Search

Background & Aims: Investigating re-infection with COVID-19 is necessary due to the existence of genetic differences among populations after a general vaccination plan. In addition to genetic differences, gender, age, the presence of underlying diseases, and the type of vaccine are factors that affect the rate and severity of re-infection after vaccination. Materials & Methods: Demography, physical activity and nutrition, underlying diseases, the period of involvement with the COVID-19 pandemic, and the percentage of re-infection before and after each stage of vaccination of the medical staff at Imam Khomeini Hospital in Ardabil (Iran) were evaluated. Our study was performed in a descriptive-analytical manner among 149 healthcare workers. The data were collected using a valid and reliable questionnaire and analyzed using SPSS version 26. Results: According to the results, 69.1% of healthcare workers had a positive PCR test or symptoms of COVID-19 before the first injection of the vaccine. The types of injected vaccines included AstraZeneca, Sinopharm, Sputnik V, Bharat, Barekat, Spicogen, and PastoCovac. After the injection of the first dose of the vaccine, the number of severe cases decreased from 30.9% to 10.7%, which indicates the effectiveness of the vaccination. Conclusion: The lowest rate of re-infection was observed in people with good physical activity compared to those who were less active (9.6% versus 59.6%). The highest rate of re-infection with COVID-19 between the first and second doses of the vaccine was related to Sinopharm, Sputnik V, and AstraZeneca. The highest rate of re-infection (82.7%) was in the age group under 40 years old.

Background:Vaccines are critical to reducing the viral attack by permitting the body to generate a safe immune response that defends it by preventing or limiting infection. Objectives: The study aimed to detect the side effects that caused by immunization with Coronavirus (COVID-19) vaccines. Materials and Methods:286 samples were collected from individuals immunized with Corona vaccines (Pfizer, Sinopharm, and AstraZeneca) of different ages, whether they were previously infected with COVID-19 or not. The side effects and pathological complications of immunization have been clinically determined by specialized doctors. Results:Pfizer vaccine was the most used vaccine, yet its typical side effects of first dose include mild fever (28%) and injection site pain (20%). The second dose side effects of Pfizer vaccine were high fever in 200/246 people (81%). Moreover, 7% of the cases did not experience side effects after both doses. The first dose of Sinopharm vaccine side effects were pain in the area of the injection (30%) and mild fever (19%), and 8% of cases suffered from fever and pain in the head and joints, whereas high fever was one of the most prominent signs when taking the second dose by (51%) whereas 27% of them did not show any side effects when taking the two doses. Only three individuals were immunized with AstraZeneca vaccine and suffered from fever, headache, and joint pain after taking the first dose, whereas two of them were suffering from high temperature, and one was suffering from fatigue and joint pain after taking the second dose. Conclusion:The symptoms of COVID-19 vaccines are as the same as other vaccines, but still needs more studies analyzing their side effects to ensure their safety for immunization.

The emergence of COVID-19 in December 2019 spurred a global effort to develop effective medical interventions. Therapeutic monoclonal antibodies (mAbs) have emerged as a promising strategy to combat the SARS-CoV-2 virus. Several mAbs targeting the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein have received Emergency Use Authorization (EUA) for the treatment of mild to moderate COVID-19. Additionally, human mAbs and hyperimmune plasma derived from recovered COVID-19 patients have been explored as potential therapeutic options. This review delves into the potential of mAbs for the diagnosis and treatment of COVID-19 infection. We discuss the mechanisms of action of mAbs, their advantages, and limitations. Furthermore, we explore the ongoing research and development efforts to optimize mAb-based therapies for COVID-19.

In recent years, there has been a notable increase in the presence of techno-scientific issues within public discourse, particularly during the COVID-19 pandemic. This proliferation has been attributed to the pervasive attention economy, which drives actors in hybrid media ecosystems to seek attention-grabbing topics. Socio-technical issues, known to evoke strong emotions like outrage and rivalry, have become recurring themes in both news and social media discussions. However, the regulatory mechanisms of the attention economy often impede the full exploration of these controversies in the public sphere, as news cycles and audience attention accelerate due to the prioritization of engaging content on social media platforms. This trend towards attention-driven content has compelled news organizations to adapt their business models, resulting in an environment where citizens may rely on confirmation bias, ultimately leading to polarization of public opinion. Consequently, effectively addressing controversies in today’s public debate has become increasingly challenging. To understand the extent of influence exerted by junk news – a transient form of content that distracts rather than nourishes public discourse – we conducted a case study focused on the controversy surrounding the adverse and lethal side effects of the AstraZeneca COVID-19 vaccine during the vaccination campaign in Italy. Our analysis, based on a comprehensive dataset of 798,954 tweets and 31,169 news articles spanning a six-month period, reveals three interconnected information disorders. Firstly, the vaccine debate displayed a relatively stagnant progression punctuated by sporadic spikes of attention. Secondly, the peaks of the debate involved sensationalized coverage in journalism and amplified discussions on Twitter, primarily centred around suspected vaccine-related deaths. Lastly, reports of these deaths by legacy media accounts on Twitter correlated with an increasing ideological and partisan reaction from social media users over time, contributing to polarization. These findings shed light on how the junk news regime can impede the shaping of public debates, particularly on contentious socio-technical issues such as vaccination campaigns. The implications of this research extend to the broader understanding of public engagement with science and the challenges posed by attention-driven media ecosystems.

Kejadian Ikutan Pasca Imunisasi (KIPI) merupakan hal yang umum terjadi pada peserta vaksin, KIPI perlu dievaluasi karena vaksinasi Covid-19 merupakan upaya pencegahan infeksi Covid-19 yang masih tergolong baru dan masyarakat masih merasa takut terjadinya kejadiaan ikutan pasca imunisasi. Agar partisipasi masyarakat meningkat sehingga dianggap perlu melakukan evaluasi KIPI baik dosis pertama dan dosis kedua (dosis lengkap). Penelitian ini bertujuan untuk membandingkan gejala KIPI 1 dengan KIPI 2 setelah vaksinasi 2 (dosis lengkap) untuk reaksi lokal dan maupun reaksi sistemik. Jenis penelitian ini adalah retrospektif dan prospektif cross sectional terhadap 113 peserta vaksin astraZeneca di UTA’45 Jakarta vaksin center dan data yang telah memenuhi kriteria inklusi dan eksklusi. Data diambil melalui form KIPI berdasarkan gejala reaksi lokal dan sistemik. Dari 113 peserta, yang berjenis kelamin wanita sebanyak 29 peserta dengan jenis kelamin laki laki sebanyak 84 peserta dan reaksi yang ditimbulkan berbeda – beda seperti nyeri, kemerahan, bengkak pada tempat suntikan, seperti demam, nyeri otot seluruh tubuh, nyeri sendi dan juga badan lemah. Hasil Perbandingan gejala reaksi lokal dan sitemik KIPI 1 dengan KIPI 2, didapat simpulan Jumlah responden pada KIPI 1 yang tidak bergejala mengalami kenaikan dibandingan KIPI 2 tapi pada yang bergejala mengalami penurunan jumlah responden dari KIPI 1 dengan KIPI 2 baik reaksi lokal maupun reaksi sistemik dan secara statistik ada perbedaan bermakna P value < 0.05 pada gejala reaksi lokal dari KIPI 1 dengan KIPI 2 dan reaksi sistemik KIPI 1 dengan KIPI 2.

