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AbstractBackgroundMethodsResultsConclusionsBNT162b2 and mRNA-1273 COVID-19 vaccines have been used for mass vaccinations in Curaçao, the Caribbean but information on adverse events (AEs)in this population is unavailable. This study describes the characteristics of vaccinees that incurred AEs, explores the associations between AEs by vaccine and doses, and estimates the rate of AEs.Vaccination and AEs data for all persons of age 5 years (range 5–105 years) and older who received two doses of COVID-19 vaccine at 71 centres in Curaçao between February 24, 2021, and April 5, 2023, were included in this retrospective observational study.The vaccines differed significantly in the frequency distribution of vaccinees by age, age groups, sex, AEs, and prior COVID-19 infection. Occurrence of AEs was strongly associated with mRNA vaccine brand, sex, number of doses, but not with age, age group, and prior COVID-19 infection. Of 209,720 doses, 84 persons (0.04%) incurred AEs following two doses of mRNA vaccines (overall rate of 40.1 per 100,000 persons (95% CI 32.4–49.6). AEs were also significantly higher in females compared to males.AE rates associated with BNT162b2, and mRNA-1273 vaccines were low, but BNT162b2 vaccinees incurred substantially significantly higher AE rates (58.3 per 100,000 persons, 95% CI 45.4–74.9) than mRNA-1273 vaccinees (21.9 per 100,000 persons, 95% CI 14.6–32.8). mRNA-1273 vaccine was associated with a significantly lower risk of AEs.AE reporting varied by age, sex, and vaccine used as well as the number of doses. Future studies with follow-up and longer-term reporting of AEs should be conducted. [ABSTRACT FROM AUTHOR]

Introduction The World Health Organization identified vaccine hesitancy as one of the top 10 threats to global health. Vaccine hesitancy is defined as a delay in acceptance or refusal of vaccination despite the availability of vaccination services. Because vaccine safety concerns are important contributors to hesitancy, people who have experienced adverse events following immunization (AEFI) may be at especially high risk for subsequent vaccine hesitancy. The Defense Health Agency Immunization Healthcare Division (DHA IHD) provides specialized vaccine care to persons who have experienced AEFI. The impact of this specialized vaccine care on subsequent vaccine hesitancy has not been fully explored. Materials and Methods A cohort of patients (n = 146) was identified among those who received consultative care from DHA IHD clinicians for AEFI concerns between April 2017 and September 2022. Analyses were restricted to non-uniformed beneficiaries of the Military Health System (MHS). Uniformed beneficiaries of the MHS were excluded from this analysis since vaccination mandates preclude the use of vaccine uptake as a measure of vaccine hesitancy. Outcomes were evaluated by reviewing MHS vaccination records after initial AEFI consultation through January 2023. Vaccine acceptance was considered the inverse of hesitancy, and was defined by: (a) receipt of any subsequent vaccination, (b) receipt of seasonal influenza vaccine, (c) receipt of subsequent doses of the AEFI-associated vaccine, if clinically recommended, and (d) receipt of COVID-19 vaccine. Results A diverse group of patients with a wide range of AEFI concerns received specialized vaccine care from DHA IHD clinicians during this period. Among the cohort, 78% of patients received any subsequent vaccination, 55.2% received seasonal influenza vaccine, 57.8% received a subsequent dose of their AEFI-associated vaccine when the vaccine was clinically recommended, and 48.9% received COVID-19 vaccine. The proportion of patients who received influenza vaccine exceeded the reported rate of influenza vaccine uptake by the general population during this time period. Conclusion Specialized vaccine care after AEFI concerns was associated with relatively high acceptance of subsequent vaccinations. The experiences of DHA IHD clinicians, in providing specialized vaccine care to AEFI patients, may serve as a model for other organizations that are working to reduce vaccine hesitancy, even beyond the MHS. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the prevalence and types of oral adverse events following immunization (AEFIs) in people who received at least one dose of any type of vaccine. Materials and Methods: We conducted a bibliographic search about oral AEFIs in MEDLINE, Embase, PubMed, and Ovid from database inception to November 07, 2022. Risk of bias was assessed using the MURAD or the Quality In Prognosis Studies tools. Random‐effects proportional meta‐analysis was applied. Results: A total of 119 studies involving 343 people were eligible. These reported AEFIs occurred following administration of the coronavirus disease 2019 vaccine, anti‐influenza vaccine, hepatitis B vaccine, and anti‐smallpox vaccine. The most common to be affected in vaccinated people were buccal mucosa (63.1%; 95% confidence interval (CI) 33.4–88.2) and lips (55.7%; 95% CI, 41.1–69.8). The most prevalent oral AEFIs were ulceration (55.2%; 95% CI 24.4–84.0), swelling (65.2%; 95% CI 34.9–89.8), and burning sensation (18.3%; 95% CI 7.9–31.8). Conclusions: The mechanisms underlying oral AEFIs should be further investigated to promptly recognize oral manifestations and provide optimal management for people undergoing vaccination. [ABSTRACT FROM AUTHOR]

