trends in serious reports. We also compared the similarity of symptoms across various regions within the United States. RESULTS Our findings revealed that the most frequently reported symptoms following COVID-19 vaccination were headache (n=141,186, 15.68%), pyrexia (n=122,120, 13.56%), and fatigue (n=121,910, 13.54%). The most common symptom combination was chills and pyrexia (n=56,954, 6.32%). Initially, general disorders and administration site conditions (SOC 22) were the most prevalent class reported. Moderna exhibited a higher reporting rate of AEFIs compared to Pfizer-BioNTech. Over time, we observed a decreasing reporting rate of AEFIs associated with COVID-19 vaccines. In addition, the overall rates of AEFIs between the Pfizer-BioNTech and Moderna vaccines were comparable. In terms of spatial analysis, the middle and north regions of the United States displayed a higher reporting rate of AEFIs associated with COVID-19 vaccines, while the southeast and south-central regions showed notable similarity in symptoms reported. CONCLUSIONS This study provides valuable insights into the temporal and spatial patterns of AEFIs associated with COVID-19 vaccines in the United States. The findings underscore the critical need for increasing vaccination coverage, as well as ongoing surveillance and monitoring of AEFIs. Implementing targeted monitoring programs can facilitate the effective and efficient management of AEFIs, enhancing public confidence in future COVID-19 vaccine campaigns.
Collapse
Affiliation(s)
- Yiming Li
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jianfu Li
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, FL, United States
| | - Yifang Dang
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Yong Chen
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Cui Tao
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, FL, United States
| |
Collapse
|
9
|
Wang J, Sun H, Yang H, Yang R, Zhu X, Guo S, Huang Y, Xu Y, Li C, Tu J, Sun C. Dessecting the toxicological profile of polysorbate 80 (PS80): comparative analysis of constituent variability and biological impact using a zebrafish model. Eur J Pharm Sci 2024; 198:106796. [PMID: 38735400 DOI: 10.1016/j.ejps.2024.106796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024]
Abstract
Polysorbate 80, commonly abbreviated as PS80, is a widely used pharmaceutical excipient renowned for its role as a solubilizer and stabilizer in drug formulations. Although PS80 is essential for various pharmaceutical applications, particularly in the formulation of injectable drugs, it has been implicated in a range of adverse reactions. However, due to the complexity of the composition of PS80, the differences in the types and contents of the constituents of PS80 from different manufacturers increase the probability or likelihood of their uneven quality. Addressing the complete spectrum of PS80's components is challenging; thus, most studies to date have examined PS80 as a singular entity. This approach, however, carries a degree of uncertainty, as it overlooks the unique composition and concentration of components within the PS80 used in experiments, which may not reflect the actual diversity in commercially available PS80 products. Recognizing the critical need to understand how PS80's composition influences biological effects and toxicity, our study aims to bridge this knowledge gap. By doing so, we can clarify how different PS80 compositions from various manufacturers might affect the quality of pharmaceutical formulations, and also guide excipient manufacturers toward producing higher-quality PS80. Such insights could further facilitate a more targeted application of PS80 in drug development. Building on our previous work, we isolated and prepared two key components of PS80-polyoxyethylene sorbitan monooleate (PSM) and polyoxyethylene isosorbide monooleate (PIM)-and conducted a systematic comparison. We evaluated the acute, hemolytic, and target organ toxicity of two different PS80 samples, as well as PSM and PIM, using a zebrafish model. Our research also delved into the potential mechanisms behind the observed toxicological effects, providing an in-depth understanding of PS80's impact on biological systems.The results show that PS80, PSM, and PIM resulted in developmental anomalies in larval zebrafish. The primary organs of acute toxicity in zebrafish exposed to PS80 and its typical components PSM and PIM include the cardiovascular system, kidneys, intestines, skin, and liver. Notably, PIM further induced severe pericardial edema and erythrocyte hemolysis, thereby affecting blood flow. The samples also instigated oxidative damage by disrupting the redox equilibrium in the larvae. Compared to PS80, both PSM and PIM induced greater oxidative damage, with PIM notably causing significantly higher lipid oxidation, suggesting that oxidative stress may play a crucial role in polysorbate80-induced toxicity. Furthermore, our study found that PS80 could induce alterations in DNA conformation. The findings underscore the necessity for excipient regulators to establish comprehensive quality standards for Polysorbate 80 (PS80). By implementing such standards, it is possible to minimize the clinical risks associated with the variability in PS80 composition, ensuring safer pharmaceutical products for patients.
Collapse
Affiliation(s)
- Jue Wang
- State Key Laboratory of Natural Medicines, NMPA Key Laboratory for Research and Evaluation of Pharmaceutical Preparations and Excipients, and Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China; NMPA Key Laboratory for Quality Control of Pharmaceutical Excipients, National Institutes for Food and Drug Control, 2 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Huimin Sun
- NMPA Key Laboratory for Quality Control of Pharmaceutical Excipients, National Institutes for Food and Drug Control, 2 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Huiying Yang
- NMPA Key Laboratory for Quality Control of Pharmaceutical Excipients, National Institutes for Food and Drug Control, 2 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Rui Yang
- NMPA Key Laboratory for Quality Control of Pharmaceutical Excipients, National Institutes for Food and Drug Control, 2 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Xiaoyu Zhu
- Hunter Biotechnology Inc, F1A, building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province 310051, China
| | - Shengya Guo
- Hunter Biotechnology Inc, F1A, building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province 310051, China
| | - Yanfeng Huang
- Hunter Biotechnology Inc, F1A, building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province 310051, China
| | - Yiqiao Xu
- Hunter Biotechnology Inc, F1A, building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province 310051, China
| | - Chunqi Li
- Hunter Biotechnology Inc, F1A, building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province 310051, China
| | - Jiasheng Tu
- State Key Laboratory of Natural Medicines, NMPA Key Laboratory for Research and Evaluation of Pharmaceutical Preparations and Excipients, and Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China.
| | - Chunmeng Sun
- State Key Laboratory of Natural Medicines, NMPA Key Laboratory for Research and Evaluation of Pharmaceutical Preparations and Excipients, and Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China.
| |
Collapse
|
10
|
Chen DTH, Copland E, Hirst JA, Mi E, Dixon S, Coupland C, Hippisley-Cox J. Uptake, effectiveness and safety of COVID-19 vaccines in individuals at clinical risk due to immunosuppressive drug therapy or transplantation procedures: a population-based cohort study in England. BMC Med 2024; 22:237. [PMID: 38858672 PMCID: PMC11165729 DOI: 10.1186/s12916-024-03457-1] [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] [Received: 11/15/2023] [Accepted: 05/30/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Immunocompromised individuals are at increased risk of severe COVID-19 outcomes, underscoring the importance of COVID-19 vaccination in this population. The lack of comprehensive real-world data on vaccine uptake, effectiveness and safety in these individuals presents a critical knowledge gap, highlighting the urgency to better understand and address the unique challenges faced by immunocompromised individuals in the context of COVID-19 vaccination. METHODS We analysed data from 12,274,946 people in the UK aged > 12 years from 01/12/2020 to 11/04/2022. Of these, 583,541 (4.8%) were immunocompromised due to immunosuppressive drugs, organ transplants, dialysis or chemotherapy. We undertook a cohort analysis to determine COVID-19 vaccine uptake, nested case-control analyses adjusted for comorbidities and sociodemographic characteristics to determine effectiveness of vaccination against COVID-19 hospitalisation, ICU admission and death, and a self-controlled case series assessing vaccine safety for pre-specified adverse events of interest. RESULTS Overall, 93.7% of immunocompromised individuals received at least one COVID-19 vaccine dose, with 80.4% having received three or more doses. Uptake reduced with increasing deprivation (hazard ratio [HR] 0.78 [95%CI 0.77-0.79] in the most deprived quintile compared to the least deprived quintile for the first dose). Estimated vaccine effectiveness against COVID-19 hospitalisation 2-6 weeks after the second and third doses compared to unvaccinated was 78% (95%CI 72-83) and 91% (95%CI 88-93) in the immunocompromised population, versus 85% (95%CI 83-86) and 86% (95%CI 85-89), respectively, for the general population. Results showed COVID-19 vaccines were protective against intensive care unit (ICU) admission and death in both populations, with effectiveness of over 92% against COVID-19-related death and up to 95% in reducing ICU admissions for both populations following the third dose. COVID-19 vaccines were generally safe for immunocompromised individuals, though specific doses of ChAdOx1, mRNA-1273 and BNT162b2 raised risks of specific cardiovascular/neurological conditions. CONCLUSIONS COVID-19 vaccine uptake is high in immunocompromised individuals on immunosuppressive drug therapy or who have undergone transplantation procedures, with documented disparities by deprivation. Findings suggest that COVID-19 vaccines are protective against severe COVID-19 outcomes in this vulnerable population, and show a similar safety profile in immunocompromised individuals and the general population, despite some increased risk of adverse events. These results underscore the importance of ongoing vaccination prioritisation for this clinically at-risk population to maximise protection against severe COVID-19 outcomes.
Collapse
Affiliation(s)
- Daniel Tzu-Hsuan Chen
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Emma Copland
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Jennifer A Hirst
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Emma Mi
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Sharon Dixon
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Carol Coupland
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| |
Collapse
|
11
|
Copland E, Patone M, Saatci D, Handunnetthi L, Hirst J, Hunt DPJ, Mills NL, Moss P, Sheikh A, Coupland CAC, Harnden A, Robertson C, Hippisley-Cox J. Safety outcomes following COVID-19 vaccination and infection in 5.1 million children in England. Nat Commun 2024; 15:3822. [PMID: 38802362 PMCID: PMC11130197 DOI: 10.1038/s41467-024-47745-z] [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: 06/17/2023] [Accepted: 04/11/2024] [Indexed: 05/29/2024] Open
Abstract
The risk-benefit profile of COVID-19 vaccination in children remains uncertain. A self-controlled case-series study was conducted using linked data of 5.1 million children in England to compare risks of hospitalisation from vaccine safety outcomes after COVID-19 vaccination and infection. In 5-11-year-olds, we found no increased risks of adverse events 1-42 days following vaccination with BNT162b2, mRNA-1273 or ChAdOX1. In 12-17-year-olds, we estimated 3 (95%CI 0-5) and 5 (95%CI 3-6) additional cases of myocarditis per million following a first and second dose with BNT162b2, respectively. An additional 12 (95%CI 0-23) hospitalisations with epilepsy and 4 (95%CI 0-6) with demyelinating disease (in females only, mainly optic neuritis) were estimated per million following a second dose with BNT162b2. SARS-CoV-2 infection was associated with increased risks of hospitalisation from seven outcomes including multisystem inflammatory syndrome and myocarditis, but these risks were largely absent in those vaccinated prior to infection. We report a favourable safety profile of COVID-19 vaccination in under-18s.
