In a recently published study in pathogensresearchers discussed the safety of vaccines against coronavirus disease 2019 (COVID-19) in healthy people and patients with autoimmunity or heart problems.
background
The COVID-19 pandemic is a serious global public health challenge. Several vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed worldwide. According to the World Health Organization, more than 300 vaccines are in various stages of preclinical and clinical development. Importantly, vaccines cannot effectively inhibit transmission of SARS-CoV-2 due to the virus’ high variability, hampering the goal of herd immunity.
In addition, there is evidence of reduced efficacy versus the Omicron variant, even after a fourth dose. Several people develop inflammatory cardiomyopathy, thrombosis, neurological problems and other rare diseases after COVID-19 vaccination. These events may increase with the administration of repeated booster doses. Therefore, in the present study, the researchers reviewed the safety of COVID-19 vaccines, particularly in people with autoimmunity and heart problems.
COVID-19 vaccination in autoimmune and healthy individuals
Clinical evidence points to an increase in autoimmunity symptoms after COVID-19 vaccination. A meta-analysis reported neurological manifestations after the first SARS-CoV-2 vaccine dose in some patient subgroups and also found that more than half of these events occurred in individuals with a history of autoimmunity. mRNA and virus vector vaccines have been reported to induce multiple sclerosis (MS)-like episodes.
Another study reported adverse events after vaccination with the Pfizer/AstraZeneca vaccine in MS patients from Germany and the United Kingdom (UK). One research team observed a 55-year-old person develop relapses of rheumatoid arthritis (RA) 12 hours after the second dose of vaccine, while another team identified new onset RA within four weeks of vaccination.
Myocarditis and pericarditis risk after COVID-19 infection or vaccination
An increase in the incidence of myocarditis/pericarditis was initially reported following the introduction of COVID-19 vaccines, with approximately one in 33,300 people at risk of heart inflammation. In addition, the risk of myocarditis/pericarditis was further increased in military personnel in the United States (USA).
An Israeli study found no evidence of a higher risk of myocarditis/pericarditis after COVID-19 in unvaccinated individuals. This contradicted evidence from a study that reported an increased incidence in hospitalized COVID-19 patients. An Italian study reported cases of myocarditis/pericarditis in young vaccinated individuals at up to 12 cases per 100,000 individuals, while a US study estimated one case of myocarditis in 6250 vaccinated individuals.
In addition, reports of booster-associated myocarditis/pericarditis in males requiring hospitalization have been reported in US universities. Overall, the data on the development of myocarditis after COVID-19 vaccination cannot be ignored, since the incidence of vaccine-associated myocarditis is not lower than that of COVID-19.
Safety of COVID-19 vaccines in individuals with autoimmunity and a history of myocarditis
Recently, a study showed elevated blood troponin T levels after COVID-19 vaccination in all tested people with systemic lupus erythematosus (SLE), suggesting heart damage. Although biomarker levels decreased over time, the fact that all subjects had higher levels is worrying and urges caution when administering vaccines to these at-risk individuals with a history of myocarditis.
Notably, nearly half of SLE patients had used immunosuppressants and immunomodulators when vaccinated, which may have affected the inflammatory response to mRNA vaccines. After the SARS-CoV-2 vaccination, SLE patients show a lower antibody response than healthy patients, even without immunosuppressants. It has been suggested that autoreactive T cells show reduced activation after vaccination.
The constitutional range of the British Isles Lupus Assessment Group (BILAG) index was significantly increased in SLE patients after receiving COVID-19 vaccines. Although no patient required a change in therapy, the researchers suggested regular monitoring of autoimmune patients. The risk-benefit balance of continued administration of vaccines may need to be revised given the increase in the BILAG index, biomarkers of cardiac damage, and the fact that COVID-19-induced myocarditis is no more common and risky than vaccine-induced myocarditis.
autoimmunity after vaccination
There is evidence of the occurrence of autoimmune diseases after SARS-CoV-2 infection or vaccination. The cellular receptor of the viral spike protein, angiotensin converting enzyme 2 (ACE2), is targeted by autoantibodies during COVID-19. Whether the vaccination also triggers similar autoantibody reactions remains to be clarified.
Over and beyond, in silico The results suggest possible cross-reactivity between the viral spike and human proteins, although some studies contradict this finding. Reports suggest myocardial inflammation in individuals with vaccine-related myocarditis and lymphocytic infiltrate, suggesting an autoimmune-like attack.
Diploma
Taken together, the authors discussed the safety of the COVID-19 vaccine and the adverse events associated with it. The scientific community must decide whether existing nucleic acid-based vaccines should be continued for at-risk individuals with autoimmunity when the long-term effects of vaccination (in these subpopulations) are unclear. Developing COVID-19 vaccines using traditional technologies may be desirable for older adults and those at risk.
quotes
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APA
Sai Lomte, Tarun. (2023, February 07). The safety profile and actual known side effects of COVID-19 vaccines in vulnerable and healthy individuals. News Medical. Retrieved February 07, 2023 from https://www.news-medical.net/news/20230207/The-safety-profile-and-the-actual-known-adverse-effects-of-COVID-19-vaccines-in -at-risk-and-healthy-individuals.aspx.
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MLA
Sai Lomte, Tarun. “The Safety Profile and Actual Known Side Effects of COVID-19 Vaccines in Vulnerable and Healthy Individuals”. News Medical. February 07, 2023.
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Chicago
Sai Lomte, Tarun. “The Safety Profile and Actual Known Side Effects of COVID-19 Vaccines in Vulnerable and Healthy Individuals”. News Medical. https://www.news-medical.net/news/20230207/The-safety-profile-and-the-actual-known-adverse-effects-of-COVID-19-vaccines-in-at-risk-and- healthy-individuals.aspx. (accessed 2023-02-07).
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Harvard
Sai Lomte, Tarun. 2023 The safety profile and actual known side effects of COVID-19 vaccines in vulnerable and healthy individuals. News-Medical accessed 07 February 2023, https://www.news-medical.net/news/20230207/The-safety-profile-and-the-actual-known-adverse-effects-of-COVID-19 -vaccines-in-at-risk-and-healthy-individuals.aspx.