Vaccines protect against many infectious diseases, including some that can directly or indirectly cause nervous system damage. Serious neurological consequences of immunization are typically extremely rare, although they have the potential to jeopardize vaccination programmes, as demonstrated most recently during the COVID-19 pandemic. Neurologists have an important role in identifying safety signals at population and individual patient levels, as well as providing advice on the benefit–risk profile of vaccination in cohorts of patients with diverse neurological conditions. This article reviews the links between vaccination and neurological disease and considers how emerging signals can be evaluated and their mechanistic basis identified. We review examples of neurotropic infections with live attenuated vaccines, as well as neuroimmunological and neurovascular sequelae of other types of vaccines. We emphasize that such risks are typically dwarfed by neurological complications associated with natural infection and discuss how the risks can be further mitigated. The COVID-19 pandemic has highlighted the need to rapidly identify and minimize neurological risks of vaccination, and we review the structures that need to be developed to protect public health against these risks in the future. Vaccination has transformed the global fight against infectious diseases and has a highly favourable benefit–risk profile in most people, although adverse events, including neurological complications, can occasionally occur. This article reviews the links between vaccination and neurological disease and considers the role of neurologists in identifying safety signals and managing risk. Key points: Vaccines have a key public health role in protecting populations against infectious diseases, including neurological diseases caused by infections. Serious neurological complications of vaccination are extremely rare, but when they do occur they have the potential to jeopardize vaccination programmes. Live attenuated vaccines, such as the yellow fever and poliomyelitis vaccines, carry a very small risk of neurotropic infections; vaccine-specific and recipient-specific factors can predispose to these complications. Very rare neurological complications of vaccination include neuroimmunological conditions such as Guillain–Barré syndrome, acute disseminated encephalomyelitis and narcolepsy, and neurovascular conditions such as cerebral venous sinus thrombosis and stroke. Apart from live vaccines in immunosuppressed individuals and the yellow fever vaccine in people with myasthenia gravis, vaccination is typically safe in individuals with neurological disease, with strongly positive benefit–risk profiles. Recent advances in data linkage have allowed monitoring of the neurological safety profile of vaccines as they are rolled out, almost in real time, and have enabled these risks to be weighed against the risks of infection in unvaccinated individuals. [ABSTRACT FROM AUTHOR]

The long-term value of efficient antigen discovery includes gaining insights into the variety of potential cancer neoantigens, effective vaccines lacking adverse effects, and adaptive immune receptor (IR) targets for blocking adaptive IR-antigen interactions in autoimmunity. While the preceding goals have been partially addressed via big data approaches to HLA (human leukocyte antigen)-epitope binding, there has been little such progress in the big data setting for adaptive IR-epitope binding. This delay in progress for the latter is likely due to, among other things, the much more complicated adaptive IR repertoire in an individual compared to individual HLA alleles. Thus, results described here represent the application of an algorithm for efficient assessment of immunoglobulin heavy chain complementarity determining region-3 (IGH CDR3)-gliadin epitope interactions, with a focus on epitopes known to be associated with an immune response in celiac disease. The hydrophobic, chemical complementarity between celiac case IGH CDR3s and known celiac epitopes was found to be greater in comparison to the hydrophobic, chemical complementarity between the same celiac case IGH CDR3s and a series of control epitopes. Thus, the approaches indicated here likely offer guidance for the development of conveniently applied algorithms for antigen verification and discovery. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 vaccines have been administered in many countries after the COVID-19 pandemic. Lymphadenopathy is a side effect of SARS-CoV-2 vaccine. We report a rare example of Kikuchi disease in the cervical lymph nodes after SARS-CoV-2 vaccination. A 41-year-old man complained of a swollen neck and fever 9 days after the first dose of SARS-CoV-2 mRNA-1273 vaccine. Computed tomography revealed enlarged cervical lymph nodes. Fine needle aspiration and resection were performed, and the clinicopathological diagnosis was consistent with Kikuchi disease. Histologically, the resected lymph nodes lost their polarity, and many histiocytes were aggregated with karyorrhectic nuclear debris and apoptosis. SARS-CoV-2 positive cells were small lymphocytes detected by immunohistochemistry. This is the first report that demonstrated SARS-CoV-2 expression in Kikuchi disease post-SARS-CoV-2 vaccination. [ABSTRACT FROM AUTHOR]

To determine the risk of optic neuritis (ON) after mRNA Coronavirus Disease 2019 (COVID-19) vaccine administration. U.S. National aggregate database retrospective cohort study. Patients were placed into cohorts based on mRNA COVID-19 vaccination status (no vaccine and positive history of COVID-19 infection, 1 vaccine, or 2 vaccines received) from December 2020 to June 2022. Two control cohorts were created with patients vaccinated against influenza or tetanus, diphtheria, and pertussis (Tdap) from June 2018 to December 2019. Patients with any history of ON or significant risk factors for ON development including infectious, inflammatory, and neoplastic diseases were excluded. A large deidentified database was queried for the Common Procedural Technology codes for immunization encounters specific to first dose and second dose of mRNA COVID-19 vaccine, influenza, or Tdap. Cohorts were 1:1 propensity score matched on age, sex, race, and ethnicity. The risk of ON development after vaccination was calculated and compared for all 5 cohorts with 95% confidence intervals (CIs) reported. Risk ratio (RR) of ON 21 days after vaccination (or COVID-19 infection) and incidence of ON per 100 000 individuals. After matching, the first dose COVID-19 and influenza vaccine cohorts (n = 1 678 598, mean age [standard deviation] at vaccination of 45.5 [23.3] years and 43.2 [25.5] years, 55% female) the RR of developing ON was 0.44 (95% CI, 0.28–0.80). The first dose of COVID-19 and Tdap vaccinations (n = 797 538, mean age 38.9 [20.0] years, 54.2% female) cohort had 10 and 16 patients develop ON (RR, 0.63; 95% CI, 0.28–1.38). Comparison of COVID-19–vaccinated patients (n = 3 698 848, 48.2 [21.5] years, 54.7% female) to unvaccinated and COVID-19–infected patients (n = 3 698 848, 49.6 [22.0] years, 55.2% female) showed 49 and 506 patients developing ON, respectively (RR, 0.09; 95% CI, 0.07–0.12). The incidence per 100 000 for ON was 1 in the first dose COVID-19 vaccine cohort, 2 in the influenza cohort, and 2 in the Tdap cohort, and 14 in the COVID-19–infected and unvaccinated cohorts. Risk of ON after mRNA COVID-19 vaccination is rare and comparable to Tdap vaccination, decreased compared with influenza vaccination, and decreased compared with COVID-19 infection in the absence of vaccination. Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]