Collapse
Affiliation(s)
- Emma Copland
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Martina Patone
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Defne Saatci
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Lahiru Handunnetthi
- Centre for Human Genetics, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Jennifer Hirst
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - David P J Hunt
- UK Dementia Research Institute, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Nicholas L Mills
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Aziz Sheikh
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Carol A C Coupland
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Anthony Harnden
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK.
| |
Collapse
|
12
|
Park J. Expertise as a Response to Limited Multilateralism: The Case of South Korea's Vaccine Procurement Task Force for COVID-19 Vaccines amid Unequal Access via the COVAX Facility. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2024; 49:99-132. [PMID: 37522333 DOI: 10.1215/03616878-10910224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This study investigates South Korea's trials and errors in procuring COVID-19 vaccines from abroad, amid the limitations of a multilateral scheme for global provision through the COVID-19 Vaccines Global Access (COVAX) program via the World Health Organization (WHO) and the discussions on COVID-19 vaccine patent waivers at the World Trade Organization. Using the framework of "self-help" in the international system and country categorization to explicate country behaviors by state-business relations and expertise to explain South Korea's COVID-19 vaccine procurement process, this study argues that in the absence of a global mechanism that guarantees adequate and timely vaccine provision, countries are left to the sole option of depending on their own capabilities: expertise, budget, and policy planning by consolidating public and private capacities to acquire vaccines for the public. To support the argument, an in-depth case investigation of South Korea's Vaccine Procurement Task Force is presented. The case study focuses on the policy assessment of critical elements in South Korea's vaccine procurement and rollout on facing obstacles to sufficient procurement through COVAX: decision-making impacting the timing and dosage of procurement, diplomatic and business channels to sign bilateral contracts, setup of a smart-factory vaccination hub, and indigenous vaccine development for WHO approval.
Collapse
|
13
|
Liu X, Cao Y, Wang W. Burden of and Trends in Urticaria Globally, Regionally, and Nationally from 1990 to 2019: Systematic Analysis. JMIR Public Health Surveill 2023; 9:e50114. [PMID: 37883176 PMCID: PMC10636626 DOI: 10.2196/50114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/04/2023] [Accepted: 10/03/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Urticaria presents a significant global health challenge due to its sudden onset and potential for severe allergic reactions. Past data on worldwide prevalence and incidence is inconsistent due to differing study methodologies, regional differences, and evolving diagnostic criteria. Past studies have often provided broad ranges instead of specific figures, underscoring the necessity for a cohesive global perspective to inform public health strategies. OBJECTIVE We aimed to assess the global burden of urticaria using the 2019 Global Burden of Disease (GBD) study data and systematically analyze urticaria prevalence, incidence, and disability-adjusted life years (DALYs) at global, regional, and national levels, thereby informing more effective prevention and treatment strategies. METHODS We analyzed the global, regional, and national burden of urticaria from 1990 to 2019 using the 2019 GBD study coordinated by the Institute for Health Metrics and Evaluation. Estimations of urticaria prevalence, incidence, and DALYs were derived using DisMod-MR 2.1, a Bayesian meta-regression tool. The Socio-demographic Index (SDI) was used to correlate development status with health outcomes. The GBD's division of the world into 21 regions and 204 countries and territories facilitated a comprehensive assessment. Age-standardized estimated annual percentage changes were generated for urticaria metrics to quantify temporal trends, with age standardization adjusting for potential confounding from age structure. RESULTS From 1990 to 2019, the global age-standardized prevalence, incidence, and DALY rates of urticaria showed marginal changes. In 2019, 65.14 million individuals were affected, with a prevalence rate of 841.88 per 100,000 population. The DALY rate was 50.39 per 100,000 population. Compared to 1990, the global age-standardized prevalence, incidence, and DALY rates saw increases of 2.92, 4.84, and 0.31 per 100,000 population, respectively. Women persistently had higher rates than men. At a regional level in 2019, low-middle SDI regions exhibited the highest age-standardized metrics, whereas high SDI regions reported the lowest. Central Europe showed the highest rates, contrasting with Western Europe's lowest rates. Nationally, urticaria prevalence in 2019 varied dramatically, from a low of 27.1 per 100,000 population in Portugal to a high of 92.0 per 100,000 population in Nepal. India reported the most DALYs at 749,495.9, followed by China, Pakistan, and the United States. Agewise data showed higher rates in younger age groups, which diminished with age and then experienced a slight resurgence in the oldest populations. This pattern was pronounced in women and younger populations, with the largest rises seen in those aged less than 40 years and the smallest in those aged more than 70 years. CONCLUSIONS Urticaria remains a significant global health issue, with considerable variation across regions, countries, and territories. The increased burden among women, the rising burden in younger populations, and the regional differences in disease burden call for tailored interventions and policies to tackle this emerging public health issue.
Collapse
Affiliation(s)
- Xiaoli Liu
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yuan Cao
- Department of Dermatology, Peking University Third Hospital, Beijing, China
| | - Wenhui Wang
- Department of Dermatology, Peking University Third Hospital, Beijing, China
| |
Collapse
|
14
|
Armeni AK, Markantes GΚ, Stathopoulou A, Saltiki K, Zampakis P, Assimakopoulos SF, Michalaki MA. Thyroid Eye Disease as Initial Manifestation of Graves' Disease Following Viral Vector SARS-CoV-2 Vaccine: Report of a Case and Review of the Literature. Vaccines (Basel) 2023; 11:1574. [PMID: 37896977 PMCID: PMC10611184 DOI: 10.3390/vaccines11101574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/30/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
COVID-19, a contagious disease caused by the novel coronavirus SARS-CoV-2, emerged in 2019 and quickly became a pandemic, infecting more than 700 million people worldwide. The disease incidence, morbidity and mortality rates have started to decline since the development of effective vaccines against the virus and the widespread immunization of the population. SARS-CoV-2 vaccines are associated with minor local or systemic adverse reactions, while serious adverse effects are rare. Thyroid-related disorders have been reported after vaccination for COVID-19, and Graves' disease (GD) is the second most common amongst them. Thyroid eye disease (TED), an extrathyroidal manifestation of GD, is rarely observed post-COVID-19 vaccination. All TED cases followed mRNA-based vaccinations, but two new onset mild TED cases post-viral vector vaccine (ChAdox1nCoV-19) have also been reported. We report the case of a 63-year-old woman who presented with new onset hyperthyroidism and moderate-to-severe and active TED 10 days after she received the first dose of a viral vector vaccine against SARS-CoV-2. This is the first case of moderate-to-severe TED after such a vaccine. Our patient was initially treated with intravenous glucocorticoids, and subsequently with intravenous rituximab, due to no response. The disease was rendered inactive after rituximab, but constant diplopia persisted, and the patient was referred for rehabilitative surgery.
Collapse
Affiliation(s)
- Anastasia K. Armeni
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
| | - Georgios Κ. Markantes
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
| | - Alexandra Stathopoulou
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
| | - Katerina Saltiki
- Endocrine Unit, Department of Clinical Therapeutics, National and Kapodistrian University, 11528 Athens, Greece;
| | - Petros Zampakis
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece;
| | - Stelios F. Assimakopoulos
- Division of Infectious Diseases—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece;
| | - Marina A. Michalaki
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
| |
Collapse
|
15
|
Wang Z, Xiao Y, Wang M, Chen Q, Lin Y, Fang X, Wang W. Acupuncture as a therapeutic intervention for post-COVID-19 vaccination urticaria: a systematic review and meta-analysis protocol. BMJ Open 2023; 13:e073914. [PMID: 37802610 PMCID: PMC10565136 DOI: 10.1136/bmjopen-2023-073914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic persisted for over 3 years since its onset in December 2019, posing an ongoing global threat to human health. In the absence of specific antiviral medications for COVID-19, vaccination has emerged as a popular preventive measure adopted by the general public. However, an undesirable consequence of COVID-19 vaccination has been the frequent incidence of urticaria, a type of adverse skin manifestations. Despite the prevalence of this issue, there is currently a lack of clinical evidence exploring the potential utility of acupuncture as a therapeutic approach to managing urticaria arising after COVID-19 vaccination. To address this knowledge gap, this study aims to comprehensively evaluate the effectiveness and safety of acupuncture as a therapeutic intervention for treating urticaria in the general population following COVID-19 vaccination. METHODS AND ANALYSIS The retrieval strategies employed in this study involve obtaining all relevant articles published from December 2019 to October 2023. These articles will be obtained from databases including PubMed, EMBASE, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (SinoMed), VIP database and the WanFang database. Subsequently, the collected articles will undergo a thorough screening process based on predefined inclusion and exclusion criteria. Additionally, study quality will be evaluated using the Cochrane risk bias assessment tool. To conduct the meta-analysis, we will employ the Review Manager software (RevMan V.5.3). Finally, the study findings will be evaluated for their level of evidence. ETHICS AND DISSEMINATION As this is a secondary review of published clinical data, this study does not involve direct contact with human subjects, and therefore, ethical approval and consent are not required. The findings of the study will be disseminated through a peer-reviewed journal, ensuring that the results undergo rigorous evaluation by experts in the field. PROSPERO REGISTRATION NUMBER CRD42022377343.
Collapse
Affiliation(s)
- Zixia Wang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yao Xiao
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Muyao Wang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiqi Chen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yueqi Lin
- The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinyue Fang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenhui Wang
- Department of Preventive Medicine, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| |
Collapse
|
16
|
Gulas E, Bant A, Kruszewski J, Betiuk B, Niedoszytko M, Chciałowski A. The usability of testing skin reaction applying skin prick tests with Comirnaty (Pfizer, USA) vaccine in detecting the risk of developing post-vaccination immediate hypersensitivity response (anaphylaxis) after administration of this vaccine. Postepy Dermatol Alergol 2023; 40:655-660. [PMID: 38028424 PMCID: PMC10646719 DOI: 10.5114/ada.2023.131860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/18/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction COVID-19 vaccines became a relevant element of prevention during COVID-19 pandemic. It is worth highlighting the importance of severe allergic post-vaccination reactions. Aim To evaluate the usability of skin reaction tests using skin prick tests with Comirnaty (Pfizer, USA) vaccine in risk detection of the post-vaccine immediate hypersensitivity reaction (anaphylaxis) after administration of this vaccine [PvIHR(A)]. Material and methods The analysis embraces 102 people, 85 women and 17 men with a history of immediate hypersensitivity (anaphylaxis) [IHR(A)]. Detailed medical history was collected and skin prick tests were made among participants. The positive and negative test results were illustrated in Figure 1. Results As it stands in Table 1, considering all participants of the study, a positive result of the skin prick tests was obtained only in 2 cases, a negative result in 99 and 1 result was questionable. The two positive results were found in participants from a group with a previous PvIHR(A) in their past medical history and they decided not to get vaccinated. The one questionable result was of a person that had PvIHR(A) after administration of the first dose of Comirnaty vaccine (Pfizer, USA). This person decided to get vaccinated again and there was no PvIHR(A) observed. Conclusions COVID-19 vaccination involves a low risk of anaphylaxis. Purposefulness of providing the skin prick tests using the mRNA vaccine is questionable, due to their low sensitivity and low specificity.