BackgroundThe aim of the study was to evaluate the humoral and cellular immunity after SARS-CoV-2 infection and/or vaccination according to the type of vaccine, number of doses and combination of vaccines.MethodsVolunteer subjects were sampled between September 2021 and July 2022 in Hospital Clínico San Carlos, Madrid (Spain). Participants had different immunological status against SARS-CoV-2: vaccinated and unvaccinated, with or without previous COVID-19 infection, including healthy and immunocompromised individuals. Determination of IgG against the spike protein S1 subunit receptor-binding domain (RBD) was performed by chemiluminescence microparticle immunoassay (CMIA) using the Architect i10000sr platform (Abbott). The SARS-CoV-2-specific T-cell responses were assessed by quantification of interferon gamma release using QuantiFERON SARS-CoV-2 assay (Qiagen).ResultsA total of 181 samples were collected, 170 were from vaccinated individuals and 11 from unvaccinated. Among the participants, 41 were aware of having previously been infected by SARS-CoV-2. Vaccinated people received one or two doses of the following vaccines against SARS-CoV-2: ChAdOx1-S (University of Oxford—AstraZeneca) (AZ) and/orBNT162b2 (Pfizer—BioNTech)(PZ). Subjects immunized with a third-booster dose received PZ or mRNA-1273 (Moderna—NIAID)(MD) vaccines. All vaccinees developed a positive humoral response (>7.1 BAU/ml), but the cellular response varied depending on the vaccination regimen. Only AZ/PZ combination and 3 doses of vaccination elicited a positive cellular response (median concentration of IFN- γ > 0.3 IU/ml). Regarding a two-dose vaccination regimen, AZ/PZ combination induced the highest humoral and cellular immunity. A booster with mRNA vaccine resulted in increases in median levels of IgG-Spike antibodies and IFN-γ as compared to those of two-dose of any vaccine. Humoral and cellular immunity levels were significantly higher in participants with previous infection compared to those without infection.ConclusionHeterologous vaccination (AZ/PZ) elicited the strongest immunity among the two-dose vaccination regimens. The immunity offered by the third-booster dose of SARS-CoV-2 vaccine depends not only on the type of vaccine administered but also on previous doses and prior infection. Previous exposure to SARS-CoV-2 antigens by infection strongly affect immunity of vaccinated individuals.

The initial phase of the COVID-19 vaccination in Ecuador occurred between April and November 2021. Initially, it focused on priority populations, including health professionals and other front-line workers. During this period, there was limited knowledge about the vaccine's adverse effects. A non-probability, observational study was conducted among university staff in Guayaquil, Ecuador, who received the AstraZeneca vaccine (n = 423) between April and November 2021. This study aimed to compare the acute adverse reactions by doses and to report the incidence of long-term adverse reactions within the AstraZeneca group. As a result, comparing acute adverse reactions between doses, the odds ratio for local pain, headache, muscle pain, fever, and chills are statistically higher after the first dose than the second dose. Survival curves indicated these symptoms appeared mainly within the first 6 h post-vaccination. This is the first pharmacovigilance study from Ecuador that analyzes survival probabilities for the AstraZeneca vaccine's adverse effects.

Aim: This study aimed to assess the prevalence and patterns of COVID-19 vaccine side effects among Syrian adults, with a focus on the AstraZeneca and Sputnik Light vaccines, in light of the low vaccination rate in Syria (below 18%) attributed to fear of side effects. Method: A cross-sectional study was conducted between January and May 2022, using probability-based and convenient sampling strategies. Data was collected through online, paper, and face-to-face questionnaires that included demographic and vaccine-related questions. Result: Out of 3,766 participants, the majority were female (56.7 %) and aged 18–24 years (53.3 %). Most participants had a university-level qualification (71.2 %) and were related to the medical sector (53.2 %). A significant proportion (47.0 %) received AstraZeneca, Sputnik Light (22.1 %) and Sinopharm (14.7 %). Common side effects included sleepiness and lethargy (50.0 %), fever and chills (45.0 %), and pain/swelling at the injection site (35.9 %). Multivariate logistic regression analysis revealed that male (OR: 0.57, CI: 0.48–0.68) and participants aged 45–65 years (OR: 0.53, CI: 0.40–0.70) were less likely to experience side effects. Participants who believed COVID-19 posed a high threat to their personal life had higher odds of side effects (OR: 1.74, CI: 1.22–2.46). Vaccine type was also associated with side effects, with Sputnik Light (OR: 2.52, CI: 1.85–3.46) and AstraZeneca (OR: 1.61, CI: 1.26–2.05) having increased odds. Conclusion: Our study found that COVID-19 vaccines are well tolerated among the Syrian population, with short-term side effects that typically resolve within three days. These findings are expected to bolster vaccination rates through enhanced public confidence and acceptance.

In order to fight the coronavirus disease 2019 (COVID-19) pandemic, the AstraZeneca vaccine was introduced in the Saudi Arabian vaccination campaign. AstraZeneca was rapidly developed, and side effects have been reported following vaccination. This review aims to evaluate the adverse side-effects of the AstraZeneca vaccine within the Saudi population. A literature search of the national and international databases PubMed, Scopus, Google Scholar, Embase databases, and Cochrane Library using the search terms “Covid-19 vaccine”, “AstraZeneca post-vaccination,” and “Covid-19 vaccine Saudi Arabia” in combination with the terms “side effects,” “adverse effects,” and “Covid-19 AstraZeneca” was performed. Articles published before 12 January 2022 were eligible for screening. A total of seven articles met the inclusion criteria, totaling 4838 participants. The most common side effects were fever and either pain or redness at the site of the injection. Furthermore, systemic reactions to AstraZeneca accounted for approximately 80% of adverse effects following vaccination. In sum, AstraZeneca appears to have mild to moderate side effects.

Background: Immunization against severe acute respiratory syndrome coronavirus 2 became necessary to control the menace of COVID-19. However, the safety of COVID-19 vaccines must be monitored continuously. The present study aims at comparing the effectiveness and adverse effects of Pfizer and AstraZeneca vaccines among the cohort of medical students. Methods: It was a single-cohort comparative study, and the data were collected using an online survey from participants who took at least two doses of AstraZeneca or Pfizer vaccines. The data included demography, breakthrough infections, and adverse effects following vaccination. Bivariate and logistic regression models were used to find associations between effectiveness and independent variables. Statistical significance was considered at P < 0.05. Results: In total, 115 students who had received Pfizer or AstraZeneca vaccines were included in the study. The mean age of the participants was 21.52. Female (n = 90) participants were more compared to males (n = 25). The majority of them received Pfizer vaccine (95), while AstraZeneca was received by only 20 participants. Overall effectiveness of both AstraZeneca and Pfizer was nearly 85%, while almost 100% protection was observed among those who were vaccinated after contracting the disease. Logistic regression revealed an independent effect of COVID-19 before any vaccination dose offered 66% protection against any subsequent breakthroughs (odds ratio 0.44, 95% confidence interval [CI]: 0.095–2.08). At least one adverse effect was reported by 96 (83.5%) participants (95% CI: 75.4%–89.75%). Pain at the site of injection, fever, generalized weakness, and headache were the most common adverse effects. Fever (P < 0.001), body ache (P < 0.001), generalized weakness (P = 0.002), and joint pain (P = 0.014) were significantly more common in AstraZeneca as compared to Pfizer. Conclusion: Coronavirus vaccines were well tolerated, safe, and induced protection in most participants. Most postvaccine adverse events were mild to moderate, mainly due to induction of immune response by the body for protection. Furthermore, these mild to moderate adverse effects should not be hindrance to vaccination.