This article presents research on the global burden of vaccine-associated angioedema, a rare but potentially serious reaction to vaccines. The study analyzed data from a global pharmacovigilance database and found that the incidence of vaccine-associated angioedema has been increasing, especially during the 2009 influenza pandemic and the 2020 COVID-19 pandemic. The COVID-19 mRNA vaccine showed the highest association with angioedema, followed by influenza and typhoid vaccines. The study also noted that angioedema was more common in females and increased with age. The authors recommend further investigation into the causes and mechanisms of this reaction and stress the importance of post-vaccination surveillance, particularly among high-risk groups. [Extracted from the article]

Objective Methods Results Significance Seizures have been reported as an adverse event of the COVID‐19 vaccine. However, there is no solid evidence of increased seizure occurrence compared to the general population. This study was undertaken to investigate seizure occurrence among COVID‐19 vaccine recipients compared to unvaccinated controls.A systematic search was made of PubMed, Web of Science, Scopus, and Cochrane Library up to April 9, 2024. Studies reporting seizure occurrence following COVID‐19 vaccination were included. This study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses framework and was conducted using random‐ and common‐effect models. The risk of bias in the studies was evaluated by the Newcastle–Ottawa Scale. The outcome of interest was new onset seizure incidence proportion compared among (1) COVID‐19 vaccine recipients, (2) unvaccinated cohorts, and (3) various types of COVID‐19 vaccines.Forty studies were included, of which seven entered the meta‐analysis. Results of the pooled analysis of the new onset seizure incidence (21‐ or 28‐day period after vaccination) in 13 016 024 vaccine recipients and 13 013 262 unvaccinated individuals by pooling the cohort studies did not show any statistically significant difference between the two groups (odds ratio [OR] = .48, 95% confidence interval [CI] = .19–1.20, p = .12, I2 = 95%, τ2 = .7145). Pooling four studies accounting for 19 769 004 mRNA versus 47 494 631 viral vector vaccine doses demonstrated no significant difference in terms of new onset seizure incidence between the groups (OR = 1.18, 95% CI = .78–1.78, p = .44, I2 = 0%, τ2 = .004).This systematic review and meta‐analysis shows no statistically significant difference in the risk of new onset seizure incidence between COVID‐19 vaccinated individuals and unvaccinated individuals. [ABSTRACT FROM AUTHOR]

The vaccination against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an important public health strategy to prevent people from the pandemic. Vaccines are a game-changing tool, it is essential to understand the adverse events after COVID-19 vaccination. This study explored the adverse events of COVID-19 Vaccination Oxford–AstraZeneca, Pfizer-BioNTech, Moderna, Johnson and Johnson on Guillain–Barré Syndrome (GBS). In this study, initially 128 documents were identified from the databases, including Pub-Med, Web of Science-Clarivate Analytics, Scopus, and Google Scholar. The articles on COVID-19 vaccination and GBs were searched using the keywords "SARS-CoV-2, COVID-19, Vaccination, and Guillain Barré Syndrome, GBS", finally, 16 documents were included in the analysis and synthesis. After administering 1,680,042,214 doses of COVID-19 vaccines, 6177 cases were identified with 10.5 cases per million vaccine doses. A significant positive risk was found between COVID-19 vaccine administration and GBS with a risk rate of RR 1.97 (95% CI 1.26–3.08, p = 0.01). The mRNA vaccines were associated with 2076 cases, and 1,237,638,401 vaccine doses were linked with 4.47 GBS events per million vaccine doses. The first dose of the m-RNA vaccine was associated with 8.83 events per million doses compared to the second dose with 02 events per million doses. The viral-vector vaccine doses 193,535,249 were linked to 1630 GBS cases with 11.01 cases per million doses. The incidence of GBS after the first dose was 17.43 compared to 1.47 cases per million in the second dose of the viral-vector vaccine. The adverse events of the Oxford–AstraZeneca vaccine were linked to 1339 cases of GBS following 167,786,902 vaccine doses, with 14.2 cases per million doses. The Oxford–AstraZeneca vaccine significantly increased the risk of GBS RR: 2.96 (95% CI 2.51–3.48, p = 0.01). For the Pfizer-BioNTech vaccine, there were 7.20 cases per million doses of the vaccine, and no significant association was identified between the Pfizer-BioNTech vaccine and GBS incidence RR: 0.99 (95% CI 0.75–1.32, p = 0.96). Moderna vaccine was related with 419 cases of GBS after administering 420,420,909 doses, with 2.26 cases per million doses. However, Johnson and Johnson's vaccination was linked to 235 GBS after 60,256,913 doses of the vaccine with 8.80 cases per million doses. A significant association was seen between the risk of GBS and Ad.26.COV2. S vaccine, RR: 2.47 (95% CI 1.30–4.69, p < 0.01). Overall, a significant association was seen between the COVID-19 vaccines and the risk of GBS. The incidence of GBS was higher after the first dose compared to GBS cases per million in the second dose. [ABSTRACT FROM AUTHOR]

