Cardiovascular, neurological, and pulmonary events following vaccination with the BNT162b2, ChAdOx1 nCoV-19, and Ad26.COV2.S vaccines: An analysis of European data

Cari, Luigi; Alhosseini, Mahdieh Naghavi; Fiore, Paolo; Pierno, Sabata; Pacor, Sabrina; Bergamo, Alberta; Sava, Gianni; Nocentini, Giuseppe

doi:10.1016/j.jaut.2021.102742

Cited by 49 publications

(62 citation statements)

References 41 publications

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“…This study demonstrated that AEs in thrombosis, heart, hematology, and nervous system were high in older people, and supported previous studies [11]. These results suggested that the elderly may need close monitoring of AEs after vaccination.…”

Section: Discussionsupporting

confidence: 91%

The Safety of mRNA-1273, BNT162b2 and JNJ-78436735 COVID-19 Vaccines: Safety Monitoring for Adverse Events Using Real-World Data

Lee

Shim

et al. 2022

Vaccines

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Two mRNA COVID-19 vaccines (mRNA-1273, Moderna; and BNT162b2, Pfizer-BioNTech) and one viral vector vaccine (JNJ-78436735, Janssen/Johnson and Johnson) are authorized in the US to hinder COVID-19 infections. We analyzed severe and common adverse events in response to COVID-19 vaccines using real-world, Vaccine Adverse Effect Reporting System (VAERS) data. From 14 December 2020 to 30 September 2021, 481,172 (50.7 ± 17.5 years, males 27.89%, 12.35 per 100,000 people) individuals reported adverse events (AEs). The median time to severe AEs was 2 days after injection. The risk of severe AEs following the one viral vector vaccine (OR = 1.044, 95% CI = 1.005–1.086) was significantly higher than that after the two mRNA vaccines, and the risk among males (OR = 1.374, 95% CI = 1.342–1.406) was higher than among females, except for anaphylaxis. For common AEs, however, the risk to males (OR = 0.621, 95% CI = 0.612–0.63) was lower than to females. In conclusion, we provided medical insight and clinical guidance about vaccine types by characterizing AEs using real-world data. In particular, COVID-19 mRNA vaccines are safer than viral vector vaccines with regard to coagulation disorders, whereas inflammation-related AEs are lower in the viral vaccine. The risk–benefit ratio of vaccines should be carefully considered, and close monitoring and management of severe AEs is needed.

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Section: Discussionsupporting

confidence: 91%

The Safety of mRNA-1273, BNT162b2 and JNJ-78436735 COVID-19 Vaccines: Safety Monitoring for Adverse Events Using Real-World Data

Lee

Shim

et al. 2022

Vaccines

View full text Add to dashboard Cite

show abstract

“…Thrombocytopenic thrombosis occurred with all four vaccines; however, the incidence was lower in those receiving BNT162b2 than in those receiving AZD1222 (Table 6). Acute cardiac injury such as myocarditis were also less in those receiving BNT162b2 than AZD1222 (Cari et al, 2021a).…”

Section: Discussionmentioning

confidence: 93%

“…Adverse reactions following COVID-19 vaccines are primarily mild and short-lasting, including headache, muscle pain, chills, diarrhea, and pain at the inoculation site. However, serious complications such as neurological events (Cari et al, 2021a) (Goss et al, 2021), myocarditis (Das et al, 2021), anaphylaxis (Shimabukuro et al, 2021), vesicolousbullous skin (Coto-Segura et al, 2021), acute kidney injury (Lebedev et al, 2021), intravascular thrombosis, and thrombocytopenia (Lebedev et al, 2021) (Cari et al, 2021b) (Pottegård et al, 2021) may rarely occur. Most mild adverse reactions can be managed through rest, intake of non-alcoholic liquids, and acetaminophen (Prevention).…”

Section: Introductionmentioning

confidence: 99%

Adverse events following COVID-19 vaccination in South Korea between February 28 and August 21, 2021: A nationwide observational study

Lee

Kim

Lee

et al. 2022

International Journal of Infectious Diseases

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“…Even though patients with VITT had similar mortality after two vaccine doses, the VITT occurrence rate was higher in the ChAdOx1-S vaccine ( 7 , 8 ). Greinacher et al reported that people receiving ChAdOx1-S had one or more thrombotic complications beginning 5 to 16 days after vaccination ( 9 ).…”

Section: Introductionmentioning

confidence: 84%

Potential Anionic Substances Binding to Platelet Factor 4 in Vaccine-Induced Thrombotic Thrombocytopenia of ChAdOx1-S Vaccine for SARS-CoV-2

Pang

Liu²,

et al. 2022

Front. Immunol.

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Recent reports of rare ChAdOx1-S vaccine-related venous thrombosis led to the suspension of its usage in several countries. Vaccine-induced thrombotic thrombocytopenia (VITT) is characterized by thrombocytopenia and thrombosis in association with anti-platelet factor 4 (PF4) antibodies. Herein, we propose five potential anionic substances of the ChAdOx1-S vaccine that can combine with PF4 and trigger VITT, including (1) the proteins on the surface of adenovirus, e.g., negative charged glycoprotein, (2) the adjuvant components of the vaccine, e.g., Tween 80, (3) the DNA of adenovirus, (4) the S protein antigen expressed by the vaccine, and (5) the negatively charged impurity proteins expressed by the vaccine, e.g., adenovirus skeleton proteins. After analysis of each case, we consider the most possible trigger to be the negatively charged impurity proteins expressed by the vaccine. Then, we display the possible extravascular route and intravascular route of the formation of PF4 autoantibodies triggered by the negatively charged impurity proteins, which is accordant with the clinical situation. Accordingly, the susceptible individuals of VITT after ChAdOx1-S vaccination may be people who express negatively charged impurity proteins and reach a certain high titer.

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Cardiovascular, neurological, and pulmonary events following vaccination with the BNT162b2, ChAdOx1 nCoV-19, and Ad26.COV2.S vaccines: An analysis of European data

Cited by 49 publications

References 41 publications

The Safety of mRNA-1273, BNT162b2 and JNJ-78436735 COVID-19 Vaccines: Safety Monitoring for Adverse Events Using Real-World Data

The Safety of mRNA-1273, BNT162b2 and JNJ-78436735 COVID-19 Vaccines: Safety Monitoring for Adverse Events Using Real-World Data

Adverse events following COVID-19 vaccination in South Korea between February 28 and August 21, 2021: A nationwide observational study

Potential Anionic Substances Binding to Platelet Factor 4 in Vaccine-Induced Thrombotic Thrombocytopenia of ChAdOx1-S Vaccine for SARS-CoV-2

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