Studies for vaccine development have been completed in an unprecedented time to prevent further outbreak of the dangerous and potentially fatal coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Some of these vaccines have been approved by various authorities and made available worldwide. While vaccine applications continue globally, the number of dermatological side effects reported after vaccination is increasing daily. Many cutaneous reactions have been reported in the literature, such as injection site reactions, pernio lesions, pityriasis rosacea, herpes zoster, and exacerbations of chronic inflammatory dermatoses such as atopic dermatitis and psoriasis. Most COVID-19 vaccines require two doses and a booster dose, and considering the new variants of the coronavirus, vaccination is estimated to continue for a while. In this context, dermatologists are more likely to encounter vaccine-related dermatological side effects in their daily practice. Dermatologists play an essential role in many issues such as diagnosis and treatment of cutaneous reactions after COVID-19 vaccination, informing patients and providing necessary counseling. This perspective will also provide helpful information for the future in terms of vaccination strategies to be developed for repeated doses. In this study, most of the cutaneous reactions reported after COVID-19 vaccination in the current literature are reviewed.

Background: The Coronavirus Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) sparked a global pandemic that resulted in huge health and economic losses. There have been almost two hundred million affirmed cases of COVID-19 to date, with over seven million deaths. Clinical trials on all three vaccines approved for use in the Egypt (Pfizer–Biotech, Oxford–AstraZeneca and Moderna) have demonstrated substantial vaccination efficacy. Numerous research groups had developed possible vaccines as early as December 2020. Despite promises from the World Health Organization and European Medicines Agency (EMA) that there was no evidence tying vaccination to potential adverse events including blood clots, numerous European countries interrupted utilization of the Oxford–AstraZeneca vaccine on March 11, 2021, and noted the adverse effects revealed. We aimed to characterize and analyze the adverse effects associated with the Oxford–AstraZeneca vaccination. Methods: This study was done following vaccination of 113 medical healthcare personnel and documentation of each participant's adverse event at the Research Institute of Ophthalmology between March and June 2021. Results: 45 (39.8%) patients with no vaccine related adverse effects symptoms, 62 (54.9%) patients with mild/moderate symptoms, and 6 patients with severe side effects (5.3%). The most frequently reported adverse effects in mild/moderate symptoms were bony aches 43 (69.3%), fever 32 (51.6%), localized arm pain 7 (11.3%), and GIT symptoms 2 (3.2%). Conclusion: AstraZeneca vaccinations have been associated with mild to moderate adverse events.

Key Clinical Message Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterized by a low platelets count. In this paper, we present a case of ITP relapse in a 31‐year‐old Iranian woman as a potential complication of the AstraZeneca vaccine.

After the emergency approval of different COVID-19 vaccines the administration of millions of doses, many concerns arise for adverse effects, especially in vulnerable groups such as diabetics. In this study, we investigate what effects different COVID vaccines could have on several biomarkers in diabetic patients and whether that raises a concern for this group or not. Materials and methods: this study includes two groups of diabetics each group consists of 20 participants ; One of the groups under study, where they received the COVID-19 vaccine either AstraZeneca or Pifizr-BioNTech vaccine and the other groups were controlled or the Pfizer-BioNTech vaccine, the other group-the control group- did not take any vaccine. Blood samples were taken from both groups about a week after the first dose and statistical studies were conducted on the results. Results: Noticed an increase in all biomarkers. Increase in RBS could simply be due to immune response, same thing could be said for the CRP increase. Ferritin increase was not important; it was only apparent in three patients and that could be due to active infection. The increase in D-dimer levels was apparent in all patients and that raises the biggest concern. Conclusion: the biggest issue was seen in the rising of D-dimer levels because it raises concern about clotting disorders and heart disease which is already a concern for diabetic patients. Further investigation should be done and careful monitoring for clotting risks is necessary after the vaccine.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging disease caused by the coronavirus. The initiation of vaccination significantly reduced the incidence and mortality of these patients. Some studies reported myocarditis as a rare complication after messenger ribonucleic acid (mRNA)-based vaccines (such as Pfizer). CASE REPORT: The patient was a 26-year-old man without any history of the underlying disease with typical chest pain which spread to the back and left arm; he was diagnosed with myocarditis after the second dose of the AstraZeneca vaccine. The mechanism of myocarditis after AstraZeneca is not known precisely. It seems to be due to the AstraZeneca vaccine using adenovirus as a vector of the spike (S) protein of the virus, and it causes the production of antibodies in the body, while adenovirus can be one of the causes of myocarditis. On the other hand, it may be due to spike protein-mediated toxicity, which causes an inflammatory reaction such as myocarditis after the virus protein enters the bloodstream and eventually accumulates in various tissues, including the heart. CONCLUSION: Myocarditis is a rare complication of the AstraZeneca vaccine, and this study could not recommend neglecting this vaccine.

Abstract Background Vaccination is a key intervention to prevent COVID-19. Many vaccines are administered globally, yet there is not much evidence regarding their safety and adverse effects. Iran also faces this challenge, especially as data regarding the Sputnik V vaccine is sparse. Therefore, the aim of this study is to determine the adverse effects of the most commonly used vaccines in Iran. Methods Using a retrospective cohort study design, 6600 subjects aged 18 years or older who had received two doses of any of the three COVID-19 vaccines (Sinopharm, AstraZeneca, and Sputnik V) were selected using a random sampling method between March and August 2021. Subjects were asked about any adverse effects of the vaccines by trained interviewers via telephone interview. Vaccine-related adverse effects in individuals during the first 72 h and subsequently following both doses of the vaccines were determined. The demographic variables, type of administered vaccine, adverse effects, and history of the previous infection with COVID-19 were collected. Descriptive statistics (mean, standard deviation) and analytical statistics (Chi-squared and Wilcoxon tests) were performed at a 95% significance level using STATA software version 15 (STATA Corp, College Station, TX, USA). Results From 6600 participants, 4775 responded (response rate = 72.3%). Of the participants, 1460 (30.6%) received the AstraZeneca vaccine, 1564 (32.8%) received the Sinopharm vaccine and 1751 (36.7%) received the Sputnik V vaccine. 2653 participants (55.56%) reported adverse effects after the first dose and 1704 (35.7%) after the second dose. Sputnik V caused the most adverse effects with 1449 (82.7%) vaccine recipients reporting symptoms after the first or second dose, compared with 1030 (70.5%) for AstraZeneca and only 585 (37.4%) for the Sinopharm vaccine. The most common adverse effects after the first dose were fatigue (28.37%), chill/fever (26.86%), and skeletal pain (22.38%). These three adverse effects were the same for the second dose, although their prevalence was lower. Conclusions In this study, we demonstrate that the Sputnik V vaccine has the highest rate of adverse effects, followed by the AstraZeneca and Sinopharm vaccines. COVID-19 vaccines used in Iran are safe and there were no reports of serious adverse effects.