Background: Vaccination has been recommended as one of the approaches for the control of COVID-19 pandemic. However, adequate vaccine coverage is critical to the effectiveness of the vaccine at population level. Data on acceptability of the vaccine in Ugandan urban areas are limited. This study examined the prevalence, factors associated with willingness to accept COVID-19 vaccine including reasons for not taking COVID-19 vaccine in a predominantly urban population of Wakiso, central Uganda. Methods: Data were obtained from a cross-sectional study conducted between March 1st, 2021 and September 30th, 2021 in the urban population-based cohort of the Africa Medical and behavioral Sciences Organization (AMBSO). A Multivariable modified Poisson regression analysis was used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals of willingness to accept the COVID-19 vaccine. Results: A total of 1,903 participants were enrolled in this study; 61% of whom were females. About 63% of participants indicated their willingness to accept the COVID-19 vaccine. Persons aged 13–19 years (aPR = 0.79; [95% CI: 0.74, 0.84]) or 20-29years (aPR = 0.93; [95% CI: 0.88, 0.98]) were less likely to accept the vaccine compared to persons aged 40–49 years. Persons with post-primary level of education (aPR = 1.05; [95% CI: 1.02, 1.09]) were more likely to accept the vaccine compared to persons with primary level of education. Additionally, students or individuals working in government (aPR = 1.13; [95% CI: 1.04, 1.23]) were more likely to accept the vaccine compared to individuals doing construction and Mechanic work as their main occupation. Reported reasons for not taking a COVID-19 vaccine included; concerns about side effects of the vaccine 154(57.0%), 64(23.7%) did not think the vaccines were effective, while 32(11.9%) did not like the vaccines. Conclusion: A substantial proportion of individuals were not willing to accept the COVID-19 vaccine. Health education campaigns on vaccination within urban communities could help reduce COVID-19 vaccine misconceptions in the urban populations more especially the young and persons with low levels of formal education. [ABSTRACT FROM AUTHOR]

This article discusses the national pharmacovigilance systems in Australia for monitoring the safety of seasonal influenza vaccines. The systems involve collaboration between the Therapeutic Goods Administration (TGA), AusVaxSafety, and state and territory health departments. The TGA collects adverse event reports and uses data mining algorithms to identify safety signals. AusVaxSafety conducts active surveillance through surveys sent to vaccine recipients. The article acknowledges the limitations of these systems, such as under-reporting and incomplete reports, and highlights ongoing efforts to improve data capture and reporting. The goal is to provide timely and transparent information to the public and ensure the safety of influenza vaccines. [Extracted from the article]

Background: Vaccination of healthcare workers (HCWs) is pivotal in decreasing the incidence of contagious infections in hospital settings. In this study, we assessed the knowledge, attitude, and practice regarding HCWs' recommended vaccines among medical students and interns in Egypt. Methods: A multicenter, cross-sectional study was conducted using a structured, pilot-tested, and self-administered questionnaire among Egyptian medical students and interns. We invited 1332 participants to our survey using a systematic random sampling that included participants across nine medical schools in Egypt during the 2021–2022 academic year. Results: Out of 1332 participants, 1141 completed our questionnaire with a response rate of 85.7%. Overall, 43% of the participants had intermediate knowledge (knew 2–3 HCWs' recommended vaccines). Furthermore, 36.7% had received a booster dose of at least one of the HCWs' recommended vaccines over the last 10 years, with only 6.1% having received all recommended vaccines. Hepatitis B vaccine was the most widely known (71%) and received (66.7%). Interns were more likely to know, receive, and recommend HCWs' recommended vaccines. The majority (> 90%) agreed that vaccination is beneficial and safe, with a median score of eight (interquartile range [IQR: Q25-Q75]: 7–9) out of ten for vaccine efficacy and eight (IQR: 7–8) for safety. However, the median score for hesitancy was five (IQR: 2–7). The most common influential and limiting factors for vaccination were scientific facts (60.1%) and fear of vaccine side effects (44.9%). Conclusion: Although medical students in Egypt have good knowledge of and attitudes towards vaccination, there is a gap in their practices. Interventions are needed to improve vaccination uptake among medical students in Egypt. [ABSTRACT FROM AUTHOR]

In this narrative review, we assess the pathophysiology of severe adverse events that presented after vaccination with DNA and mRNA vaccines against COVID‐19. The focus is on the perspective of an undersulfated and degraded glycocalyx, considering its impact on immunomodulation, inflammatory responses, coagulation and oxidative stress. The paper explores various factors that lead to glutathione and inorganic sulfate depletion and their subsequent effect on glycocalyx sulfation and other metabolites, including hormones. Components of COVID‐19 vaccines, such as DNA and mRNA material, spike protein antigen and lipid nanoparticles, are involved in possible cytotoxic effects. The common thread connecting these adverse events is endotheliopathy or glycocalyx degradation, caused by depleted glutathione and inorganic sulfate levels, shear stress from circulating nanoparticles, aggregation and formation of protein coronas; leading to imbalanced immune responses and chronic release of pro‐inflammatory cytokines, ultimately resulting in oxidative stress and systemic inflammatory response syndrome. By understanding the underlying pathophysiology of severe adverse events, better treatment options can be explored. [ABSTRACT FROM AUTHOR]