Collapse
Affiliation(s)
- Ewelina Gulas
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
| | - Andrzej Bant
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
| | - Jerzy Kruszewski
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
| | - Barbara Betiuk
- Vaccination Clinic of Military Instytute of Medicine, National Research Institute, Warsaw, Poland
| | - Marek Niedoszytko
- Allergology Department, Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Chciałowski
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, National Research Institute, Warsaw, Poland
| |
Collapse
|
17
|
Dev A, Sharma A, Bishnoi A, Parsad D, Kumaran MS. Covid-19 Vaccination and Chronic Urticaria: A Paradigm Study. Indian Dermatol Online J 2023; 14:637-642. [PMID: 37727574 PMCID: PMC10506802 DOI: 10.4103/idoj.idoj_629_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/13/2022] [Accepted: 12/26/2022] [Indexed: 09/21/2023] Open
Abstract
Background Multiple vaccines were introduced during 2020-2021 to combat Covid-19 pandemic, being one of the successful vaccine programmes in the present era. Very few studies are available on status of chronic urticaria (CU) post Covid-19 vaccination. Aim The aim of this study was to study effect of Covid-19 vaccination on our urticaria cohort. Materials and Methods In this retrospective study, case records of CU patients registered in urticaria clinic, who had received any type of Covid-19 vaccine during the interval of March 2021-2022 were retrieved. Patients were classified as 'vaccine induced urticaria' (VIU) when CU developed for first time post-vaccination and 'vaccine exacerbated urticaria' (VEU) when administration of vaccine exacerbated disease activity in previously diagnosed CU. Results Overall, 353 CU patients registered with us during this period, 265 had received atleast one dose of a Covid-19 vaccine, of which 12 reported VEU (ten of whom had received adenovirus vector vaccine), and three patients were diagnosed with VIU (all had received inactivated virus vaccine). Mean vitamin D3 levels were significantly higher in patients who had VEU as compared to those CU patients without exacerbation (p = 0.003). Significant correlation was observed between level of concern regarding adverse effects of vaccination, pre-vaccination, and post-vaccination urticaria activity score (UAS-7), (Pearson correlation coefficient = 0.66, P = 0.007) in both VEU and VIU. Urticaria symptoms were controlled in 75% and 66.6% patients, respectively, of VEU and VIU, after one month of initiating standard antihistamine treatment. Conclusion Hence, we conclude that though Covid-19 vaccines can trigger CU, standard treatment protocols control disease activity in most patients.
Collapse
Affiliation(s)
- Anubha Dev
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Apoorva Sharma
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
18
|
Choi JH, Chung SJ. A Case Series of Chronic Spontaneous Urticaria After COVID-19 Vaccination. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:695-698. [PMID: 37153976 PMCID: PMC10570777 DOI: 10.4168/aair.2023.15.5.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/27/2022] [Accepted: 12/13/2022] [Indexed: 10/14/2023]
Affiliation(s)
- Jeong-Hee Choi
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
- Allergy and Clinical Immunology Research Center, Hallym University College of Medicine, Chuncheon, Korea.
| | - Soo Jie Chung
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
- Allergy and Clinical Immunology Research Center, Hallym University College of Medicine, Chuncheon, Korea
| |
Collapse
|
19
|
Huang LL, Hong WW, Hu WW, Guan XH, Jiang YH. Understanding factors affecting Chinese medical staff's fear of receiving the fourth dose of COVID-19 vaccine: A cross-sectional study in Taizhou. Hum Vaccin Immunother 2023; 19:2261201. [PMID: 37920885 PMCID: PMC10627059 DOI: 10.1080/21645515.2023.2261201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
The study was conducted to assess medical staffs' fear of receiving the fourth dose of the Coronavirus disease 2019 (COVID-19) vaccine. From December 17, 2022, to January 31, 2023, an online survey was conducted to assess the fear among medical staffs regarding the administration of the fourth dose of the COVID-19 vaccine. The participants were exclusively drawn from a tertiary grade hospital in Taizhou. Out of the 1, 832 medical staffs invited to participate in the questionnaire, a total of 613 (33.5%) provided valid responses for subsequent analysis. Among them, 81 (13.8%) expressed fear of receiving the fourth dose of COVID-19. The fear was significantly influenced by these factors: the presence of serious food/drug allergic reactions (OR = 3.84, 95% CI: 1.40-10.52), received booster COVID-19 vaccine (OR = 0.20, 95% CI: 0.11-0.35), opinion on vaccination requirement (OR = 0.20, 95% CI: 0.11-0.35), viewpoint (OR = 0.23, 95% CI: 0.12-0.44) with scores ≥10, and positive attitude toward vaccination (OR = 0.21, 95% CI: 0.13-0.35). Our study revealed that a subset of medical staffs still harbor apprehension toward receiving the fourth dose of the new COVID-19 vaccine. Factors influencing this fear encompass allergic reactions, booster COVID-19 vaccine, as well as opinion, viewpoint, and attitude toward vaccination. Educating medical staffs on these factors may help mitigate their fear.
Collapse
Affiliation(s)
- Li-Li Huang
- Department of Emergency, Taizhou First People’s Hospital, Taizhou, Zhejiang, China
| | - Wei-Wen Hong
- Department of Anus & Intestine Surgery, Taizhou First People’s Hospital, Taizhou, Zhejiang, China
| | - Wei-Wei Hu
- Department of General Surgery, Taizhou First People’s Hospital, Taizhou, Zhejiang, China
| | - Xian-Hua Guan
- Intensive Care Unit, Taizhou First People’s Hospital, Huangyan, Zhejiang, China
| | - Yan-Hong Jiang
- Department of Outpatient, Taizhou First People’s Hospital, Taizhou, Zhejiang, China
| |
Collapse
|
20
|
Grandinetti R, Palazzolo E, Rizzo L, Carbone R, Pisi G, Fainardi V, Esposito S. Impact of SARS-CoV-2 Infection in Children with Asthma and Impact of COVID-19 Vaccination: Current Evidence and Review of the Literature. Microorganisms 2023; 11:1745. [PMID: 37512917 PMCID: PMC10383403 DOI: 10.3390/microorganisms11071745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
The clinical aspects of SARS-CoV-2 infection, as well as the COVID-19 vaccines' safety, efficacy and effectiveness in pediatric patients with asthma, are crucial to adapting clinical management in this fragile population and for prevention strategies. The aim of this narrative review was to evaluate the impact of SARS-CoV-2 infection in children with asthma and the impact of COVID-19 vaccination. Systematic research using the principal medical databases was conducted using specific search query strings from the early spreading of COVID-19 globally until March 2023; further relevant data were drawn from the main national and supranational institutions. No significant differences in SARS-CoV-2 incidence and morbidity were found in asthmatic pediatric patients compared to non-asthmatic ones; however, subjects with uncontrolled asthma were found to be at increased risk of developing a serious disease during SARS-CoV-2 infection. Regarding COVID-19 vaccines, accumulating data support their safety, efficacy and effectiveness on asthmatic children regardless of asthma severity. Further cohort-based studies are needed as the evidence of new epidemic waves caused by new viral variants makes the current knowledge outdated.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy (E.P.); (G.P.); (V.F.)
| |
Collapse
|
21
|
Brice Y, Morgan L, Kirmani M, Kirmani M, Udeh MC. COVID-19 Vaccine Evolution and Beyond. Neurosci Insights 2023; 18:26331055231180543. [PMID: 37351483 PMCID: PMC10280118 DOI: 10.1177/26331055231180543] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
In December 2019, a new severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) was first reported in China. It would quickly spread and emerge as a COVID-19 pandemic. The illness caused by SARS CoV-2 would fall on a clinical spectrum ranging from asymptomatic, mild to severe respiratory symptoms, ARDS, and death. This led to significant morbidity and mortality further impacting at-risk populations with severe complications. Thus, a concerted worldwide effort to meet the challenges of diagnosing, treating, and preventing COVID-19 led to rapid advances in medicine. Some mitigating methods of masking, social distancing, and frequent handwashing, helped to slow the spread of SARS-CoV-2. Effective therapeutics consisting of antivirals and monoclonal antibodies, plus their use for prophylaxis, contributed to the management of COVID-19. The vaccines from various platforms (mRNA, viral vectors, protein base, and inactivated) contributed to decreased incidence, severity, and overall decreased hospitalizations and mortality. This article aims to review the novel mRNA vaccines (Moderna + Pfizer/BioNTech), viral vector (Janssen& Johnson), and protein base (Novavax), their side effects, and their use as boosters.
Collapse
Affiliation(s)
- Yardley Brice
- Yale-Lawrence Memorial Hospital, New London, CT, USA
| | | | - Maaida Kirmani
- Department of Neurosciences and Experimental Therapeutics, Texas A & M University, College Station, TX, USA
| | - Maha Kirmani
- Department of Neurosciences and Experimental Therapeutics, Texas A & M University, College Station, TX, USA
| | - Mercy C Udeh
- Texas A & M University, College Station, TX, USA
| |
Collapse
|
22
|
Meiers J, Dastbaz J, Adam S, Rasheed S, Kirsch SH, Meiser P, Gross P, Müller R, Titz A. Pineapple Lectin AcmJRL Binds SARS-CoV-2 Spike Protein in a Carbohydrate-Dependent Fashion. Chembiochem 2023; 24:e202200463. [PMID: 36420784 PMCID: PMC10107836 DOI: 10.1002/cbic.202200463] [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: 08/10/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
The highly glycosylated spike protein of SARS-CoV-2 is essential for infection and constitutes a prime target for antiviral agents and vaccines. The pineapple-derived jacalin-related lectin AcmJRL is present in the medication bromelain in significant quantities and has previously been described to bind mannosides. Here, we performed a large ligand screening of AcmJRL by glycan array analysis, quantified the interaction with carbohydrates and validated high-mannose glycans as preferred ligands. Because the SARS-CoV-2 spike protein was previously reported to carry a high proportion of high-mannose N-glycans, we tested the binding of AcmJRL to the recombinantly produced extraviral domain of spike protein. We could demonstrate that AcmJRL binds the spike protein with a low-micromolar KD in a carbohydrate-dependent fashion.