Acceptance of COVID-19 vaccine among health-care workers (HCWs) is crucial for controlling the pandemic and ensuring HCW and patient safety. Information on the acceptance of different COVID-19 vaccines is lacking. Despite the United Arab Emirates (UAE) having vaccinated most of its population, vaccine acceptance still raises concerns. This study explores COVID-19 vaccine acceptance, vaccine choice, and associated factors among HCWs in the UAE. An online national cross-sectional study was conducted among 517 HCWs. Acceptance and choice of COVID-19 vaccines were assessed, and logistic regression analysis identified predictors for vaccine acceptance. More than half (58%) of HCWs were willing to take the vaccine and give it to their family. Reasons for taking the vaccine were concerns for families contracting COVID-19 (67%) and social responsibility (64%). Reasons for refusals included concerns with side-effects (61%). Most HCWs knew of the Pfizer (79%) and Sinopharm (57%) vaccines; however, acceptance was higher for Pfizer (35%) and AstraZeneca (21%) vaccines. Being male and being influenza vaccinated predicted willingness to take the vaccine (aOR: 2.34; 95% CI:1.34–4.08; p ≤ 0.001) and (aOR: 2.13; 95% CI: 1.29–3.51; p ≤ 0.001), respectively. HCWs who expressed concerns with inadequate safety data were less likely to take the vaccine (aOR: 0.17; 95% CI: 0.10–0.30; p ≤ 0.001). Additionally, side effects, perception of risk, and level of trust of company and country of manufacture predicted acceptance and choice of vaccines. Effective vaccine policy campaigns to improve acceptance should target HCW’s knowledge and awareness of perceived risks of COVID-19, safety data, social responsibility, and individual preferences for vaccine choice.

Background: Due to increased vaccination rates and the continued spread of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, many people are developing “hybrid immunity” to the virus. On the other hand, a high body mass index (BMI) has been associated with a reduced immune response to vaccination.the aims of this study was to measuring the level of immunoglobulin G (IgG) and interferon-gamma (IFN-γ) generated against different types of vaccines in vaccinated individuals with and without previous infection and with BMI. a cross-sectional study was conducted between November 2021 and April 2022. Methods: A blood sample was obtained from 174 vaccinated persons. SARS-CoV-2 IgG levels and IFN-γ were detected using SARS-CoV-2 IgG II quant and ELISAtechniques, respectively. statistical Analysis Used IBM SPSS version 24 software was used. Quantitative results are indicated as mean ± standard deviation. The statistical significance level was set at P < 0.05. Results: There was no statistically significant difference in IgG and IFN-γ mean levels between the vaccinated individual with and without confirmed previous infection. However, there was a significant difference in the case of the AstraZeneca vaccine regarding IgG levels only. The mean antibody concentration of patients with normal weight who received the Pfizer vaccine showed a slightly significant difference. Regarding the IFN-γ level, there was a significant difference among the three types of vaccines in obese individuals. Conclusion: Previous infection with coronavirus disease-2019 seems to have no effect on IgG and IFN-γ levels after vaccination. In addition, normal-weight individuals might possibly respond better to the vaccine and produce more antibody levels.

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccines represent the only way in combating the COVID-19 pandemic. Studying the differences in immune response to different types of vaccines is considered an important tool for optimizing vaccine selection and dosage required. The aim of this study was to evaluate the immunoglobulin G (IgG) concentration following vaccination with Pfizer, AstraZeneca, and Sinopharm vaccines. A cross-sectional study was conducted between November 2021 and April 2022. Methods: A blood sample was obtained from 174 vaccinated persons, IgG levels were detected using the SARS-COV-2 IgG II Quant assay on the ARCHITECT I system. Statistical analysis used IBM SPSS VERSION 24 software. Quantitative results are indicated as mean ± standard deviation. The statistical significance level was set at P < 0.05. Results: Out of 60.3%, 33.9%, and 5.7% had received Pfizer, Sinopharm, and AstraZeneca vaccines, respectively. Ninety participants were men and 84 were women with ages ranging from 18 to 70 years. IgG concentrations were higher in participants vaccinated with Pfizer's vaccine. There were significant differences among the three types of vaccine within age groups. The mean IgG concentration was higher in male participants vaccinated with Pfizer and AstraZeneca. No significant variation was observed between the first and second doses for each type of the three vaccines. The IgG concentration for a vaccination with Pfizer varied significantly among the weeks after vaccination, the maximum concentration was seen between the 6th and 7th weeks. Conclusions: Participants vaccinated with the Pfizer vaccine produce the highest antibody concentration as compared to other vaccines, especially in male participants. Younger participants produce higher amount of antibody response.

Background: Rare cases of acquired thrombotic thrombocytopenic purpura (aTTP) have been reported since the administration of the COVID-19 vaccination. Based on our information, the present study provides the first case report of aTTP developed after the COVID-19 vaccination in Iran. Case presentation: A 22‐year‐old Iranian woman presented with symptoms of ataxia, dysphasia, paresthesia, and acute numbness of her left upper limb four weeks after the AstraZeneca COVID-19 vaccination. Laboratory data suggested hemolytic anemia and thrombocytopenia. Also, schistocytes were noted on her peripheral blood smear. Acquired thrombotic thrombocytopenic purpura (aTTP) was diagnosed in accordance with clinical manifestations along with initial blood test results and was confirmed later through findings of ADAMTS-13 low level activity and the ADAMTS-13 positive inhibitor. She underwent 22 sessions of plasma exchange, receiving corticosteroid and rituximab. Finally, the treatment was successful. Conclusion: Despite the presence of rare complications such as aTTP, vaccination is one of the best ways to prevent COVID-19 disease. The present case report describes the potential, but unproven, role of the AstraZeneca COVID-19 vaccine in aTTP pathogenesis. Vaccine-associated aTTP can be successfully treated with plasma exchange, corticosteroids, and rituximab.

Vaccine-associated thrombotic thrombocytopenic purpura (TTP) is a rare type of acquired TTP recently reported after COVID-19 vaccination. Merely four cases are ascribed to the ChAdOx1 nCoV-19 vaccine in the medical literature till the preparation of this study. In this case report, we describe a 43-year-old man who developed symptoms of TTP four days after receiving the second dose of the ChAdOx1 nCoV-19 vaccine. Peripheral blood smear demonstrated multiple schistocytes. Given a high plasmic score, he received plasma exchange, corticosteroids, and rituximab, and later, low ADAMTS 13 activity and high-titer ADAMTS inhibition antibody confirmed the diagnosis of COVID-19 vaccine-associated TTP. COVID-19 vaccine-associated TTP is an infrequent consequence of SARS-CoV-2 vaccination but with a substantial mortality rate which must be considered as one of the crucial differential diagnoses of post-COVID-19 vaccine thrombocytopenia besides vaccine-induced immune thrombotic thrombocytopenia and Immune thrombocytopenic purpura.