Background Previous research on COVID-19 vaccination highlights future thoughts associated with possible Coronavirus infection and vaccine side effects as key predictors of vaccine hesitancy. Yet, research has focused on independent contributions of such future thoughts, neglecting their interactive aspects. Purpose We examined whether thoughts about two possible COVID-related futures (suffering from COVID-19 and vaccine side effects) interactively predict vaccine hesitancy and vaccination behavior among unvaccinated and vaccinated people. Importantly, we compared two forms of future thinking: beliefs or expectations (likelihood judgments) versus fantasies (free thoughts and images describing future events). Methods In Study 1, we conducted a longitudinal study with an unvaccinated group (N = 210). We assessed expectations versus fantasies about the two COVID-related futures as predictors. As outcome variables, we measured vaccine hesitancy, and 9 weeks later we assessed information seeking and vaccine uptake. Study 2 was a cross-sectional study comparing vaccine hesitancy of an unvaccinated group (N = 307) to that of a vaccinated group (N = 311). Results Study 1 found that more negative fantasies about COVID-19 impact and less negative fantasies about vaccine side effects interactively predicted lower vaccine hesitancy and more vaccine-related behaviors among unvaccinated people; no such interaction was observed between respective expectations. Study 2 replicated these results of Study 1. Additionally, for vaccinated people, low expectations of negative COVID-19 impact and high expectations of negative vaccine impact interactively predicted higher vaccine hesitancy, whereas no such interaction was observed for respective fantasies. Conclusions Research on vaccine hesitancy should explore interactions between future thinking about disease and about vaccine side effects. Importantly, there is much to be gained by distinguishing expectations versus fantasies: vaccination interventions aiming to boost vaccine uptake among unvaccinated people should tap into their negative future fantasies regarding both disease and vaccine side effects. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nine-valent human papillomavirus (9vHPV) vaccines can be administered in 2 doses 6 to 12 months apart in adolescents. The impact of extended dose intervals is unknown. We report immunogenicity and safety data in adolescents of a second 9vHPV vaccine dose administered ≥1 year after the first. METHODS: This open-label safety and immunogenicity study (NCT04708041) assessed extended-interval 2-dose regimens of 9vHPV vaccine among adolescents (10 to 15 years) who received 2 9vHPV vaccine doses: the first ≥1 year before enrollment, and second, at enrollment (day 1). We measured serologic responses to vaccine-targeted human papillomavirus (HPV) types at enrollment day 1 (pre-dose 2) and 1 month post-dose 2 (month 1) using a competitive LuminexV® immunoassay. We estimated effects of dose interval on geometric mean titers (GMTs) using regression modeling. Participants reported adverse events (AEs) through 15 days after vaccination. RESULTS: We enrolled 146 adolescents (mean age 13.3 years) with median 25 months since first 9vHPV vaccine dose (range: 12-53 months). Across vaccine-targeted HPV types, GMTs increased from day 1 to month 1; seropositivity at month 1 was 100%. Anti-HPV GMTs at month 1 were not affected by differences in dose interval of 12 to 53 months, based on regression modeling. The most common AEs were mild-to-moderate injection site reactions; no serious AEs were reported. CONCLUSIONS: Extending the interval between first and second 9vHPV vaccine doses to 12 to 53 months did not affect antibody responses, with favorable safety profile. These results support feasibility of extended interval regimens for 9vHPV vaccine. [ABSTRACT FROM AUTHOR]

The Oka varicella vaccine strain remains neurovirulent and can establish lifelong latent infection, raising safety concerns about vaccine-related herpes zoster. In this study, we aimed to evaluate the immunogenicity and safety of a skin-attenuated and neuro-attenuated varicella vaccine candidate (v7D vaccine). We did this randomised, double-blind, controlled, phase 2a clinical trial in Jiangsu, China. Healthy children aged 3–12 years with no history of varicella infection or vaccination were enrolled and randomly assigned (1:1:1:1) to receive a single subcutaneous injection of the v7D vaccine at 3·3 log 10 plaque forming units (PFU; low-dose v7D group), 3·9 log 10 PFU (medium-dose v7D group), and 4·2 log 10 PFU (high-dose v7D group), or the positive control varicella vaccine (vOka vaccine group). All the participants, laboratory personnel, and investigators other than the vaccine preparation and management staff were masked to the vaccine allocation. The primary outcome was assessment of the geometric mean titres (GMTs) and seroconversion rates of anti-varicella zoster virus immunoglobulin G (IgG) induced by different dose groups of v7D vaccine at 0, 42, 60, and 90 days after vaccination in the per-protocol set for humoral immune response analysis. Safety was a secondary outcome, focusing on adverse events within 42 days post-vaccination, and serious adverse events within 6 months after vaccination. This study was registered on Chinese Clinical Trial Registry, ChiCTR2000034434. On Aug 18–21, 2020, 842 eligible volunteers were enrolled and randomly assigned treatment. After three participants withdrew, 839 received a low dose (n=211), middle dose (n=210), or high dose (n=210) of v7D vaccine, or the vOka vaccine (n=208). In the per-protocol set for humoral immune response analysis, the anti-varicella zoster virus IgG antibody response was highest at day 90. At day 90, the seroconversion rates of the low-dose, medium-dose, and high-dose groups of v7D vaccine and the positive control vOka vaccine group were 100·0% (95% CI 95·8–100·0; 87 of 87 participants), 98·9% (93·8–100·0; 87 of 88 participants), 97·8% (92·4–99·7; 91 of 93 participants), and 96·4% (89·8–99·2; 80 of 83 participants), respectively; the GMTs corresponded to values of 30·8 (95% CI 26·2–36·0), 31·3 (26·7–36·6), 28·2 (23·9–33·2), and 38·5 (31·7–46·7). The v7D vaccine, at low dose and medium dose, elicited a humoral immune response similar to that of the vOka vaccine. However, the high-dose v7D vaccine induced a marginally lower GMT compared with the vOka vaccine at day 90 (p=0·027). In the per-protocol set, the three dose groups of the v7D vaccine induced a similar humoral immune response at each timepoint, with no statistically significant differences. The incidence of adverse reactions in the low-dose, medium-dose, and high-dose groups of v7D vaccine was significantly lower than that in the vOka vaccine group (17% [35 of 211 participants], 20% [41 of 210 participants], and 13% [27 of 210 participants] vs 24% [50 of 208 participants], respectively; p=0·025), especially local adverse reactions (10% [22 of 211 participants], 14% [30 of 210 participants] and 9% [18 of 210 participants] vs 18% [38 of 208 participants], respectively; p=0·016). None of the serious adverse events were vaccine related. The three dose groups of the candidate v7D vaccine exhibit similar humoral immunogenicity to the vOka vaccine and are well tolerated. These findings encourage further investigations on two-dose vaccination schedules, efficacy, and the potential safety benefit of v7D vaccine in the future. The National Natural Science Foundation of China, CAMS Innovation Fund for Medical Sciences, the Fundamental Research Funds for the Central Universities, and Beijing Wantai. For the Chinese translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