Collapse
Affiliation(s)
- Joscha Meiers
- Chemical Biology of Carbohydrates (CBCH)Helmholtz Institute for Pharmaceutical Research Saarland (HIPS)Helmholtz Centre for Infection Research66123SaarbrückenGermany
- Deutsches Zentrum für Infektionsforschung (DZIF)Standort Hannover-Braunschweig38124BraunschweigGermany
- Department of ChemistrySaarland University66123SaarbrückenGermany
| | - Jan Dastbaz
- Deutsches Zentrum für Infektionsforschung (DZIF)Standort Hannover-Braunschweig38124BraunschweigGermany
- Department of PharmacySaarland University66123SaarbrückenGermany
- Microbial Natural Products (MINS)Helmholtz Institute for Pharmaceutical Research Saarland (HIPS)Helmholtz Centre for Infection Research66123SaarbrückenGermany
| | - Sebastian Adam
- Deutsches Zentrum für Infektionsforschung (DZIF)Standort Hannover-Braunschweig38124BraunschweigGermany
- Drug Design and Optimisation (DDOP)Helmholtz Institute for Pharmaceutical Research Saarland (HIPS)Helmholtz Centre for Infection Research66123SaarbrückenGermany
| | - Sari Rasheed
- Deutsches Zentrum für Infektionsforschung (DZIF)Standort Hannover-Braunschweig38124BraunschweigGermany
- Department of PharmacySaarland University66123SaarbrückenGermany
- Microbial Natural Products (MINS)Helmholtz Institute for Pharmaceutical Research Saarland (HIPS)Helmholtz Centre for Infection Research66123SaarbrückenGermany
| | - Susanne H. Kirsch
- Deutsches Zentrum für Infektionsforschung (DZIF)Standort Hannover-Braunschweig38124BraunschweigGermany
- Microbial Natural Products (MINS)Helmholtz Institute for Pharmaceutical Research Saarland (HIPS)Helmholtz Centre for Infection Research66123SaarbrückenGermany
| | - Peter Meiser
- URSAPHARM Arzneimittel GmbH66129SaarbrückenGermany
| | - Peter Gross
- Hochschule KaiserslauternProtein Chemistry Group66953PirmasensGermany
| | - Rolf Müller
- Deutsches Zentrum für Infektionsforschung (DZIF)Standort Hannover-Braunschweig38124BraunschweigGermany
- Department of PharmacySaarland University66123SaarbrückenGermany
- Microbial Natural Products (MINS)Helmholtz Institute for Pharmaceutical Research Saarland (HIPS)Helmholtz Centre for Infection Research66123SaarbrückenGermany
| | - Alexander Titz
- Chemical Biology of Carbohydrates (CBCH)Helmholtz Institute for Pharmaceutical Research Saarland (HIPS)Helmholtz Centre for Infection Research66123SaarbrückenGermany
- Deutsches Zentrum für Infektionsforschung (DZIF)Standort Hannover-Braunschweig38124BraunschweigGermany
- Department of ChemistrySaarland University66123SaarbrückenGermany
| |
Collapse
|
23
|
Klosko RC, Lynch SE, Cabral DL, Nagaraju K, Johnston YA, Steinberg JD, McCall KL. Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022. Vaccines (Basel) 2023; 11:vaccines11020276. [PMID: 36851154 PMCID: PMC9962937 DOI: 10.3390/vaccines11020276] [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] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the Vaccine Adverse Event Reporting System (VAERS) database from 2017 to 2022 and identified cases involving anaphylaxis with an onset within one day of vaccine administration. The primary outcome was the combined prevalence of death or disability for each setting while the secondary outcome was the prevalence of hospitalization. Adjusted (age, sex, prior history of allergy, vaccine type) odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated using logistic regression analysis. A total of 2041 cases of anaphylaxis comprised the primary study cohort with representation in the sample from all 50 US states and the District of Columbia. The mean age was 43.3 ± 17.5 years, and most cases involved women (79.9%). Cases of anaphylaxis were reported after receiving a coronavirus vaccine (85.2%), influenza vaccine (5.9%), tetanus vaccine (2.2%), zoster vaccine (1.6%), measles vaccine (0.7%), and other vaccine (4.5%). Outcomes associated with reports of vaccine anaphylaxis included 35 cases of death and disability and 219 hospitalizations. Compared with all other settings, the aOR of death and disability when anaphylaxis occurred was 1.92 (95% CI, 0.86-4.54) in a medical provider's office, 0.85 (95% CI, 0.26-2.43) in a pharmacy and 1.01 (95% CI, 0.15-3.94) in a public health clinic. Compared with all other settings, the aOR of hospitalization when anaphylaxis occurred was 1.02 (95% CI, 0.71-1.47) in a medical provider's office, 1.06 (95% CI, 0.72-1.54) in a pharmacy, and 1.12 (95% CI, 0.61-1.93) in a public health clinic. An analysis of a national database across six years revealed no significant differences in the odds of death/disability and odds of hospitalization associated with post-vaccination anaphylaxis in the medical office, pharmacy, and public health clinic compared with all other settings. This study expands our understanding of the safety of immunization services and reinforces that all settings must be prepared to respond to such an emergency.
Collapse
Affiliation(s)
- Rachel C. Klosko
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Sarah E. Lynch
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Danielle L. Cabral
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Kanneboyina Nagaraju
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Yvonne A. Johnston
- Master of Public Health Program, Decker College of Nursing and Health Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Joshua D. Steinberg
- United Health Services Family Medicine Residency and Upstate Medical University College of Medicine Clinical Campus, Johnson City, NY 13790, USA
| | - Kenneth L. McCall
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
- Correspondence: ; Tel.: +607-777-5853
| |
Collapse
|
24
|
Zhang Q, Yu Y, He J, Yao X, He Y, Wu J, Xu C, Ye C. Did the COVID-19 pandemic impact urticaria information-seeking behavior in China? A retrospective longitudinal study. Front Public Health 2023; 11:1098066. [PMID: 36741961 PMCID: PMC9894563 DOI: 10.3389/fpubh.2023.1098066] [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] [Received: 11/14/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023] Open
Abstract
Purpose To investigate information-seeking behavior related to urticaria before and during the COVID-19 pandemic in China. Methods Search query data for terms related to urticaria were retrieved using Baidu Index database from October 23, 2017 to April 23, 2022, and daily COVID-19 vaccination doses data were obtained from the website of the Chinese Center for Disease Control and Prevention. Among the 23 eligible urticaria search terms, four urticaria themes were generated as classification, symptom, etiology, and treatment of urticarial, respectively. Baidu Search Index (BSI) value for each term were extracted to analyze and compare the spatial and temporal distribution of online search behavior for urticaria before and after the COVID-19 pandemic, and to also explore the correlation between search query and daily COVID-19 vaccination doses. Results The classification of urticaria accounted for nearly half of the urticaria queries on the internet. Regular seasonal patterns of BSI were observed in urticaria-related online search, by attaining its highest level in spring and summer and lowest level in winter. The BSIs of all urticaria themes significantly increased after the COVID-19 pandemic than that before the pandemic (all P<0.05). Xizang, Qinghai and Ningxia are the most active geographical areas for increased urticaria-searching activities after the COVID-19 pandemic. There was also a significant positive correlation between daily BSIs and daily COVID-19 vaccination doses in each urticaria theme. Cross-correlation analysis found that the search of symptom, etiology, and treatment attained their strongest correlation with daily COVID-19 vaccination doses at 11-27 days before the injection of vaccine, imply vaccination hesitation related to concerns of urticaria. Conclusions This study used the internet as a proxy to provide evidence of public search interest and spatiotemporal characteristics of urticaria, and revealed that the search behavior of urticaria have increased significantly after the COVID-19 pandemic and COVID-19 vaccination. It is anticipated that the findings about such increase in search behavior, as well as the behavior of urticaria-related vaccine-hesitancy, will help guide public health education and policy regulation.
Collapse
Affiliation(s)
- Qinzhun Zhang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yi Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jialu He
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xinmeng Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yinan He
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jinghua Wu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Chenjie Xu
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Chengyin Ye
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China,*Correspondence: Chengyin Ye ✉
| |
Collapse
|
25
|
Haq HN, Khan H, Chaudhry H, Nimmala S, Demidovich J, Papudesi BN, Potluri SD. Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273) COVID-19 mRNA vaccines and hypersensitivity reactions. J Natl Med Assoc 2022; 114:601-612. [PMID: 36511275 PMCID: PMC9613973 DOI: 10.1016/j.jnma.2022.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 06/13/2022] [Accepted: 08/24/2022] [Indexed: 11/05/2022]
Abstract
The SARS-CoV-2 Virus (COVID-19) is responsible for over 239 million cases and 4.8 million deaths globally (Data source WHO COVID-19 Dashboard accessed on October 14, 2021). It continues to surge and ravage countries, leaving healthcare systems in constant struggle and uncertainty. A variety of vaccines were developed to combat the spread of the COVID-19 Virus. Reports of possible allergic reactions with COVID-19 vaccines are a significant cause of public concern, especially among those with a known history of a severe allergic reaction (e.g., anaphylaxis). Here we review articles relevant to COVID-19 vaccines and their excipients (especially PEG (Polyethylene glycol) and hypersensitivity reactions associated with COVID-19 vaccines (including clinical features, pathophysiology, special populations receiving COVID-19 vaccinations, potential diagnostic tests, and preventive measures that can be taken to minimize the risks of hypersensitivity reactions with COVID-19 vaccines).
Collapse
Affiliation(s)
- Hannah N Haq
- Department of Medicine, All Saints University, School of Medicine, Roseau, Dominica.
| | - Hafiz Khan
- Dept. of Internal Medicine, Suburban Community Hospital Norristown PA 19401, United States
| | - Haroon Chaudhry
- Dept. of Internal Medicine, Suburban Community Hospital Norristown PA 19401, United States
| | - Swathi Nimmala
- Dept. of Internal Medicine, Suburban Community Hospital Norristown PA 19401, United States
| | - Joseph Demidovich
- Dept. of Internal Medicine, Suburban Community Hospital Norristown PA 19401, United States
| | | | - Sai Deepika Potluri
- Dept. of Internal Medicine MedStar Union Memorial Hospital 201 E University Pkwy, Baltimore, MD 21218 Unites States
| |
Collapse
|
26
|
Chiewchalermsri C, Hengkrawit K, Srinithiwat P, Kiatsermkachorn W, Luecha O. Risk of Adverse Events of Live-Attenuated COVID-19 Vaccination Among Atopic Patients. J Asthma Allergy 2022; 15:1605-1621. [PMID: 36387834 PMCID: PMC9662003 DOI: 10.2147/jaa.s386611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/28/2022] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Atopic patients have more risk of adverse drug reactions. COVID-19 vaccination is very important in the current situation. We still do not have data about risks of adverse effects from vaccine in atopic patients. The goal of our study was to evaluate atopic risks and adverse effects of live-attenuated Oxford/AstraZeneca COVID-19 vaccination. PATIENTS AND METHODS Data was collected using a prospective descriptive cohort study from participants 18 years old and above who came to the Outpatient Department, Panyananthaphikkhu Chonprathan Medical Center for live-attenuated COVID-19 vaccination between March and December 2021. The sample size was 3016 individuals. The information about adverse reactions at 6, 2, 72 hours and 7.30 and 60 days after each live-attenuated Oxford/AstraZeneca COVID-19 vaccination was collected by telephone. Participants with history of severe allergic reaction to vaccine components were excluded. RESULTS There were 732 atopic patients and 2284 non-atopic patients. Atopic patients included 556 with allergic rhinitis, 83 with asthma, 23 with urticaria and 73 with food allergies. The underlying diseases of hypertension, hyperlipidemia and hyperthyroidism were more common in non-allergic patients, with p-value <0.001, <0.001 and 0.042, respectively. Atopic patients developed significantly more fever, nausea and vomiting, skin rash (urticaria), and local reaction than non-atopic patients, with p-values of <0.001, 0.018, <0.001 and <0.001, respectively. CONCLUSION Atopic patients had more risk of adverse reactions to live-attenuated Oxford/AstraZeneca COVID-19 vaccination. No life-threatening adverse reaction was seen. Physicians should screen atopic risks in people who are getting vaccinated. Atopic patients should be knowledgeable about their risk and how to monitor clinical reactions by themselves.