This paper addresses the SARS-CoV-2 vaccination progress in Australia. Globally, Australia was initially praised for its national COVID-19 response, reflecting well with regard to case numbers and mortality rates. However, Australia’s progress with its vaccine rollout has come under scrutiny. When compared globally, it fares very low in terms of the number of vaccine doses administered. This paper discusses the first three months of the vaccination process, and the challenges Australia faced during that time. Through an extensive literature review, data was collected on relevant topics concerning all aspects of the Australian COVID-19 situation. The following key points are discussed: the specific COVID-19 organisation at the federal vs. the state government levels, the Australian economy, the vaccine supply strategy, and the vaccine priority roll out. In conclusion, we highlight the impact of Australia initially relying heavily on the AstraZeneca vaccine, which subsequently came under fire regarding safety issues likely linking the vaccine to thrombosis with thrombocytopenia syndrome (TTS).

Mahmoodullah Azimi,1 Wazhma Masoom Dehzad,1 Mohammad Asif Atiq,1 Barin Bahain,1 Abdullah Asady2 1Department of Clinical Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan; 2Department of Microbiology, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Abdullah AsadyDepartment of Microbiology, Kabul University of Medical Sciences, Kabul, AfghanistanTel +93731087928Email asady_abdullah@yahoo.comPurpose: To evaluate the occurrence, extent, and severity of adverse reactions associated with the vaccine of COVID-19 (ChAdOx1 nCoV-19 vaccine or AstraZeneca) among Kabul University of Medical Sciences staff.Patients and Methods: A retrospective observational, interview-based study was conducted from 4 to 20 April, 2021, to evaluate the adverse reactions associated with the vaccine of COVID-19 (ChAdOx1 nCoV-19 vaccine or AstraZeneca) among the staff and lecturers of the Kabul University of Medical Sciences, Kabul, Afghanistan. Participants were interviewed following the administration of the first dose of the AstraZeneca vaccines. They were asked to report any adverse reactions that occurred within 8– 10 days after vaccination. The frequency, duration, severity, and outcome of the reactions were recorded. Association of the adverse reactions was analysed with the ages of participants and previous infection with SARS CoV-2.Results: The most common adverse reactions reported by the participants were muscle pain (68.3%), local pain (58.8%) at the site of injection (68.3%), fever (66.3%) and fatigue (66.3%). Almost half of the respondents reported chills, joint pain and headache after receiving the first shot of the vaccine. The frequency of adverse reactions was higher in participants aged 40 years or less, and in those previously infected with SARS CoV-2. The severity of most adverse reactions was mild to moderate. No serious case or death was reported.Conclusion: The adverse reactions reported by the participants were mild to moderate in severity, and for a short duration. The findings of this study help us to address the vaccine hesitancy caused by worries about severe adverse effects associated with the COVID-19 vaccine.Keywords: adverse effects, COVID-19, vaccine, ChAdOx1 nCoV-19, AstraZeneca

Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy. In two-thirds of patients, it is preceded by an upper respiratory or gastrointestinal tract infection. Temporally associated cases of GBS following COVID-19 vaccination have been described with different COVID-19 vaccines. In this study, we report three cases of GBS patients following COVID-19 vaccine. Two of the studied patients received the Sinopharm vaccine and one patient received the AstraZeneca vaccine. All patients were diagnosed with acute motor axonal neuropathy (AMAN) type of GBS, on nerve conduction studies. All three patients responded well to treatment with intravenous immunoglobulin (IVIg). The association between COVID-19 vaccination and GBS is not well understood and more studies are needed to establish whether it is merely an association or a causal relationship.

While the use of artificial intelligence (AI) systems promises to bring significant economic and social benefits, it is also coupled with ethical, legal, and technical challenges. Business leaders thus face the question of how to best reap the benefits of automation whilst managing the associated risks. As a first step, many companies have committed themselves to various sets of ethics principles aimed at guiding the design and use of AI systems. So far so good. But how can well-intentioned ethical principles be translated into effective practice? And what challenges await companies that attempt to operationalize AI governance? In this article, we address these questions by drawing on our first-hand experience of shaping and driving the roll-out of AI governance within AstraZeneca, a biopharmaceutical company. The examples we discuss highlight challenges that any organization attempting to operationalize AI governance will have to face. These include questions concerning how to define the material scope of AI governance, how to harmonize standards across decentralized organizations, and how to measure the impact of specific AI governance initiatives. By showcasing how AstraZeneca managed these operational questions, we hope to provide project managers, CIOs, AI practitioners, and data privacy officers responsible for designing and implementing AI governance frameworks within other organizations with generalizable best practices. In essence, companies seeking to operationalize AI governance are encouraged to build on existing policies and governance structures, use pragmatic and action-oriented terminology, focus on risk management in development and procurement, and empower employees through continuous education and change management.

While vaccination against COVID-19 is still ongoing, some rare adverse events temporally related to vaccinations have been reported, particularly with ChAdOx1 nCoV-19. Here, a 77-year-old male presented to our outpatient department with persistent ptosis of his left eye for 1 month. He initially received vaccination with ChAdOx1 nCoV-19 and developed symptoms of Bell's palsy 3 days later. He received a 14-day course of prednisolone, but the ptosis persisted. Marin-Amat syndrome was compatible with his symptoms of ptosis exacerbation during orbicularis oris exertion. A temporal correlation between ChAdOx1 nCoV-19 vaccination and Bell's palsy without infectious or autoimmune diseases was delineated. Further studies are needed to clarify the possible relationship between these two events.

This article presents a case of rapidly progressive glomerulonephritis following the Oxford-AstraZeneca COVID-19 vaccine in a female patient 58 years old. After 5 days, she presented fatigue, paleness, arthralgia on hands, knees, ankles, foamy urine, and elevated blood pressure. Exams showed serum creatinine of 2.2 mg/dL (baseline creatinine of 1.0 mg/dL). Urinalysis revealed hematuria, and her 24-h urinary protein excretion was 4.4 g. Additional exams showed hypercholesterolemia, severe anemia, and normal serum albumin. Testing of antineutrophil cytoplasmic antibodies anti-myeloperoxidase was positive at a titer of 1/80. Serum and urine protein electrophoresis and other exams showed no alterations. She was started on steroid pulse therapy after worsening kidney function, reaching serum creatinine of 3.3 mg/dL. A kidney biopsy revealed crescentic glomerulonephritis with glomerular sclerosis, fibrous crescents, interstitial fibrosis, and tubular atrophy. Induction therapy was given with intravenous cyclophosphamide 0.5 g/m2 for 6-monthly pulses, followed by maintenance therapy with oral azathioprine at 2 mg/kg and prednisone tapering. The patient did not develop any complications during the induction therapy, and is currently on maintenance therapy with a serum creatinine of 1.87 mg/dL.