The article reports on a legal dispute regarding an alleged vaccine injury after a coronavirus vaccination. The plaintiff, a nurse for the sick and elderly, was vaccinated with the BioNTech/Pfizer vaccine and claims to have health problems. The Higher Regional Court of Stuttgart ruled that the state alone is liable, as the administration of coronavirus vaccines is a sovereign activity. The text also mentions the possibility of widespread vaccination with protective vaccines by medical practices and company doctors, who are exempt from the obligation to contribute to statutory accident insurance. Furthermore, it concerns the claim of a pharmaceutical wholesaler for compensation for the delivery of contrast agents to contracted medical practices. The agreements between the Association of Statutory Health Insurance Physicians in Rhineland-Palatinate and the health insurance companies are decisive for the disputed delivery of contrast agents and their compensation. [Extracted from the article]

The article "Desired C-section" is about a legal dispute in which the plaintiff sues the defendants for alleged treatment and disclosure errors during childbirth. The plaintiff claims that he had requested a cesarean section, which is disputed by the defendants. It is determined that the settlement between the parties is valid and that the plaintiff's declaration of annulment is ineffective. It is also noted that errors regarding motives or calculations in a settlement are irrelevant. The article also contains information about the course of the birth and the medical measures taken. The plaintiff was born with Apgar scores of 6/6/8 and was transferred to the neonatology department due to respiratory adaptation disorder. Movement restrictions of the right arm and diaphragmatic paralysis were detected. The plaintiff was fed through a tube and had to be treated in the pediatric intensive care unit for almost four weeks. The plaintiff claims that the treating doctors should have performed a cesarean section as his mother was recommended to do so due to his sister's previous difficult birth. The court dismissed the lawsuit as no treatment error was proven. In the present case, it concerns a medical treatment during childbirth that resulted in complications. An expert determined that the treatment was appropriate and no errors were made. In particular, the administration of the medication Cytotec for labor induction was considered professional. Furthermore, no connection could be established between the use of Cytotec and the occurring complications. The court also decided that the disclosure regarding labor induction was sufficient. The appeal does not raise any legal objections to the findings of the district court and also does not contain any specific objections to the court's evaluation of evidence. The court does not doubt the correctness and completeness of the findings of the district court. It assumed the mother's consent to the intake of the medication Cytotec based on the disclosure form and the mother's statements. Even if the disclosure about the effects of the medication should not have been sufficient, this would not result in liability of the defendants. Liability due to a lack of disclosure about a primary cesarean section as an alternative treatment also does not arise. Finally, the court rightly denied liability due to disregarding an expressed desire for an elective cesarean section and failing to disclose its risks. In the present case, it concerns a lawsuit regarding an alleged vaccine injury after a COVID-19 vaccination. The plaintiff completed training as a nurse for the sick and elderly and was vaccinated against COVID-19 with the BioNTech/Pfizer vaccine by the defendants. The plaintiff had previously received an information leaflet and filled out the medical history form. After the vaccinations, a vaccine reaction was observed in the plaintiff. The court decided that administering COVID-19 vaccines is a sovereign activity and therefore the state is solely liable. Self-liability of the sovereign actor is not possible. [Extracted from the article]

The COVID-19 pandemic, caused by SARS-CoV-2, has significantly impacted various organ systems, including the eyes. Initially considered a primarily respiratory disease, it is now evident that COVID-19 can induce a range of ocular symptoms. Recognizing these ocular manifestations is crucial for eye care practitioners as they can serve as early indicators of the disease. This review consolidates current evidence on the ocular effects of COVID-19, identifying manifestations such as conjunctivitis, scleritis, uveitis, and retinopathy. The increasing prevalence of these symptoms highlights the importance of thorough eye examinations and detailed patient histories in COVID-19 cases. Potential routes of viral entry into ocular tissues and the underlying mechanisms, including direct infection, immune responses, and vascular involvement, are explored. Additionally, this review addresses ocular side effects associated with COVID-19 vaccines, such as corneal graft rejection, uveitis, and retinal issues. These findings emphasize the need for ongoing surveillance and research to ensure vaccine safety. [ABSTRACT FROM AUTHOR]

