2.A review of COVID-19 vaccination and the reported cardiac manifestations.
Jamie Sin Ying HO ; Ching-Hui SIA ; Jinghao Nicholas NGIAM ; Poay Huan LOH ; Nicholas Wen Sheng CHEW ; William Kok-Fai KONG ; Kian-Keong POH
Singapore medical journal 2023;64(9):543-549
In Singapore, 9.03 million doses of the mRNA COVID-19 vaccines by Pfizer-BioNTech and Moderna have been administered, and 4.46 million people are fully vaccinated. An additional 87,000 people have been vaccinated with vaccines in World Health Organization's Emergency Use Listing. The aim of this review is to explore the reported cardiac adverse events associated with different types of COVID-19 vaccines. A total of 42 studies that reported cardiac side effects after COVID-19 vaccination were included in this study. Reported COVID-19 vaccine-associated cardiac adverse events were mainly myocarditis and pericarditis, most commonly seen in adolescent and young adult male individuals after mRNA vaccination. Reports of other events such as acute myocardial infarction, arrhythmia and stress cardiomyopathy were rare. Outcomes of post-vaccine myocarditis and pericarditis were good. Given the good vaccine efficacy and the high number of cases of infection, hospitalisation and death that could potentially be prevented, COVID-19 vaccine remains of overall benefit, based on the current available data.
Adolescent
;
Humans
;
Male
;
Young Adult
;
COVID-19/prevention & control*
;
COVID-19 Vaccines/adverse effects*
;
Myocarditis/etiology*
;
Pericarditis
;
RNA, Messenger
;
Vaccination/adverse effects*
3.Flare and change in disease activity among patients with stable rheumatoid arthritis following coronavirus disease 2019 vaccination: A prospective Chinese cohort study.
Yan GENG ; Yong FAN ; Yu WANG ; Xuerong DENG ; Lanlan JI ; Xiaohui ZHANG ; Zhibo SONG ; Hong HUANG ; Yanni GUI ; Haoze ZHANG ; Xiaoying SUN ; Guangtao LI ; Juan ZHAO ; Zhuoli ZHANG
Chinese Medical Journal 2023;136(19):2324-2329
BACKGROUND:
Vaccination has been shown effective in controlling the global coronavirus disease 2019 (COVID-19) pandemic and reducing severe cases. This study was to assess the flare and change in disease activity after COVID-19 vaccination in patients with stable rheumatoid arthritis (RA).
METHODS:
A prospective cohort of RA patients in remission or with low disease activity was divided into a vaccination group and a non-vaccination group based on their COVID-19 vaccination status. Each of them was examined every 3 to 6 months. In the vaccination group, disease activity was compared before and after vaccination. The rates of flare defined as disease activity scores based on 28-joint count (DAS28) >3.2 with ΔDAS28 ≥0.6 were compared between vaccination and non-vaccination groups.
RESULTS:
A total of 202 eligible RA patients were enrolled. Of these, 98 patients received no vaccine shot (non-vaccination group), and 104 patients received two doses of vaccine (vaccination group). The median time interval from pre-vaccination visit to the first immunization and from the second dose of vaccine to post-vaccination visit was 67 days and 83 days, respectively. The disease activity scores at pre-vaccination and post-vaccination visits in the vaccination group patients were similar. At enrollment, gender, RA disease course, seropositivity, and disease activity were comparable across the two groups. Flare was observed in five (4.8%) of the vaccination group patients and nine (9.2%) of the non-vaccination group patients at post-vaccination assessment ( P = 0.221). In terms of safety, 29 (27.9%) patients experienced adverse events (AEs) after vaccination. No serious AEs occurred.
CONCLUSIONS
COVID-19 vaccinations had no significant effect on disease activity or risk of flare in RA patients in remission or with low disease activity. Patients with stable RA should be encouraged to receive the COVID-19 vaccination.
Humans
;
Arthritis, Rheumatoid
;
Cohort Studies
;
COVID-19/prevention & control*
;
COVID-19 Vaccines/adverse effects*
;
East Asian People
;
Prospective Studies
;
Vaccination/adverse effects*
4.A case of vitiligo after COVID-19 vaccination: a possible role of thymic dysfunction.