The long-term immunoglobulin responses of COVID-19 vaccinations is important to determine the efficacy of these vaccinations. This study aimed to investigate and compare the long-term immunoglobulin response of COVID-19 vaccination recipients, using anti-S IgG, anti-N IgG, and IgM titer levels. This study included 267 participants, comprising individuals who tested positive for COVID-19 through PCR testing (n = 125), and those who received the Pfizer (n = 133), Sinopharm (n = 112), AstraZeneca (n = 20), or Sputnik (n = 2) vaccines. Female participants comprised the largest share of this study (n = 147, 55.1%). This study found that most participants had positive IgG antibodies, with 96.3% having anti-S IgG and 75.7% having anti-N IgG. Most participants (90.3%) tested negative for anti-N IgM antibodies. Sinopharm-vaccinated individuals exhibited a notably lower rate of positive anti-S IgG (93.8%) and a significantly higher rate of positive anti-N IgG antibodies (91%). Anti-N IgG levels were significantly correlated with the number of prior COVID-19 infections (p = 0.015). Specifically, individuals with a history of four COVID-19 infections had higher anti-N IgG titers (14.1 ± 1.4) than those with only one experience of COVID-19 infection (9.4 ± 7.2). Individuals who were infected with COVID-19 after receiving the vaccine demonstrated higher levels of anti-N IgG, exhibiting a 25% increase in mean titer levels compared to those who were infected prior to vaccination. There was a statistically significant association between anti-N IgG positivity with age (p = 0.034), and smoking status (p = 0.006) of participants. Participants younger than 20 and older than 60 showed the highest positivity rate of anti-N (>90%). Smokers had a low positivity rate of anti-N (68.8%) compared to nonsmokers (83.6%). In conclusion, this study demonstrated that most COVID-19 vaccination recipients had positive IgG antibodies, with differences in the long-term immunoglobulin response depending on the type of vaccine administered and occurrence of COVID-19 infection.

Introduction: Guillain-Barre Syndrome (GBS) is an autoimmune acute inflammatory demyelinating polyneuropathy usually elicited by an upper respiratory tract infection. Several studies reported GBS associated with Coronavirus Disease 2019 (COVID-19) infection. In this study, we described nine GBS patients following the COVID-19 vaccine. Methods: In this study, nine patients were introduced from six referral centers for neuromuscular disorders in Iran between April 8 and June 20, 2021. Four patients received the Sputnik V, three patients received the Sinopharm, and two cases received the AstraZeneca vaccine. All patients were diagnosed with GBS evidenced by nerve conduction studies and/or cerebrospinal fluid analysis. Results: The median age of the patients was 54.22 years (ranged 26-87 years), and seven patients were male. The patients were treated with Intravenous Immunoglobulin (IVIg) or Plasma Exchange (PLEX). All patients were discharged with some improvements. Conclusion: The link between the COVID-19 vaccine and GBS is not well understood. Given the prevalence of GBS over the population, this association may be coincidental; therefore, more studies are needed to investigate a causal relationship.

Over the past decades, the rapid pace of vaccine development saved 37 million lives, mostly children. The ongoing corona virus disease (COVID-19) pandemic caused the death of more than 4 million worldwide. During 2020, to encounter the pandemic, scientists developed more than 300 vaccines projects against SARS-CoV (severe acute respiratory syndrome coronavirus 2). In 2021, the results emerging from the clinical trials led to the approval and rollout of few vaccines in different countries. To date, at least one dose of a COVID-19 vaccine has been received by more than 3.81 billion people worldwide, equal to about 49.7 percent of the world population. This review was written to the aim of providing a snapshot of COVID-19 disease, highlighting the well-known vaccines, and, finally understanding the effect of mix and match vaccines from different types.

El COVID-19 está asociada a una alta morbimortalidad en los pacientes de la tercera edad y/o con presencia de enfermedades crónicas. Se presenta en la mayoría de los casos con un cuadro clínico correspondiente a una infección respiratoria alta autolimitada; sin embargo, en grupos de riesgo presenta una rápida progresión a una neumonía grave (Abreu y otros, 2020, p.3) Según Ortiz (2022). Esta pandemia desafia la continuidad del desarrollo mundial. Su impacto en Nicaragua es leve, comparado con países de las Américas, a noviembre de 2021 totalizaron 16,877 casos y 209 fallecidos, según la Universidad Johns Hopkins (Johns Hopkins Medicine, 2021). En este articulo por ser de carácter analítico transversal , tiene como Objetivo determinar el factor de protección de las vacunas Astrazeneca y Sputnik V mediante la aplicación estadística Epidemiológica del cálculo de Odds ratio, se exploraron simultáneamente la exposición y la enfermedad entre los individuos de una población especifica de chontales que fueron los habitantes adultos mayores de los municipios de Acoyapa y la Libertad, formada tanto por enfermos y no enfermos lo que implicóuna primera etapa donde se obtiene una muestra aleatoria de la población y que posteriormente los sujetos muestreados son clasificados de acuerdo con la exposición y estado de salud de estos. Se concluye que la asociación es estadísticamente significativa, es decir que por cada persona que no se vacunó y le dio Covid19, hay 0.1 personas mayores de 50 años que se vacunaron y les dio SARS-CoV-2, como el OR es menos de 1 se expresa que el vacunarse es un factor que protege a las personas mayores de 50 años que habitan en estos municipios debido a que el grupo de alto riesgo es significativamente más bajo según el odds ratio de ambos grupos.

Abstract One of the most prevalent neurological impairments is cerebrovascular accident (CVA). Ischemic stroke and CVST have been linked to the AstraZeneca COVID‐19 vaccine. Three Sudanese patients developed these diseases after receiving the AstraZeneca COVID‐19 vaccine, indicating a relationship between the AstraZeneca COVID‐19 vaccine and these conditions.

Abstract The common side effects of COVID‐19 vaccination were mostly self‐restricted local reactions that quickly resolved. Nevertheless, rare autoimmune hepatitis cases have been reported in some vaccinated with mRNA COVID‐19 vaccines. This article presents a young man who developed fulminant hepatitis a few days after vaccination with the first dose of the AstraZeneca COVID‐19 vaccine. A 35‐year‐old man was admitted to our hospital with generalized weakness, abdominal pain, and jaundice. He received the first dose of the AstraZeneca COVID‐19 vaccine 8 days earlier. He was admitted to the hospital with a chief complaint of abdominal pain. On admission and because of his high D‐dimers, low platelet count, and low Fibrinogen level, vaccine‐induced immune thrombosis thrombocytopenia was suspected, which was ruled out later. Then, after a surge in his liver function tests, decreasing platelet, and abnormal clotting tests, fulminant hepatitis was considered for this patient. Several bacterial, viral, and autoimmune etiologies were then suspected, with all ruled out. Thus, fulminant hepatitis secondary to his AstraZeneca COVID‐19 vaccine was confirmed. Unfortunately, he died 3 days later of disseminated intravascular coagulopathy, after which a liver necropsy was performed, indicating drug/toxin‐induced hepatitis.