Background and purpose Methods Results Conclusion In October 2020, the European Academy of Neurology (EAN) consensus statement for management of patients with neurological diseases during the coronavirus disease 2019 (COVID‐19) pandemic was published. Due to important changes and developments that have happened since then, the need has arisen to critically reassess the original recommendations and address new challenges.In step 1, the original items were critically reviewed by the EAN COVID‐19 Task Force. In addition, new recommendations were defined. In step 2, an online survey with the recommendations forged in step 1 was sent to the Managing Groups of all Scientific and Coordinating Panels of EAN. In step 3, the final set of recommendations was made.In step 1, out of the original 36 recommendations, 18 were judged still relevant. They were edited to reflect the advances in knowledge and practice. In addition, 21 new recommendations were formulated to address the new knowledge and challenges. In step 2, out of the 39 recommendations sent for the survey, nine were approved as they were, whilst suggestions for improvement were given for the rest. In step 3, the recommendations were further edited, and some new items were formed to accommodate the participants' suggestions, resulting in a final set of 41 recommendations.This revision of the 2020 EAN Statement provides updated comprehensive and structured guidance on good clinical practice in people with neurological disease faced with SARS‐CoV‐2 infection. It now covers the issues from the more recent domains of COVID‐19‐related care, vaccine complications and post‐COVID‐19 conditions. [ABSTRACT FROM AUTHOR]

The aim was to estimate the effect of reported history of smallpox vaccination prior to 1980 on clinical expression of mpox. We included all confirmed mpox cases identified by the national mpox surveillance system in France between May and July 2022. Cases tested positive for monkeypox virus or orthopoxviruses by PCR. Cases were interviewed by phone using a questionnaire documenting demographics, symptoms and exposures. To estimate the effect of smallpox vaccination on the presence of marked mpox symptoms (association of fever, lymphadenopathy and extensive mucocutaneous lesions), we estimated prevalence ratios (PRs) and 95% CIs using Poisson regression models with robust standard errors. There were 1888 confirmed mpox cases with date of symptom onset between 7 May and 31 July 2022. Overall, 7% (93/1394) presented marked mpox symptoms. Among patients who provided information about their vaccination status, 14% (207/1469) reported smallpox vaccination prior to 1980. The proportion of cases with marked symptoms was 2% (3/170) among those reporting smallpox vaccination prior to 1980 and 8% (76/974) among those who reported no vaccination. The proportion of marked symptoms was four times lower among cases reporting previous smallpox vaccination than in cases reporting no vaccination (PR, 0.24; 95% CI: 0.08–0.76). There was no evidence of an effect of smallpox vaccination on development of complications (PR, 0.65; 95% CI: 0.35–1.22) or hospitalization due to mpox (PR, 0.64; 95% CI: 0.23–1.80). Our results suggest that smallpox vaccination during childhood attenuated the clinical expression of monkeypox virus infection, but there was no evidence of an effect on complications or hospitalization. [ABSTRACT FROM AUTHOR]

Introduction: Respiratory syncytial virus (RSV) and influenza pose major disease burdens in older adults due to an aging immune system and comorbidities; seasonal overlap exists between these infections. In 2023, the RSV prefusion protein F3 older adult (RSVPreF3 OA) vaccine was first approved in the USA as a single dose for prevention of lower respiratory tract disease due to RSV in adults aged ≥ 60 years. The vaccine has since been approved in the European Union and elsewhere. RSVPreF3 OA and FLU-QIV-HD could be coadministered if immunogenicity, safety, and reactogenicity are not affected. Methods: This open-label, randomized (1:1), controlled, phase 3 study in 1029 adults aged ≥ 65 years in the USA evaluated the immunogenicity (up to 1 month after last vaccine dose) and safety (up to 6 months after last vaccine dose) of RSVPreF3 OA coadministered with FLU-QIV-HD (co-ad group) versus FLU-QIV-HD alone followed by RSVPreF3 OA at a separate visit 1 month later (control group). Non-inferiority criterion was defined as an upper limit of the two-sided 95% confidence interval of the geometric mean titer (GMT) group ratio (control/co-ad) ≤ 1.5. Secondary endpoints included safety and reactogenicity. Results: Proportions of participants across age categories between groups and proportions of male (50.4%) and female (49.6%) participants were well balanced; most participants were white (68.7%). Group GMT ratios for RSV-A neutralizing titers, hemagglutination inhibition titers for four influenza vaccine strains, and RSV-B neutralizing titers were non-inferior in the co-ad group versus the control group. No clinically meaningful differences in local or systemic solicited and unsolicited adverse events (AEs), serious AEs, and potential immune-mediated diseases were identified. The most common solicited AEs in both groups were injection-site pain and myalgia. Conclusion: In adults aged ≥ 65 years, coadministration of RSVPreF3 OA and FLU-QIV-HD was immunogenically non-inferior to the sequential administration of both vaccines 1 month apart, and had clinically acceptable safety and reactogenicity profile. Trial Registration: ClinicalTrials.gov identifier, NCT05559476. Plain Language Summary: Adults aged 65 years or older are vulnerable to infections caused by influenza and respiratory syncytial viruses, due to an aging immune system and other underlying conditions. Infections with both viruses increase during autumn and winter seasons in temperate climates. In 2023, a vaccine against respiratory syncytial virus, called RSVPreF3 OA, was first approved for use in adults aged 60 years or older in the USA; the vaccine has since also been approved in the European Union and elsewhere. Giving RSVPreF3 OA in the same vaccination visit (coadministration) with a high-dose influenza vaccine, called FLU-QIV-HD, which is given to adults aged 65 years or older, could help protect against both respiratory syncytial virus and influenza. This article reports the results of a phase 3 trial comparing coadministration of the RSVPreF3 OA and FLU-QIV-HD vaccines with sequential administration (FLU-QIV-HD followed by RSVPreF3 OA 1 month later) in 1029 adults aged 65 years or older in the USA. Proportions of participants across age categories between groups, and the proportions of male (50.4%) and female (49.6%) participants were well balanced; most participants were white (68.7%). Immune response to both the vaccines among participants in the coadministration arm was non-inferior to that in the sequential arm. Coadministration was well tolerated, with no meaningful differences in adverse reactions to the vaccines compared with sequential administration. The most common adverse reactions were pain at the injection site and muscle aches. This study supports the coadministration of RSVPreF3 OA and FLU-QIV-HD in adults aged 65 years or older. [ABSTRACT FROM AUTHOR]