Collapse
Affiliation(s)
- Chirawat Chiewchalermsri
- Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Kitchawan Hengkrawit
- Department of Pediatrics, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Palakorn Srinithiwat
- Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Wipawee Kiatsermkachorn
- Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Orawin Luecha
- Department of Pediatrics, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| |
Collapse
|
27
|
Puspitarani F, Sitaresmi MN, Ahmad RA. Adverse events following immunization of COVID-19 vaccine among children aged 6-11 years. Front Public Health 2022; 10:999354. [PMID: 36388348 PMCID: PMC9640945 DOI: 10.3389/fpubh.2022.999354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/04/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction Starting in December 2021, the Indonesian Government has recommended inactivated SARS-CoV-2 vaccine (CoronaVac) for children aged 6-11 years. This study aims to determine the prevalence and determinant factors of adverse events following immunization (AEFI) of the first dose and the second dose of the COVID-19 vaccine among children aged 6-11 years old. Materials and methods We conducted a cross-sectional study in Bantul District, Yogyakarta, Indonesia, in February-March 2022. Data were collected by trained interviews with 1,093 parents of children 6-11 years old who received the first dose and the second dose of the COVID-19 vaccine. Data were analyzed with chi-square and logistic regression. Results The prevalence of AEFI in the first dose of the COVID-19 vaccine was 16.7%, while the second dose was 22.6%. The most common symptoms of AEFI at the first dose were local site pain and fever, while at the second dose were cough and cold. Determinants of AEFI of COVID-19 vaccination among children were girls with OR 1.31 (95% CI 1.0-1.7; P 0.04), mass-setting of vaccination with OR 0.70 (95% CI 0.5-0.9; P 0.01), the history of AEFI in childhood vaccination with OR 1.63 (95% CI 1.2-2.2; P < 0.01) and administering other vaccines within 1 month before COVID-19 vaccination, with OR 5.10 (95% CI 2.1-12.3 P < 0.01). Conclusion The prevalence of AEFI in the first and the second dose of inactivated COVID-19 vaccine was comparable to that reported in the clinical trial study and the communities. Risk communication should be provided to the child and their parents regarding the risk of mild AEFI of the COVID-19 vaccine, especially for children with a history of AEFI in childhood vaccination and who received other vaccines containing the same adjuvant with CoronaVac within 1 month. A mass-setting of vaccination should be taken as an advantage to educate parents about the risk of AEFI and also about the reporting pathways.
Collapse
Affiliation(s)
- Fitriana Puspitarani
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
| | - Mei Neni Sitaresmi
- Departement of Child Health, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, DR. Sardjito Hospital, Yogyakarta, Indonesia,*Correspondence: Mei Neni Sitaresmi
| | - Riris Andono Ahmad
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, Indonesia,Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
| |
Collapse
|
28
|
Himed S, Gray A, Awethe Z, Libson K, Kaffenberger BH, Korman AM, Trinidad JCL. SARS-CoV-2 Infection and Vaccination Cutaneous Manifestations for the Inpatient Dermatologist. CURRENT DERMATOLOGY REPORTS 2022; 11:252-262. [PMID: 36274753 PMCID: PMC9579541 DOI: 10.1007/s13671-022-00374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review The overall purpose of this review was to characterize and summarize cutaneous eruptions associated with coronavirus disease 2019 (COVID-19) as well as COVID-19 vaccination. Recent Findings Cutaneous eruptions associated with COVID-19 infection have a reported frequency of 1-20%. Increased COVID-19 disease severity has been associated with morbilliform exanthems, urticaria, retiform purpura, and livedo racemosa. Papulovesicular eruptions were associated with a milder COVID-19 disease course. A range of dermatoses have also been reported with COVID-19 vaccination but have rarely prevented subsequent vaccination. Summary Dermatologists should be aware of the associations between COVID-19 disease severity and cutaneous eruptions. Livedo racemosa and retiform purpura are particularly associated with increased disease severity and death. In the setting of COVID-19 vaccination, cutaneous eruptions can largely be managed symptomatically and very rarely do these reactions prevent subsequent vaccination.
Collapse
Affiliation(s)
- Sonia Himed
- College of Medicine, University of Cincinnati, Cincinnati, OH USA
| | - Ashley Gray
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Zaynah Awethe
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Karissa Libson
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Benjamin H. Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Abraham M. Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - John C. L. Trinidad
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| |
Collapse
|
29
|
Mohseni Afshar Z, Tavakoli Pirzaman A, Liang JJ, Sharma A, Pirzadeh M, Babazadeh A, Hashemi E, Deravi N, Abdi S, Allahgholipour A, Hosseinzadeh R, Vaziri Z, Sio TT, Sullman MJM, Barary M, Ebrahimpour S. Do we miss rare adverse events induced by COVID-19 vaccination? Front Med (Lausanne) 2022; 9:933914. [PMID: 36300183 PMCID: PMC9589063 DOI: 10.3389/fmed.2022.933914] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused many complications, the invention of coronavirus disease 2019 (COVID-19) vaccines has also brought about several adverse events, from common side effects to unexpected and rare ones. Common vaccine-related adverse reactions manifest locally or systematically following any vaccine, including COVID-19 vaccines. Specific side effects, known as adverse events of particular interest (AESI), are unusual and need more evaluation. Here, we discuss some of the most critical rare adverse events of COVID-19 vaccines.
Collapse
Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Jackson J. Liang
- Division of Cardiovascular Medicine, Cardiac Arrhythmia Service, University of Michigan, Ann Arbor, MI, United States
| | - Akanksha Sharma
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, United States
| | - Marzieh Pirzadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Erfan Hashemi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadaf Abdi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Amirreza Allahgholipour
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rezvan Hosseinzadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Vaziri
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Terence T. Sio
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, United States
| | - Mark J. M. Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Mohammad Barary
- Student Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
30
|
Shavit R, Maoz-Segal R, Offengenden I, Yahia SH, Maayan DM, Lifshitz Y, Niznik S, Deutch M, Elbaz E, Genaim H, Iancovici-Kidon M, Agmon-Levin N. Assessment of Immediate Allergic Reactions After Immunization With the Pfizer BNT162b2 Vaccine Using Intradermal Skin Testing With the COVID-19 Vaccines. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2677-2684. [PMID: 35973526 PMCID: PMC9375246 DOI: 10.1016/j.jaip.2022.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/24/2022] [Accepted: 08/02/2022] [Indexed: 12/26/2022]
Abstract
Background Allergic reactions to the coronavirus disease 2019 (COVID-19) vaccines have raised concerns, particularly as repeated doses are required. Skin tests with the vaccines excipient were found to be of low value, whereas the utility of skin tests with the whole vaccine is yet to be determined. Objective To evaluate a panel of skin tests and the outcomes of subsequent doses of immunization among subjects who suffered an immediate allergic reaction to the BioNTech (BNT162b2) COVID-19 vaccine. Methods Between March and December 2021, patients who experienced symptoms consistent with immediate allergic reactions to the BNT162b2 vaccine and were referred to the Sheba Medical Center underwent skin testing with polyethylene glyol (PEG)-containing medicines, Pfizer-BNT162b2, and Oxford–AstraZeneca vaccine (AZD1222). Further immunization was performed accordingly and under medical observation. Results A total of 51 patients underwent skin testing for suspected allergy to the COVID vaccines, of which 38 of 51 (74.5%) were nonreactive, 7 of 51(13.7%) had no skin sensitization but suffered a clinical reaction during skin testing (mainly cough), and 6 of 51 (11.7%) exhibited immediate skin sensitization. Both skin sensitization and cough during testing were related to a higher use of adrenaline following immunization (P = .08 and P = .024, respectively). Further immunization with the BNT162b2 vaccine was recommended unless sensitization or severe reaction to previous immunization was evident. The latter were referred to be tested/receive the alternative AZD1222 vaccine. Ten patients underwent skin testing with AZD1222: 2 of 10 (20%) demonstrated skin sensitization to both vaccines; thus, 8 of 10 were immunized with the AZD1222, of which 2 of 8 (25%) had allergic reactions. Conclusions Immediate allergic reactions to COVID-19 vaccines are rare but can be severe and reoccur. Intradermal testing with the whole vaccine may discriminate sensitized subjects, detect cross-sensitization between vaccines, and enable estimation of patients at higher risk.
Collapse
Affiliation(s)
- Ronen Shavit
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Ramit Maoz-Segal
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Irena Offengenden
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Soad Haj Yahia
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Diti Machnes Maayan
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yulia Lifshitz
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Stanley Niznik
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Michal Deutch
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Eti Elbaz
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Hosney Genaim
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Mona Iancovici-Kidon
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nancy Agmon-Levin
- Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
31
|
Cha B, Kwon KS, Lee HL, Kim CW. Successful mRNA COVID-19 Vaccination and Colonoscopy After Oral Desensitization in a Patient With Polyethylene Glycol Allergy. J Korean Med Sci 2022; 37:e251. [PMID: 35971765 PMCID: PMC9424693 DOI: 10.3346/jkms.2022.37.e251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/10/2022] [Indexed: 12/01/2022] Open
Abstract
Anaphylaxis to polyethylene glycol (PEG) is rare and mainly occurs with the use of laxatives containing PEG. Recently, an increasing number of PEG allergies have been reported, particularly those related to coronavirus disease 2019 (COVID-19) vaccines. mRNA COVID-19 vaccines, such as the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines, contain PEG2000 as an excipient and are contraindicated when allergy to a vaccine component exist. We report a 55-year-old woman's history as a case of successful mRNA COVID-19 vaccination and colonoscopy after oral desensitization to PEG in a patient with PEG allergy who required both COVID-19 vaccination and colon evaluation. Allergy to PEG was diagnosed based on clinical history, skin test results, and basophil histamine release testing. Oral desensitization effectively suppressed histamine release from basophils in response to PEG stimulation, suggesting that oral desensitization using PEG-based laxatives may be an effective treatment option for patients with allergy to the substance.