Berichte über seltene schwere Komplikationen im Zusammenhang mit der Verwendung des „Vaxzevria“-Impfstoffes von AstraZeneca haben zu einer erheblichen Verunsicherung der Impflinge geführt. Dazu schreibt das renommierte „Winton Centre for Risk and Evidence Communication“ der Universität Cambridge (Prof. David Spiegelhalter): „Alle medizinischen Behandlungen haben sowohl potenzielle Schäden als auch potenziellen Nutzen, und es ist wichtig, diese gegeneinander abwägen zu können“. In dem Artikel „Communicating the potential benefits and harms of the Astra-Zeneca Covid-19-vaccine“ (1) berichtet das Winton Centre über den potenziellen Nutzen und Schaden des Covid-19-Impfstoffs von AstraZeneca in Abhängigkeit von Alter und Expositionsrisiko. Demnach überwiegt der potenzielle Nutzen (vermiedene Aufnahme in die Intensivstation) die potenziellen Schäden (Blutgerinnsel) bei weitem. Nur bei Menschen unter 30, die ein geringes Expositionsrisiko haben, bringt das Impfen keinen Vorteil. Dazu meint Prof. Woods, ehemaliger Chef der Britischen Zulassungsbehörde, nach einem Bericht der „Financial Times“ (2), dass es „auf dem Kontinent keine solche evidenzbasierte Analyse“ gäbe und er den Eindruck habe, dass man dort „die Zahlen aus der Luft gegriffen“ habe.

Social media have been the arena of different types of discourse during the COVID-19 pandemic. We aim to characterize public discourse during health crises in different international communities. Using Tweetpy and keywords related to the research, we collected 3,748,302 posts from the English, French, Portuguese, and Spanish Twitter communities related to two crises during the pandemic: (a) the AstraZeneca COVID-19 vaccine, and (b) the Omicron variant. In relation to AstraZeneca, ‘blood clot’ was the main focus of public discourse. Using quantitative classifications and natural language processing algorithms, results are obtained for each language. The English and French discourse focused more on “death”, and the most negative sentiment was generated by the French community. The Portuguese discourse was the only one to make a direct reference to a politician, the former Brazilian President Bolsonaro. In the Omicron crisis, the public discourse mainly focused on infection cases follow-up and the number of deaths, showing a closer public discourse to the actual risk. The public discourse during health crises might lead to different behaviours. While public discourse on AstraZeneca might contribute as a barrier for preventive measures by increasing vaccine hesitancy, the Omicron discourse could lead to more preventive behaviours by the public, such as the use of masks. This paper broadens the scope of crisis communication by revealing social media’s role in the constructs of public discourse.

Summary: Background: The main objective of the present study was to analyze both clinical characteristics and evolution during hospitalization of a cohort of patients admitted for COVID-19 pneumonia who were not vaccinated, or with a complete or incomplete vaccination schedule. Methods: This COVID-19 specialized single-center cohort study of 1888 COVID-19 patients hospitalized at the “Enfermera Isabel Zendal” Emergencies Hospital (HEEIZ), Madrid (Spain) was performed between July 1 and September 30, 2021. It compared the results of 1327 hospitalized unvaccinated patients to 209 hospitalized fully vaccinated and 352 hospitalized partially vaccinated patients. The four different COVID-19 vaccines authorized in Spain during the time-period studied were: BNT162b2 (Pfizer); ChAdOx1 nCoV-19 (AstraZeneca), mRNA-1273 (Moderna); Ad26.COV2.S (Janssen). Findings: Hospitalized patients’ median age was 41 years (IQR 33–50) for the unvaccinated and 61 years (IQR 53–67) for the fully vaccinated ones. The main comorbidities were obesity, hypertension and diabetes mellitus. 20% of unvaccinated patients (266) required noninvasive respiratory care, as did 14% (51) of partially and 14% (30) of fully vaccinated; 6% (78) of the unvaccinated patients also needed invasive respiratory care, as did 5% (16) of partially and 11 (5%) fully vaccinated. Interpretation: Fully vaccinated patients were 84% (95% CI: 82–86%) less likely to be admitted to hospital, and protection rose for those aged

Abstract Although the presence of morphea following COVID‐19 has been rarely reported, the development of its generalized form following COVID‐19 vaccination has not been reported yet. Here, we reported the first case of generalized morphea following COVID‐19 vaccination and another similar case following SARS‐Cov‐2 infection. Other etiologic factors were also dealt with.

A 57-year-old man presented to the outpatient clinic with tremor, palpitations, weight loss and fatigue 1 week after receiving the first dose of the Oxford-AstraZeneca SARS-CoV-2 vaccine (ChAdOx1 nCoV-19). Laboratory studies showed a suppressed TSH with elevated total and free T4. Thyroid peroxidase and thyroglobulin antibodies were elevated but thyrotropin receptor autoantibodies were indeterminate. Thyroid scintigraphy with technetium Tc-99m pertechnetate revealed increased diffuse, symmetric uptake. The patient was treated with thiamazole 15 mg three times a day and propranolol with resolution of his symptoms and normalization of his thyroid function tests until discontinuation of the antithyroid drug 6 months after symptom onset.

Penile Mondor’s disease is a rare condition characterised by superficial thrombophlebitis of the penis which is usually self-limiting. The cause is often unknown. The AstraZeneca ChAdOx1-S vaccine has been found to cause a hypercoagulable state, which is well documented. This case report describes a man who presented with Mondor’s disease following ChAdOx1-S vaccination with no other risk factors.

Mass vaccination has been the main policy to overcome the Covid-19 pandemic. Several vaccines have been approved by the World Health Organization. With growing vaccination, safety concerns and adverse events that need prompt evaluation are also emerging. Herein, we report a case of a healthy woman with longitudinally extensive transverse myelitis after vaccination with the AstraZeneca vaccine. The patient was successfully treated after ruling out all the possible causes.

Autoimmunity following COVID-19 vaccination has been reported. Herein, a 79-year-old man with clinical and immunological features of autoimmune hepatitis type 1 after ChAdOx1 nCoV-19 vaccination is presented. Clinical manifestations rapidly remitted after the instauration of immunomodulatory management. This case, together with a comprehensive review of the literature, illustrates the association between COVID-19 vaccines and the development of autoimmune conditions.

BackgroundThe relationships of the coronavirus disease 2019 (COVID-19) vaccination with reactogenicity and the humoral immune response are important to study. The current study aimed to assess the reactogenicity and immunogenicity of the Pfizer and AstraZeneca COVID-19 vaccines among adults in Madinah, Saudi Arabia.MethodsA cross-sectional study, including 365 randomly selected adult Pfizer or AstraZeneca vaccine recipients who received a homologous prime-boost vaccination between February 1st and June 30th, 2021. Data of height and weight were collected to assess the weight status of percipients. An evaluation of seropositivity for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies was assessed using enzyme-linked immunosorbent assay (ELISA).ResultsAmong the participants, 69% (n = 250) reported at least one vaccine-related symptom. Pain at the injection site was the most frequently reported vaccine-related symptom. The mean total score for vaccine-related symptoms was significantly higher among participants who received the AstraZeneca vaccine, women, and participants with no previous COVID-19 infection (p < 0.05). Spike-specific IgG antibodies were detected in 98.9% of participants after the receipt of two vaccine doses, including 99.5% of Pfizer vaccine recipients and 98.3% of AstraZeneca vaccine recipients. Significantly, higher proportions of participants in the

We describe the case of a 64 years-old woman admitted to the Emergency Department of the ASST-Spedali Civili of Brescia with fever and gastrointestinal symptoms 10 days after the first dose of ChAdOx1 nCov-19 vaccine. Laboratory investigations showed severe thrombocytopenia and high D-dimer, while an abdominal CT scan reported a partially occluding thrombosis of the superior mesenteric artery. Following treatment with fondaparinux, immunoglobulins and high dosage steroid therapy, we observed a rapid improvement of patient’s conditions. An ELISA assay showed the presence of antibodies against heparin PF4-complex. Subsequent abdominal CT-scan showed the superior mesenteric artery thrombosis resolution, and the patient was finally discharged after 12 days of hospitalization. Several reports pointed to the venous system as the main district affected by Vaccine-Induced Thrombotic Thrombocytopenia (VITT), while a peculiar feature of this report is the involvement of the mesenteric arterial system. Further investigation of VITT’s pathophysiological mechanisms is mandatory to develop preventive strategies and effective treatments.