Denis KUZNETSOV ; Oleg KALYUZHIN ; Andrey MIRONOV ; Valery NESCHISLIAEV ; Anastasiia KUZNETSOVA
Journal of Zhejiang University. Science. B 2023;24(12):1141-1150
During the coronavirus disease 2019 (COVID-19) pandemic, vaccines help control the spread of infection. To date, 47 vaccines have been approved, with another 227 candidates in various stages of development. In the short period of time since the beginning of their use, evidence has begun to emerge of complications following vaccination in the form of the development or exacerbation of a number of pathological conditions (Block et al., 2022; Haseeb et al., 2022). For example, a population-based study in France identified 1612 cases of myocarditis and 1613 cases of pericarditis requiring hospital treatment within five months of vaccination (le Vu et al., 2022).
Humans
;
COVID-19/prevention & control*
;
COVID-19 Vaccines/adverse effects*
;
Vaccination/adverse effects*
;
Vitiligo/etiology*
;
Thymus Gland/physiopathology*
7.Progress in research of safety, efficiency and vaccination status of influenza vaccine in populations at high risk.
Hai Tian SUI ; Yang GUO ; Jie ZHAO ; Zhong Nan YANG ; Jin Feng SU ; Yuan YANG ; Qing WANG ; Lu Zhao FENG
Chinese Journal of Epidemiology 2022;43(3):436-439
This paper reviews the domestic and foreign studies published in 2020 on the application of influenza vaccine in populations at high risk. The importance of influenza vaccination in population at high risk has been proved by larger sample, multicentre, high-quality evidence-based studies. Influenza vaccination is the most cost-effective measure to prevent influenza. However, the coverage rate of influenza vaccine is very low in China, it is necessary to strengthen the health education to promote influenza vaccination in different populations. It is recommended to give influenza vaccination to the population in whom influenza vaccination has been proven safe and effective before influenza season. Research of the safety, efficiency and cost-effectiveness of influenza vaccine should be accelerated for the populations in whom such data are lacking or insufficient.
China
;
Costs and Cost Analysis
;
Humans
;
Influenza Vaccines/adverse effects*
;
Influenza, Human/prevention & control*
;
Vaccination
8.A review of the safety and efficacy of current COVID-19 vaccines.
Zehong HUANG ; Yingying SU ; Tianying ZHANG ; Ningshao XIA
Frontiers of Medicine 2022;16(1):39-55
Vaccination is the most effective and feasible way to contain the Coronavirus disease 2019 (COVID-19) pandemic. The rapid development of effective COVID-19 vaccines is an extraordinary achievement. This study reviewed the efficacy/effectiveness, immunogenicity, and safety profile of the 12 most progressed COVID-19 vaccines and discussed the challenges and prospects of the vaccine-based approaches in a global crisis. Overall, most of the current vaccines have shown safety and efficacy/effectiveness during actual clinical trials or in the real-world studies, indicating a development of pandemic control. However, many challenges are faced by pandemic control in terms of maximizing the effect of vaccines, such as rapid vaccine coverage, strategies to address variants with immune escape capability, and surveillance of vaccine safety in the medium- and long-terms.
COVID-19/prevention & control*
;
COVID-19 Vaccines/adverse effects*
;
Humans
;
Pandemics/prevention & control*
;
SARS-CoV-2
;
Vaccination
9.Early assessment of the safety and immunogenicity of a third dose (booster) of COVID-19 immunization in Chinese adults.