Collapse
Affiliation(s)
- Boram Cha
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Kye Sook Kwon
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hong Lyeol Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Cheol-Woo Kim
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
| |
Collapse
|
32
|
Moosa AS, Wee YMS, Jaw MH, Tan QF, Tse WLD, Loke CY, Ee GLA, Ng CCD, Aau WK, Koh YLE, Tan NC. A multidisciplinary effort to increase COVID-19 vaccination among the older adults. Front Public Health 2022; 10:904161. [PMID: 35979453 PMCID: PMC9376249 DOI: 10.3389/fpubh.2022.904161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background COVID-19 vaccination significantly reduces the risk of infection and its associated morbidity and mortality. However, poor uptake of the COVID-19 vaccination was reported among the high-risk group of older people amidst emerging variants of concern. This community case study reports an outreach program in Singapore, COVE (COVID-19 Vaccination for the Elderly) initiated by healthcare workers in a cluster of primary care clinics. They assessed the vaccine hesitancy among these older persons, addressed their concerns and facilitated their vaccination appointment during a brief phone conversation. Method Twenty one thousand six hundred and sixty three unvaccinated adults aged ≥60 years were contacted by healthcare worker volunteers over two phases from June to October 2021. In phase I, they contacted adults aged above 70 years over 2 weeks. Adults who were uncontactable in phase I and those aged 60-69 years were sent SMS in phase II. Data were analyzed via descriptive data analysis. Results After phase 1, 65.5% (n = 5,646/8,617) of older adults had received at least one dose of the COVID-19 vaccine. The respondents expressed intention to vaccinate (39%, n = 3,390), requested to seek further information (25%, n = 2,138), reported access barrier (8%, n = 715), or were concerned of the vaccine adverse effects (3%, n = 288). Vaccination was refused by 24% (n = 2,086) of the respondents. Eventually 60.4% (n = 13,082/21,663) of them were vaccinated 3 months after COVE implementation. Conclusion The COVE program increased the COVID-19 vaccination uptake of older adults from 84.6 to 96.3%. A person-centric proactive approach by healthcare workers addressed vaccine hesitancy and optimized vaccination. The outreach scheduling of vaccination appointments is key in promoting vaccination uptake among older adults.
Collapse
Affiliation(s)
- Aminath S. Moosa
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Yi M. S. Wee
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Meng H. Jaw
- SingHealth Polyclinics, Singapore, Singapore
| | | | - Wan L. D. Tse
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | | | - Guan L. A. Ee
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Chee C. D. Ng
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Wai K. Aau
- SingHealth Polyclinics, Singapore, Singapore
| | | | - Ngiap C. Tan
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| |
Collapse
|
33
|
Paul P, Janjua E, AlSubaie M, Ramadorai V, Mushannen B, Vattoth AL, Khan W, Bshesh K, Nauman A, Mohammed I, Bouhali I, Khalid M, Zakaria D. Anaphylaxis and Related Events Post-COVID-19 Vaccination: A Systematic Review. J Clin Pharmacol 2022; 62:1335-1349. [PMID: 35794852 PMCID: PMC9349886 DOI: 10.1002/jcph.2120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19), induced by the SARS CoV-2 virus, is responsible for a global pandemic following widespread transmission and death. Several vaccines have been developed to counter this public health crisis using both novel and conventional methods. Following approval based on promising efficacy and safety data, the AstraZeneca, Janssen, Moderna, Pfizer/BioNTech, and SinoVac vaccines have been administered globally among different populations with various reported side effects. Reports of life-threatening anaphylaxis following administration were of particular concern for both healthcare providers and the public. A systematic literature search using PubMed, Embase, Scopus, Web of Science, Science Direct, MedRxiv, and Lens.org databases identified relevant studies reporting anaphylaxis following vaccine administration. This systematic review includes 41 studies reporting anaphylaxis out of 19908 studies that were retrieved for screening. A total of 7942 cases, including 43 deaths, were reported across 14 countries. Most cases occurred following the administration of the first dose. Importantly, the benefits of vaccination far outweigh the risks of anaphylaxis. Subsequently, as populations continue to get vaccinated, it is important for healthcare providers to be able to recognize individuals at risk of developing anaphylaxis. Furthermore, they must be familiar with both the clinical hallmarks and treatment of anaphylactic reactions to minimize long term sequalae and prevent death in vaccinated individuals. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Pradipta Paul
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Emmad Janjua
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Mai AlSubaie
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Vinutha Ramadorai
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Beshr Mushannen
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | | | - Wafa Khan
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Khalifa Bshesh
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Areej Nauman
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Ibrahim Mohammed
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar.,Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA
| | - Imane Bouhali
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Mohammed Khalid
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Dalia Zakaria
- Weill Cornell Medicine Qatar, Qatar Foundation, Education City, Doha, Qatar
| |
Collapse
|
34
|
Labella M, Céspedes JA, Doña I, Shamji MH, Agache I, Mayorga C, Torres MJ. The value of the basophil activation test in the evaluation of patients reporting allergic reactions to the BNT162b2 mRNA COVID-19 vaccine. Allergy 2022; 77:2067-2079. [PMID: 34689351 PMCID: PMC8653141 DOI: 10.1111/all.15148] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND mRNA-based COVID-19 vaccines have been reported to induce hypersensitivity reactions (HSR) in a small number of individuals. We aimed to evaluate the real-world incidence of the BNT162b2 mRNA COVID-19 vaccine HSR and to determine the value of the basophil activation test (BAT) in the allergological workup of patients reporting these reactions. METHODS We prospectively enrolled patients with a clinical history indicative of HSR to the BNT162b2 mRNA COVID-19 vaccine. The allergological workup included skin testing (STs) and BAT with polyethylene glycol (PEG) and the vaccine. In those with negative allergy assessments, the administration of the second dose of the BNT162b2 mRNA COVID-19 vaccine was offered. RESULTS Seventeen adults were included. Eleven cases (64.7%) tested negative in the allergological workup and tolerated the re-administration of the second dose of the vaccine and considered non-allergic. Six cases (35.3%) were considered allergic and classified into three groups: 2 subjects displayed positive STs and/or BAT to PEG (Group A), two individuals displayed positive BAT to the vaccine (Group B), and in 2 patients with moderate or severe reactions, the culprit was not identified, tested negative to STs and BAT to both PEG and vaccine (Group C). We further evaluated the value of BAT when the results were positive to the vaccine and negative to PEG by performing BAT in controls groups, finding positive BAT results in 50% of controls, all of them recovered from COVID-19 infection. In contrast, BAT was negative in patients who had not suffered from COVID-19 disease. CONCLUSIONS BAT can be used as a potential diagnostic tool for confirming allergy to PEG excipient but not to the vaccine as a positive result in BAT may indicate a past COVID-19 infection instead of an allergy.
Collapse
Affiliation(s)
- Marina Labella
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain,Allergy UnitHospital Regional Universitario de MálagaMálagaSpain
| | - Jose Antonio Céspedes
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain
| | - Inmaculada Doña
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain,Allergy UnitHospital Regional Universitario de MálagaMálagaSpain
| | - Mohamed H. Shamji
- National Heart and Lung InstituteImperial College LondonLondonUK,NIHR Imperial Biomedical Research CentreLondonUK
| | - Ioana Agache
- Faculty of MedicineTransylvania UniversityBrasovRomania
| | - Cristobalina Mayorga
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain
| | - Maria José Torres
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain,Allergy UnitHospital Regional Universitario de MálagaMálagaSpain,Departamento de MedicinaUniversidad de MálagaMalagaSpain
| |
Collapse
|
35
|
Jeong S, Hong YR, Hwang H. Performance comparison between Elecsys Anti-SARS-CoV-2 and Anti-SARS-CoV-2 S and Atellica IM SARS-CoV-2 Total and SARS-CoV-2 IgG assays. KOSIN MEDICAL JOURNAL 2022. [DOI: 10.7180/kmj.22.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Although serological severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests from several manufacturers have been introduced in South Korea and some are commercially available, the performance of these test kits has not yet been sufficiently validated. Therefore, we compared the performance of Elecsys Anti-SARS-CoV-2 (ACOV2) and Anti-SARS-CoV-2 S (ACOV2S) and Atellica IM SARS-CoV-2 Total (COV2T) and SARS-CoV-2 IgG (sCOVG) serological tests in this study.Methods: A total of 186 patient samples were used. For each test, we analyzed the positive rate of serological antibody tests, precision, linearity, and agreement among the four assays.Results: The positive rates of COV2T, sCOVG, and ACOV2S were high (81.7%–89.2%) in total, with those for ACOV2S being the highest, while those of ACOV2 were as low as 44.6%. This may be related to the high completion rate of vaccination in Korea. The repeatability and within-laboratory coefficients of variation were within the claimed allowable imprecision; however, further research is needed to establish an allowable imprecision at low concentrations. COV2T showed a linear fit, whereas sCOVG and ACOV2S were appropriately modeled with a nonlinear fit. Good agreement was found among COV2T, sCOVG, and ACOV2S; however, the agreement between ACOV2 and any one of the other methods was poor.Conclusions: Considering the different antigens used in serological SARS-CoV-2 antibody assays, the performance of the tested assays is thought to show no significant difference for the qualitative detection of antibodies to SARS-CoV-2.
Collapse
|
36
|
Seirafianpour F, Pourriyahi H, Gholizadeh Mesgarha M, Pour Mohammad A, Shaka Z, Goodarzi A. A systematic review on mucocutaneous presentations after COVID-19 vaccination and expert recommendations about vaccination of important immune-mediated dermatologic disorders. Dermatol Ther 2022; 35:e15461. [PMID: 35316551 PMCID: PMC9111423 DOI: 10.1111/dth.15461] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications.
Collapse
Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Homa Pourriyahi
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | | | - Arash Pour Mohammad
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Zoha Shaka
- Faculty of MedicineIran University of Medical SciencesTehranIran
- Systematic Review and Meta‐Analysis Expert Group (SRMEG)Universal Scientific Education and Research NetworkTehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical SciencesTehranIran
| |
Collapse
|
37
|
Novembre E, Tosca M, Caffarelli C, Calvani M, Cardinale F, Castagnoli R, Chiappini E, Cravidi C, Del Giudice MM, Duse M, Licari A, Manti S, Martelli A, Ricci G, Pingitore G, Marseglia GL. Management of BNT162b2 mRNA COVID-19 vaccine in children aged 5-11 years with allergies, asthma, and immunodeficiency: consensus of the Italian Society of Pediatric Allergy and Immunology (SIAIP). Ital J Pediatr 2022; 48:76. [PMID: 35578294 PMCID: PMC9109428 DOI: 10.1186/s13052-022-01272-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/04/2022] [Indexed: 01/31/2023] Open
Abstract
BNT162b2 vaccine, developed by BioNTech and Pfizer ha recently approved for use in children aged 5 to 11 years. Recent data show evidence of safety on the administration and serious adverse events have been rarely reported. However, allergic systemic reactions could occur. In some cases, a correct allergic evaluation allows identifying patients at risk of developing an anaphylactic reaction. Risk assessment of allergic reactions to COVID-19 vaccines is useful to limit contraindications to vaccination and help to safely vaccinate people supposed to be at risk of allergic reactions.