Various vaccines against COVID-19 have been developed since SARS-CoV-2 emerged at the end of 2019. Their emergency administration in healthcare settings has been accompanied by numerous adverse effects. A case of Guillain-Barré syndrome following vaccination with Covishield is presented here to highlight this possible adverse condition.

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

(1) Background: Vaccination may be a key intervention to prevent infection in chronic hemodialysis (CHD) patients. This study aimed to determine the COVID-19 vaccination status in Egyptian CHD patients and to analyze the safety and detailed side effect profile of the COVID-19 vaccine among these patients. (2) Methods: This survey-based study was conducted on 670 end-stage renal disease (ESRD) patients on CHD from 3 December 2021 to 5 February 2022. Subjects were asked about sociodemographic characteristics, clinical and therapeutic data, in addition to their COVID-19 vaccination status. If the subject had been vaccinated, we inquired about the type of vaccine and the side effects that occurred within a few days after administration of the first and second dose of the COVID-19 vaccine. Additionally, subjects were asked about the onset of side effects (days from vaccination), timing of maximum symptoms, intensity of symptoms and their effect on activity and need for medical attention. (3) Results: The study included 670 CHD patients with a mean age of 50.79 years; 58.1% were females. The vast majority (614; 91.6%) of the studied patients received two doses of the vaccine. Side effects were more commonly reported after the first dose than the second dose. The main side effects reported were generalized weakness/fatigue (56%), headache (43.8%) and fever (40.4%), and sore arm/pain was also reported (29.3%). Adverse events mostly occurred within one day after vaccination and the maximum symptoms usually happened on the second day. The median duration of symptoms was 3 days with a maximum duration up to 5 days. The univariate logistic regression analysis showed that male gender (OR 1.848; (95% CI, 1.242–2.749), p = 0.002), age (OR 0.981; (95% CI, 0.969–0.993), p = 0.003), smoking (OR 6.067; (95% CI, 3.514–10.475), p < 0.001), duration since starting HD (OR 0.998; (95% CI, 0.998–0.999), p < 0.001), associated comorbidities (OR 2.202; (95% CI, 1.478–3.281), p < 0.001) and prior COVID-19 infection (OR 3.318; (95% CI, 1.952–5.642), p < 0.001) were the main determinants of adverse events related to COVID-19 vaccination. (4) Conclusions: our preliminary findings support the favorable short-term safety profile of the COVID-19 vaccine among CHD patients, and hence can reassure both clinicians and patients, as well as further promote COVID-19 vaccine administration among these patients.

The definition of criteria and processes for the submission of price and reimbursement requests (P&R) of a drug in Italy cannot be separated from the definition of an overall “Pharmaceutical Policy” that includes, in an organic vision: (i) the governance related to the research, marketing and monitoring of drugs in the Italian market; (ii) the availability of drugs on the national territory as an element included in the essential levels of care (LEA) and the related conditions in terms of timing and equity of access between different regions, as well as towards other European countries; (iii) the assessment criteria used. The decree published in the Italian Official Journal in the summer of 2020, which defines the new criteria for the regulation of P&R of medicines in Italy, focuses on the final part of the process, i.e. the price negotiation. It would be necessary to frame this last step within a broader and more organic structure of drug policies aimed at: 1. optimising healthcare funding by encouraging competition between healthcare technologies; 2. reducing assessment time by simplifying processes; 3. improving early access to drugs for unmet need; 4. increasing the quality of P&R dossiers by improving interaction with the companies; 5. encouraging innovative agreements and complementary elements to the price; 6. encouraging the reproducibility of assessment methodologies in a value-based pricing system; 7. considering cost-benefit analyses as tools for the definition of price and conditions of reimbursability; 8. creating a place for discussion on drug policies.

Introducción: la vacunación contra SARS-CoV-2 es una herramienta imprescindible en el combate contra la pandemia de COVID-19. La vacuna desarrollada en colaboración entre la Universidad de Oxford y el laboratorio de productos farmacéuticos AstraZeneca (AZN) ha demostrado buena eficacia, pero ha habido reporte de trombosis venosas. Caso clínico: se presenta el caso de un paciente de 70 años, de sexo masculino, que 7 días después de la administración de la primera dosis de la vacuna AZN desarrolla trombosis venosa profunda de ambos miembros inferiores y tromboembolismo pulmonar. Coincide con trombocitopenia de 15.000/mm3, descenso del fibrinógeno y elevación de los D-dímeros. La situación clínica evoca el planteo de trombocitopenia trombótica inducida por vacuna (VITT). Se realizó tratamiento con inmunoglobulinas intravenosas, metilprednisolona y crioprecipitados. Requirió colocación de un filtro de la vena cava inferior. Una vez mejorado el recuento plaquetario se instaló tratamiento anticoagulante con apixaban. Evolucionó favorablemente. Discusión: se trata del primer reporte nacional de VITT. Las trombosis subsiguientes a la vacuna de AZN pueden verse con las vacunas que comparten la misma plataforma vacunal (adenovirus inactivado). Se han reportado casos fundamentalmente en menores de 60 años y en topografías inhabituales. Este caso tiene la particularidad de que se trata de un paciente mayor de 60 años, que ya había tenido COVID-19 cinco meses antes y que se presenta con una trombosis en sitios habituales. El manejo terapéutico se adecuó a las pautas internacionales. El caso deja un aprendizaje relevante tanto en lo que refiere al diagnóstico precoz como al manejo terapéutico.

The ChAdOx1 nCoV-19 vector vaccine (Vaxzevria, AstraZeneca, Cambridge, UK) was developed at Oxford University and is considered safe for the administration in lactating mothers. Nevertheless, as a novel vaccine, there are gaps in the knowledge regarding possible adverse events in breastfeeding infants of vaccinated mothers. This case report provides first-time data on a possible delayed, cutaneous, adverse reaction in a breastfed, 16-month-old female infant after the first administration of the AstraZeneca vaccine to her 33-year-old mother. Even though, no clinical adverse effects were observed in the mother, her daughter had a 2-day rash in the lower extremities and face. The infant’s cutaneous rashes might be a coincidental event. However, all skin lesions were analogous to previous descriptions and photographs of dermatologic reactions, which resolved spontaneously with no medical intervention, in people who had been vaccinated with other COVID-19 vaccines. Our aim is that this short report contributes to the enhancement of parental awareness about the possibility of similar skin rashes in breastfed children when the mothers receive a vaccination and the importance of reporting those adverse reactions to the competent authorities.