Yuntao ZHANG ; Yunkai YANG ; Niu QIAO ; Xuewei WANG ; Ling DING ; Xiujuan ZHU ; Yu LIANG ; Zibo HAN ; Feng LIU ; Xinxin ZHANG ; Xiaoming YANG
Frontiers of Medicine 2022;16(1):93-101
Inducing durable and effective immunity against severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) via vaccination is essential to combat the current pandemic of coronavirus disease 2019 (COVID-19). It has been noticed that the strength of anti-COVID-19 vaccination-induced immunity fades over time, which calls for an additional vaccination regime, as known as booster immunization, to restore immunity among previously vaccinated populations. Here we report a pilot open-label trial of a third dose of BBIBP-CorV, an inactivated SARS-CoV-2 vaccine (Vero cell), on 136 participants aged between 18 to 63 years. Safety and immunogenicity in terms of neutralizing antibody titers and cytokine/chemokine responses were analyzed as the main endpoint until day 28. While systemic reactogenicity was either absent or mild, SARS-CoV-2-specific neutralizing antibody titers rapidly arose in all participants within 4 weeks, surpassing the peak antibody titers elicited by the initial two-dose immunization regime. Broad increases of cellular immunity-associated cytokines and chemokines were also detected in the majority of participants after the third vaccination. Furthermore, in an exploratory study, a newly developed recombinant protein vaccine, NVSI-06-08 (CHO Cells), was found to be safe and even more effective than BBIBP-CorV in eliciting humoral immune responses in BBIBP-CorV-primed individuals. Together, these results indicate that a third immunization schedule with either homologous or heterologous vaccine showed favorable safety profiles and restored potent SARS-CoV-2-specific immunity, providing support for further trials of booster vaccination in larger populations.
Adolescent
;
Adult
;
Antibodies, Neutralizing
;
Antibodies, Viral
;
COVID-19/prevention & control*
;
COVID-19 Vaccines/adverse effects*
;
China
;
Humans
;
Immunogenicity, Vaccine
;
Middle Aged
;
SARS-CoV-2
;
Vaccination
;
Young Adult
10.Pericarditis and myocarditis after COVID-19 mRNA vaccination in a nationwide setting.
Jonathan YAP ; Mun Yee THAM ; Jalene POH ; Dorothy TOH ; Cheng Leng CHAN ; Toon Wei LIM ; Shir Lynn LIM ; Yew Woon CHIA ; Yean Teng LIM ; Jonathan CHOO ; Zee Pin DING ; Ling Li FOO ; Simin KUO ; Yee How LAU ; Annie LEE ; Khung Keong YEO
Annals of the Academy of Medicine, Singapore 2022;51(2):96-100
INTRODUCTION:
Despite reports suggesting an association between COVID-19 mRNA vaccination and pericarditis and myocarditis, detailed nationwide population-based data are sparsely available. We describe the incidence of pericarditis and myocarditis by age categories and sex after COVID-19 mRNA vaccination from a nationwide mass vaccination programme in Singapore.
METHODS:
The incidence of adjudicated cases of pericarditis and myocarditis following COVID-19 mRNA vaccination that were reported to the vaccine safety committee between January to July 2021 was compared with the background incidence of myocarditis in Singapore.
RESULTS:
As of end July 2021, a total of 34 cases were reported (9 pericarditis only, 14 myocarditis only, and 11 concomitant pericarditis and myocarditis) with 7,183,889 doses of COVID-19 mRNA vaccine administered. Of the 9 cases of pericarditis only, all were male except one. The highest incidence of pericarditis was in males aged 12-19 years with an incidence of 1.11 cases per 100,000 doses. Of the 25 cases of myocarditis, 80% (20 cases) were male and the median age was 23 years (range 12-55 years) with 16 cases after the second dose. A higher-than-expected number of cases were seen in males aged 12-19 and 20-29 years, with incidence rates of 3.72 and 0.98 case per 100,000 doses, respectively.
CONCLUSION
Data from the national registry in Singapore indicate an increased incidence of pericarditis and myocarditis in younger men after COVID-19 mRNA vaccination.
Adolescent
;
Adult
;
COVID-19/prevention & control*
;
COVID-19 Vaccines/adverse effects*
;
Child
;
Female
;
Humans
;
Male
;
Middle Aged
;
Myocarditis/etiology*
;
Pericarditis/etiology*
;
RNA, Messenger
;
SARS-CoV-2
;
Vaccination/adverse effects*
;
Vaccines, Synthetic
;
Young Adult
;
mRNA Vaccines

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