Collapse
Affiliation(s)
- Elio Novembre
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | | | - Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, Parma, Italy.
| | - Mauro Calvani
- Operative Unit of Pediatrics, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Fabio Cardinale
- Pediatric Unit, Azienda Ospedaliero-Universitaria "Policlinico- Giovanni XXIII, Bari, Italy
| | - Riccardo Castagnoli
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Elena Chiappini
- Paediatric Infectious Diseases Unit, Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, Florence, Italy
| | | | - Michele Miraglia Del Giudice
- Department of Woman and Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marzia Duse
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Amelia Licari
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Sara Manti
- Pediatric Respiratory Unit, Department of Clinical and Experimental Medicine, San Marco Hospital, University of Catania, Catania, Italy
| | | | - Giampaolo Ricci
- Alma Mater Studiorum, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Gian Luigi Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
38
|
Homologous COVID-19 BNT162b2 mRNA Vaccination at a German Tertiary Care University Hospital: A Survey-Based Analysis of Reactogenicity, Safety, and Inability to Work among Healthcare Workers. Vaccines (Basel) 2022; 10:vaccines10050650. [PMID: 35632406 PMCID: PMC9147477 DOI: 10.3390/vaccines10050650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 01/14/2023] Open
Abstract
At the start of the SARS-CoV-2 pandemic, healthcare workers had an increased risk of acquiring coronavirus disease (COVID)-19. As tertiary care hospitals are critical for the treatment of severely ill patients, the University Hospital Erlangen offered BNT162b2 mRNA vaccination against COVID-19 to all employees when the vaccine became available in Germany. Here, we performed a survey to assess the age- and sex-dependent reactogenicity and safety of BNT162b2 in a real-life setting with a special emphasis on the rate of vaccine-related incapacity to work amongst the employees. All vaccinated employees were invited to participate in the survey and received access to an electronic questionnaire between 31 March and 14 June 2021, which allowed them to report local and systemic adverse effects after the first or second vaccine dose. A total of 2372 employees completed the survey. After both the first and second dose, women had a higher risk than men for vaccine-related systemic side effects (odds ratio (OR) 1.48 (1.24–1.77) and 1.49 (1.23–1.81), respectively) and for inability to work (OR 1.63 (1.14–2.34) and 1.85 (1.52–2.25), respectively). Compared to employees ≥ 56 years of age, younger vaccinated participants had a higher risk of systemic reactions after the first (OR 1.35 (1.07–1.70)) and second vaccination (OR 2.08 (1.64–2.63)) and were more often unable to work after dose 2 (OR 2.20 (1.67–2.88)). We also recorded four anaphylactic reactions and received two reports of severe adverse effects indicative of vaccine complications. After the first and second vaccination, 7.9% and 34.7% of the survey participants, respectively, were temporarily unable to work, which added up to 1700 days of sick leave in this cohort. These real-life data extend previous results on the reactogenicity and safety of BNT162b2. Loss of working time due to vaccine-related adverse effects was substantial, but was outweighed by the potential benefit of prevented cases of COVID-19.
Collapse
|
39
|
Chen L, Cai X, Zhao T, Han B, Xie M, Cui J, Zhang J, Wang C, Liu B, Lu Q, Cui F. Safety of Global SARS-CoV-2 Vaccines, a Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10040596. [PMID: 35455344 PMCID: PMC9030038 DOI: 10.3390/vaccines10040596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines were developed in only a short amount of time and were widely distributed. We conducted this meta-analysis to understand the safety of SARS-CoV-2 vaccines. (2) Methods: We searched the corresponding literature published from 1 January 2020 to 20 October 2021. Information of adverse events (AEs) of each selected work was collected. The quality and bias of studies was evaluated, and meta-analysis was carried out by using Stata 17.0. (3) Results: Totally, 11,451 articles were retrieved, and 53 of them were included for analysis. The incidence rate of AEs was 20.05–94.48%. The incidence rate of vascular events increased after viral vector vaccination, while the incidence rate of vascular events decreased after mRNA vaccination. Viral vector vaccine had a higher AE rate compared to mRNA vaccines and inactivated vaccines. In most circumstances, the incidence of AEs was higher in older people, female and after the second dose. The sensitivity of meta-analysis was acceptable; however, the literature was subject to a certain publication bias. (4) Conclusions: The safety of SARS-CoV-2 vaccines was acceptable. The incidence of allergic symptoms and cardiovascular and cerebrovascular symptoms was low. Viral vector vaccine had a higher risk of leading to thrombosis events. The understanding of SARS-CoV-2 vaccine AEs should be enhanced, so as to promote the vaccination.
Collapse
Affiliation(s)
- Linyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Xianming Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Bingfeng Han
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Mingzhu Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Jiahao Cui
- Faculty of Medicine, Imperial College London, London SW7 2AZ, UK;
| | - Jiayu Zhang
- Bioinformatics Program, School of Science, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China;
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
- Correspondence: ; Tel./Fax: +86-10-8280-1518
| |
Collapse
|
40
|
Cazzato G, Romita P, Foti C, Lobreglio D, Trilli I, Colagrande A, Ingravallo G, Resta L. Development of Flat Warts on the Cheeks after BioNTech-Pfizer BNT162b2 Vaccine: Is There a Correlation? Vaccines (Basel) 2022; 10:532. [PMID: 35455281 PMCID: PMC9032489 DOI: 10.3390/vaccines10040532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
The SARS-CoV-2 pandemic has affected health systems across the globe, making the use of vaccines more urgent and topical than ever. Since the first months after the introduction of vaccinations, several reactions, both local and systemic, have been reported although they were mostly very mild and only rarely harbingers of more serious complications. We present a case of multiple flat warts onset over the cheeks in a patient after the second dose of mRNA BioNTech-Pfizer BNT162b2 vaccine, and we discuss the possible temporal association between the two events, also considering the patient's antibody status.
Collapse
Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
| | - Paolo Romita
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (P.R.); (C.F.); (D.L.)
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (P.R.); (C.F.); (D.L.)
| | - Debora Lobreglio
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (P.R.); (C.F.); (D.L.)
| | - Irma Trilli
- Odontomastotologic Clinic, University of Chieti “G. d’Annunzio”, 66100 Chieti, Italy;
| | - Anna Colagrande
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
| |
Collapse
|
41
|
Han T, Ma W, Zhang Y, Wang C. Be Alert to the Risk of Adverse Cardiovascular Events after COVID-19 Vaccination. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2022; 7:64-67. [DOI: 10.14218/erhm.2021.00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
42
|
Ben Salem C, Khelif A, Sahnoun D, Ghariani N, Sriha B, Denguezli M. Another case of generalized bullous fixed drug eruption following an adenoviral-vector based Covid-19 vaccine (ChAdOx1 nCov-19). J Eur Acad Dermatol Venereol 2022; 36:e516-e517. [PMID: 35274363 PMCID: PMC9114837 DOI: 10.1111/jdv.18059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/07/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Chaker Ben Salem
- Pharmacovigilance Center of Sousse, University of Sousse, Tunisia
| | | | - Dhouha Sahnoun
- Pharmacovigilance Center of Sousse, University of Sousse, Tunisia
| | | | | | | |
Collapse
|
43
|
Yeo A, Kuek B, Lau M, Tan SR, Chan S. Post COVID-19 vaccine deaths - Singapore's early experience. Forensic Sci Int 2022; 332:111199. [PMID: 35078041 PMCID: PMC8767909 DOI: 10.1016/j.forsciint.2022.111199] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/20/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023]
Abstract
Singapore has been using mRNA vaccines developed by Pfizer-BioNTech and Moderna as part of the nation's COVID vaccination program since 30 December 2020. From 1 February 2021-30 June 2021, a total of 34 deaths that occurred within 72 h of the deceased receiving their COVID-19 vaccination were referred to the Forensic Medicine Division of the Health Sciences Authority of Singapore. Autopsies, histological sampling and ancillary investigations consisting of total tryptase level, Immunoglobulin E (IgE), and C-reactive Protein (CRP), were performed on 29 of these cases. Our study has shown no definite causative relationship between the mRNA vaccination and deaths of individuals who died within 72 h after receiving the vaccination, in particular with regards to anaphylactic reactions, myocarditis and pericarditis, and thrombotic complications. Further studies may consider increasing the incident time frame from 72 h to seven days post-vaccination or longer to include any potential delayed presentation of adverse effects.
Collapse
Affiliation(s)
- Audrey Yeo
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore.
| | - Benjamin Kuek
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| | - Mandy Lau
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| | - Shi Rui Tan
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| | - Shijia Chan
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| |
Collapse
|
44
|
Karattuthodi MS, Chandrasekher D, Panakkal LM, C S, Salman M, E MS, Fasil M, A M M, Reji M. Pharmacist-directed Sputnik V (GAM-COVID-VAC) surveillance program: a prospective observational study in Southern India. J Basic Clin Physiol Pharmacol 2022; 0:jbcpp-2021-0345. [PMID: 35172420 DOI: 10.1515/jbcpp-2021-0345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The study underwent to evaluate the adverse events, the incidence of COVID-19 and the participant's attitude and perception towards the vaccine following Sputnik V administration through an active surveillance program. METHODS The prospective observational study was conducted four months in the Sputnik V vaccination center that enrolled 700 participants. Sociodemographic details, medical histories, COVID-19 incidences and adverse events following immunization (AEFI) of each sample were collected through face-to-face interviews and a telephonic feedback system. A self-prepared and validated questionnaire addressed their acceptances and perceptions towards the vaccination drive. RESULTS Our study reported 42.1% of AEFIs after the first dose and 9.1% after the second. Fever, pain at the injection site, body pain, headache and fatigue were predominant, while dizziness and diarrhoea were rare. However, AEFIs were not influenced by the presence of comorbidities (p > 0.05). On the other hand, there were limited post immunization (1.8%) COVID-19 patients and that too with minor severity (p < 0.01). Our participants were overall satisfied with the Sputnik V immunization. However, those presented with AEFIs on the consecutive three days depicted slightly declined gratification (p < 0.05). CONCLUSIONS Our pharmacist-directed surveillance program on Sputnik V showed fewer events of AEFIs and negligible occurrence of COVID19 following immunization. Moreover, the population had appreciable attitude and positive perceptions towards Sputnik V vaccination.
