Hypersensitivity Reactions to Vaccines: Current Evidence and Standards for SARS-CoV-2 Vaccines

Carvalho, Joana; Cunha, Francisca; Coutinho, Iolanda Alen; Loureiro, Carlos; Faria, Emília; Todo-Bom, Ana

doi:10.20344/amp.16096

Cited by 11 publications

(7 citation statements)

References 33 publications

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“… 20–23 The mRNA expressing the SARS-CoV-2 spike protein and PEG as immunogenic agents can be themselves triggers to HS-like reactions. 21 , 24 An exaggerated reactogenicity may give rise to a cascade of immunological events, eventually leading to the aberrant activation of the immune system, resulting in activation of proinflammatory cascades and immunologic pathways that may play a role in the development of AKI as part of a systemic reaction. 20 , 21 , 24 …”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine

Mira¹,

Carvalho²,

Almeida³

et al. 2021

IJNRD

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Background The development of vaccines to prevent COVID-19 breakouts came with highly positive results but some unexpected side effects. Rare side effects have been seen with the BNT162b2 SARS-CoV 2 vaccine. Case Presentation We present the case of a 45-year-old female patient who developed an acute kidney injury needing urgent hemodialysis one week after the second administration of the BNT162b2 SARS-CoV 2 vaccine. She developed a macular rash on her lower limbs and palms as well. A kidney biopsy was performed 10 days after vaccine inoculation, diagnosing acute interstitial nephritis and acute tubular necrosis with cellular casts. The patient was treated with three corticosteroid pulses followed by daily prednisolone. We witnessed clinical improvement 4 days after the initial corticosteroid treatment with progressive recovery of kidney function and hemodialysis withdrawal. After 2 weeks, the patient had recovered her kidney function. Immunophenotyping was performed, diagnosing a hypersensitivity to the vaccine and the polyethylene glycol excipient. Conclusion Patients may develop acute reactions to vaccines. In this case, symptoms seem to correlate significantly with its inoculation and, although this case had a favourable outcome, these side effects must be made aware for clinicians and patients.

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Section: Discussionmentioning

confidence: 99%

A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine

Mira¹,

Carvalho²,

Almeida³

et al. 2021

IJNRD

Self Cite

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“…5 Components in the SARS-CoV-2 vaccines, such as polyethylene glycol, are also known to be immunogenic and can trigger hypersensitivity like reaction. 17 Consequently, in our three patients given the proximity of the SARS-CoV-2 vaccination to the onset of AKI, it is plausible that the immune mediated AKI was precipitated due to ramping up of the immune system in presence of ICPi and recent vaccination.…”

Section: Discussionmentioning

confidence: 86%

Acute kidney injury (AKI) post-mRNA SARS-CoV-2 vaccine in patients with cancer, treated with immune check point inhibitor (ICPi): An immune double whammy!

Baker

Gosalia

Jhaveri

et al. 2022

Journal of Onco-Nephrology

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Background: Immune check point inhibitors (ICPi) have become the first line treatment for most of the cancers and have shown promising results. However, they can provoke reactions, the most feared being immune related adverse events (irAE). Case presentation: We present a series of three cases, of patients recieving ICPi. All three patients developed AKI after administration of SARS-CoV-2 mRNA vaccine. Two patients had kidney-biopsy-proven acute interstitial nephritis (AIN) which responded to ICPi discontinuation and treatment with steroids. One had presumed AIN based on the high levels of CRP and urine retinol binding protein to creatinine ratio and responded to cessation of ICPi alone. Conclusion: These three cases demonstrate that a strong immune response from the SARS-CoV-2 mRNA vaccine combined with an uninhibited immune system under influence of ICPi led to an amplification of autoimmunity leading to AKI presenting as AIN.

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“…Levam-se anos para o desenvolvimento de vacinas, pois necessitam de vários estágios de estudos e testes. Mas a necessidade urgente de um imunizante eficaz para evitar a propagação da SARS-CoV-2, motivou seu desenvolvimento em tempo recorde (Carvalho, 2021). Em concordância com a Sociedade Brasileira de Imunização (SBIM) as vacinas aprovadas no Brasil descrevem uma segurança análoga às aplicadas há anos.…”

Section: Resultsunclassified

Perfil dos exames laboratoriais dos pacientes internados em uma Unidade de Terapia Intensiva (UTI) com formas graves da COVID-19

Café

Moura²,

Pierote³

et al. 2022

RSD

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O SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus) é o agente etiológico responsável pelo desenvolvimento da doença do coronavírus (COVID-19). Que é uma doença que acomete as vias respiratórias, e na maior parte das vezes pode causar a pneumonia. Apesar da origem viral, frequentemente, são prescritos medicamentos antimicrobianos, sendo assim, cerca de 15% dos pacientes contagiados pelo SARS-CoV-2 apresentam um quadro de infecção secundária causada por bactérias, o que explica o tratamento com antibióticos. Esses fármacos, quando prescritos independentemente da existência de uma infecção causada por bactérias, podem acarretar em uma possível resistência bacteriana. O objetivo deste trabalho é analisar o perfil dos exames laboratoriais dos pacientes internados em uma UTI com formas graves da COVID-19, em um hospital privado de um município da região sudoeste da Bahia. Trata-se de um estudo de caráter documental, com fonte primária de dados. A abordagem é quantitativa de cunho descritivo, exploratório e de natureza transversal, por meio do levantamento de dados. Dentre os 52 prontuários avaliados, foi possível observar que o gênero masculino obteve uma maior taxa de internação e em sua maioria eram idosos. É possível observar um aumento do número de leucócitos e plaquetas, após a antibioticoterapia. E em relação a PCR, o valor foi significativamente reduzido, após a administração de fármacos antimicrobianos. De acordo com a análise dos resultados laboratoriais, foi possível observar que houve alterações importantes nos marcadores de infecção, o que pode estar relacionado com uso dos antimicrobianos.

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Hypersensitivity Reactions to Vaccines: Current Evidence and Standards for SARS-CoV-2 Vaccines

Cited by 11 publications

References 33 publications

A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine

A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine

Acute kidney injury (AKI) post-mRNA SARS-CoV-2 vaccine in patients with cancer, treated with immune check point inhibitor (ICPi): An immune double whammy!

Perfil dos exames laboratoriais dos pacientes internados em uma Unidade de Terapia Intensiva (UTI) com formas graves da COVID-19

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