Collapse
Affiliation(s)
- Mohammed Salim Karattuthodi
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Dilip Chandrasekher
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Linu Mohan Panakkal
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Shinu C
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Mohammed Salman
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Muhammad Swabeeh E
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Mohamed Fasil
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Mohammad A M
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| | - Monika Reji
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kerala University of Health Sciences, Kizhattoor, Kerala, India
| |
Collapse
|
45
|
Pitlick MM, Sitek AN, D'Netto ME, Dages KN, Chiarella SE, Gonzalez-Estrada A, Joshi AY, Park MA. Utility and futility of skin testing to address concerns surrounding messenger RNA coronavirus disease 2019 vaccine reactions. Ann Allergy Asthma Immunol 2022; 128:153-160. [PMID: 34798275 PMCID: PMC8594060 DOI: 10.1016/j.anai.2021.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/27/2021] [Accepted: 11/10/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The mechanism of coronavirus disease 2019 (COVID-19) vaccine hypersensitivity reactions is unknown. COVID-19 vaccine excipient skin testing has been used in evaluation of these reactions, but its utility in predicting subsequent COVID-19 vaccine tolerance is also unknown. OBJECTIVE To evaluate the utility of COVID-19 vaccine and vaccine excipient skin testing in both patients with an allergic reaction to their first messenger RNA COVID-19 vaccine dose and patients with a history of polyethylene glycol allergy who have not yet received a COVID-19 vaccine dose. METHODS In this multicenter, retrospective review, COVID-19 vaccine and vaccine excipient skin testing was performed in patients referred to 1 of 3 large tertiary academic institutions. Patient medical records were reviewed after skin testing to determine subsequent COVID-19 vaccine tolerance. RESULTS A total of 129 patients underwent skin testing, in whom 12 patients (9.3%) had positive results. There were 101 patients who received a COVID-19 vaccine after the skin testing, which was tolerated in 90 patients (89.1%) with no allergic symptoms, including 5 of 6 patients with positive skin testing results who received a COVID-19 vaccine after the skin testing. The remaining 11 patients experienced minor allergic symptoms after COVID-19 vaccination, none of whom required treatment beyond antihistamines. CONCLUSION The low positivity rate of COVID-19 vaccine excipient skin testing and high rate of subsequent COVID-19 vaccine tolerance suggest a low utility of this method in evaluation of COVID-19 vaccine hypersensitivity reactions. Focus should shift to the use of existing vaccine allergy practice parameters, with consideration of graded dosing when necessary. On the basis of these results, strict avoidance of subsequent COVID-19 vaccination should be discouraged.
Collapse
Affiliation(s)
| | - Andrea N Sitek
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota
| | | | - Kelley N Dages
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | - Avni Y Joshi
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota
| | - Miguel A Park
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
46
|
Sobczak M, Pawliczak R. The risk of anaphylaxis behind authorized COVID-19 vaccines: a meta-analysis. Clin Mol Allergy 2022; 20:1. [PMID: 35039051 PMCID: PMC8762434 DOI: 10.1186/s12948-022-00167-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/06/2022] [Indexed: 12/31/2022] Open
Abstract
Background A serious allergic reaction that may occur in response to medical products is anaphylaxis, which potentially can lead to anaphylactic shock. In the light of recent COVID-19 pandemic, much public attention had been paid to the severe allergic reactions occurring after COVID-19 vaccination. Therefore, in our study we would like to investigate the risk of authorized COVID-19 vaccines to induce anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock. Methods We searched databases, such as PubMed, Web of Science and Embase and found eight articles about the incidence of anaphylactic and anaphylactoid reactions. Also, we used data from four databases from Canada, the U.S., the European Union and the United Kingdom. To calculate effect sizes, we used random effects model with inverse variance method. The risk ratio with 95% confidence interval were used for dichotomous outcomes. Statistical analysis was prepared in R. Results were considered statistically significant at p < 0.05. Results The most cases of anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock were reported in female aged 18–85 years after BNT162b2 vaccine according to data from the EU. Analyzed COVID-19 vaccines can cause the anaphylaxis/anaphylactic reaction with risk of 106.99 (95% CI [39.95; 286.57], p < 0.0001, I2 = 59%), whereas the anaphylactoid reaction, anaphylactic and anaphylactoid shocks with risk of 113.3 (95% CI [28.11; 456.53], p < 0.0001), 344.2 (95% CI [85.77; 1381.39], p < 0.0001), 14.9, 95% CI [1.96; 112.79], p = 0.009), respectively. Conclusions Our meta-analysis shows that the risk of anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock do not occur only after mRNA COVID-19 vaccines. Therefore, vaccination centers should be prepared to render assistance in the event of a reaction in all cases.
Collapse
Affiliation(s)
- Marharyta Sobczak
- Department of Immunopathology, Faculty of Medicine, Division of Biomedical Science, Medical University of Lodz, St. Zeligowskiego 7/9, 90-752, Lodz, Poland
| | - Rafał Pawliczak
- Department of Immunopathology, Faculty of Medicine, Division of Biomedical Science, Medical University of Lodz, St. Zeligowskiego 7/9, 90-752, Lodz, Poland.
| |
Collapse
|
47
|
Podder I, Mondal H, Mondal S. Online information-seeking behavior for allergies and its association with COVID-19 vaccine-hesitancy in India: An info-epidemiologic study. Indian J Dermatol 2022; 67:92. [PMID: 35656237 PMCID: PMC9154147 DOI: 10.4103/ijd.ijd_593_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Vaccine-hesitancy is an important obstacle to attain herd-immunity against COVID-19. Undue fears about adverse effects like allergic reactions may be an important reason for vaccine-hesitancy. Objectives: To assess the online information-seeking behavior of Indian internet users regarding 'allergies' and determine its association with COVID-19 vaccine-hesitancy. Methods: We conducted a Google trend analysis to obtain the relative search volume (RSV) for keywords—'skin allergy,' 'drug allergy,' 'food allergy,' 'vaccine allergy,' 'contact dermatitis,' and 'allergy' using a public domain https://trends.google.com/trends. We further obtained state-wise data and statistically analyzed it to assess any association with vaccine-hesitancy. Results: Higher RSV was found for 'vaccine allergy' after the advent of COVID-19 vaccines, showing the steepest peak. 'Skin allergy' showed two peaks. The first peak was after the advent of COVID-19 pandemic and second peak was after introduction of vaccines. RSV of 'contact dermatitis' remained unchanged. Eastern and North-Eastern states showed the highest RSV for 'skin' and 'vaccine' allergies. Literacy rate showed a significant positive correlation with vaccination, whereas vaccine-hesitancy was inversely proportional to RSV for 'allergy. Conclusion: Increased online information-seeking behavior is demonstrated by Indians regarding various 'allergies,' particularly after the advent of COVID-19 vaccines. Literacy was directly proportional to vaccination status, whereas vaccine-hesitancy was inversely proportional to search-volume for 'allergy.'
Collapse
|
48
|
Burlando M, Herzum A, Micalizzi C, Cozzani E, Parodi A. Cutaneous reactions to COVID-19 vaccine at the dermatology primary care. Immun Inflamm Dis 2021; 10:265-271. [PMID: 34837354 PMCID: PMC8767505 DOI: 10.1002/iid3.568] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID‐19) vaccines can cause adverse reactions, mainly from vaccine‐induced immune responses. Some of these may also involve the skin and worry unaware patients. A better understanding of such adverse reactions may reduce concerns and help promote the vaccination of large population groups. Methods All the reports of patients admitted to our Dermatology Primary Care, from March 2021 to June 2021, were retrospectively examined to collect descriptive data on skin reactions arising after COVID‐19 vaccination. Results Out of 200 vaccinated patients admitted to the Dermatology Primary Care, 21 (10.5%) referred cutaneous reactions with onset after vaccination. Only one patient required hospitalization for generalized bullous erythema multiforme, which occurred 48 h after the second vaccine dose. The other patients' cutaneous reactions to vaccination were of mild/moderate degree. Three patients presented exacerbation of their cutaneous diseases. Conclusions Cutaneous reactions observed in our sample were mostly mild or moderate. Awareness must be raised to recognize and treat eventual severe reactions. Future studies are needed to assess the incidence of cutaneous reactions following COVID‐19 vaccination.
Collapse
Affiliation(s)
- Martina Burlando
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Astrid Herzum
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Claudia Micalizzi
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Emanuele Cozzani
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Aurora Parodi
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| |
Collapse
|
49
|
Pourani MR, Shahidi Dadras M, Salari M, Diab R, Namazi N, Abdollahimajd F. Cutaneous adverse events related to COVID-19 vaccines: A cross-sectional questionnaire-based study of 867 patients. Dermatol Ther 2021; 35:e15223. [PMID: 34820975 DOI: 10.1111/dth.15223] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 12/17/2022]
Abstract
Considering the emergency approval of the Food and Drug Administration for widespread use of coronavirus disease 2019 (COVID-19) vaccines, evaluating potential vaccine-related adverse effects is critical as it will allow physicians to diagnose and manage these complications properly. In this descriptive cross-sectional questionnaire-based study, we evaluated the possible side effects of the COVID-19 vaccine from June 1, 2021 to June 21, 2021. The Iranian population is generally vaccinated with AstraZeneca, Sputnik V, Sinopharm, and Bharat vaccines. The continuous and categorical variables were described and data analyzed by the SPSS software version 25. Cutaneous reactions occurred in 30% of individuals vaccinated against COVID-19. The most common cutaneous complications were focal injection site reaction, exanthematous rash, and urticaria. There were infrequent cutaneous adverse events that included vesicular eruption, pernio-like lesions, angioedema, erythema multiforme-like eruption, and zoster. Acquainting physicians with COVID-19 vaccine-related cutaneous complications will assist them in detection and management. In addition, introducing these complications to individuals might improve acceptance of vaccine-related adverse effects in the general population.
Collapse
Affiliation(s)
| | | | - Mehri Salari
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reem Diab
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Namazi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Abdollahimajd
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
50
|
Vu MT, Nguyen AQ, Nguyen BD, Duong HT, Van Nguyen Q, Nguyen HH, Phung LN, Van Nguyen D. Utility of skin testing in assessment of post-AZD1222 vaccine (AstraZeneca) allergic reactions: case series in Vietnam. Asia Pac Allergy 2021; 11:e40. [PMID: 34786370 PMCID: PMC8563096 DOI: 10.5415/apallergy.2021.11.e40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mai Thi Vu
- Respiratory, Allergy and Immunology Unit, Internal Medicine Department, Vinmec Healthcare System, Hanoi, Vietnam
| | - Anh Quynh Nguyen
- Respiratory, Allergy and Immunology Unit, Internal Medicine Department, Vinmec Healthcare System, Hanoi, Vietnam
| | - Bo Duy Nguyen
- Respiratory, Allergy and Immunology Unit, Internal Medicine Department, Vinmec Healthcare System, Hanoi, Vietnam
| | - Huong Thu Duong
- Pharmacy Department, Vinmec Healthcare System, Hanoi, Vietnam
| | - Quyet Van Nguyen
- Health Check Department, Vinmec Healthcare System, Hanoi, Vietnam
| | - Ha Hai Nguyen
- Vaccine Center, Vinmec Healthcare System, Hanoi, Vietnam
| | - Lam Nam Phung
- Intensive Care Unit, Vinmec Healthcare System, Hanoi, Vietnam.,College of Health Sciences, VinUniversity, Hanoi, Vietnam
| | - Dinh Van Nguyen
- Respiratory, Allergy and Immunology Unit, Internal Medicine Department, Vinmec Healthcare System, Hanoi, Vietnam.,College of Health Sciences, VinUniversity, Hanoi, Vietnam
| |
Collapse
|