Introduction: Many immunization programs in Europe recommend quadrivalent meningococcal vaccinations, which are often administered concomitantly with other vaccines. We compared the immune response of a tetanus toxoid conjugated quadrivalent meningococcal vaccine (MenACYW-TT, MenQuadfi®) with another quadrivalent meningococcal conjugate vaccine (MCV4-TT; Nimenrix®) when administered alone or concomitantly with Tdap-IPV and 9vHPV vaccines in adolescents. Methods: In this phase IIIb trial, healthy adolescents (MenC-naïve or MenC-primed before 2 years of age) from Spain, Italy, Hungary, and Singapore were randomized in a 3:3:2 ratio to receive either MenACYW-TT or MCV4-TT alone, or MenACYW-TT concomitantly with 9vHPV and Tdap-IPV. The primary objective was to demonstrate the non-inferiority of the seroprotection rate (human serum bactericidal assay [hSBA] titer ≥ 1:8) to serogroups A, C, W, and Y 30 days post-vaccination with a single dose of MenACYW-TT or MCV4-TT. Secondary objectives included describing hSBA titers for the four serogroups before and 1 month following vaccination and according to MenC priming status. Results: A total of 463 participants were enrolled (MenACYW-TT, n = 173; MCV4-TT, n = 173; MenACYW-TT/9vHPV/Tdap-IPV n = 117). Non-inferiority based on seroprotection was demonstrated for MenACYW-TT versus MCV4-TT for all serogroups. Immune responses were comparable whether MenACYW-TT was administered alone or concomitantly with Tdap-IPV and 9vHPV. Post-vaccination hSBA GMTs were higher in MenACYW-TT vs. MCV4-TT for serogroups C, Y, and W and comparable for serogroup A. The percentages of participants with an hSBA vaccine seroresponse were higher in MenACYW-TT vs. MCV4-TT for all serogroups. For serogroup C, higher GMTs were observed in both MenC-naïve or -primed participants vaccinated with MenACYW-TT vs. MCV4-TT. Seroprotection and seroresponse were higher in MenC-naïve participants vaccinated with MenACYW-TT vs. MCV4-TT and comparable in MenC-primed. The safety profiles were comparable between groups and no new safety concerns were identified. Conclusions: These data support the concomitant administration of MenACYW-TT with 9vHPV and Tdap-IPV vaccines in adolescents. Trial Registrations: Clinicaltrials.gov, NCT04490018; EudraCT: 2020-001665-37; WHO: U1111-1249-2973. Plain Language Summary: MenACYW conjugate vaccine has been made to protect against meningococcal disease caused by four common types of bacteria (germs) called Neisseria meningitidis (or meningococcus), A, C, W, and Y. Many people, particularly adolescents, have the germs of this disease in their nose or throat, and therefore may develop the disease or transmit the bacteria to other people. Hence, adolescent meningococcal vaccination against serogroups ACWY is increasingly recommended in several countries. This study assessed the immune response to these serogroups in healthy adolescents after one dose of MenACYW conjugate vaccine or Nimenrix®, a meningococcal licensed vaccine. Moreover, the immune response and safety were assessed when the vaccines were given alone or when given concomitantly with other adolescent vaccines, including the human papillomavirus (9vHPV) and tetanus, diphtheria, pertussis, and poliomyelitis (Tdap-IPV) vaccines. A total of 463 adolescents (aged 10–17 years) participated in this study and received either MenACYW or Nimenrix® alone, or MenACYW concomitantly with 9vHPV and Tdap-IPV vaccine. The immune response induced by MenACYW was as good as the immune response induced by Nimenrix®, and when given alone or concomitantly with 9vHPV and Tdap IPV vaccines. None of the participants experienced any serious side effects of any vaccine. The most common non-serious side effects were injection site pain, muscle pain, and headache. These data support the use of MenACYW in adolescents, with or without concomitant administration with 9vHPV and Tdap-IPV, which may help to increase the number of adolescents vaccinated. [ABSTRACT FROM AUTHOR]

Eosinophils are a critical type of immune cell and central players in type 2 immunity. Existing literature suggests that eosinophils also can play a role in host antiviral responses, typically type 1 immune events, against multiple respiratory viruses, both directly through release of antiviral mediators and indirectly through activation of other effector cell types. One way to prime host immune responses toward effective antiviral responses is through vaccination, where typically a type 1–skewed immunity is desirable in the context of intracellular pathogens like respiratory viruses. In the realm of breakthrough respiratory viral infection in vaccinated hosts, an event in which virus can still establish productive infection despite preexisting immunity, eosinophils are most prominently known for their link to vaccine-associated enhanced respiratory disease upon natural respiratory syncytial virus infection. This was observed in a pediatric cohort during the 1960s following vaccination with formalin-inactivated respiratory syncytial virus. More recent research has unveiled additional roles of the eosinophil in respiratory viral infection and breakthrough infection. The specific contribution of eosinophils to the quality of vaccine responses, vaccine efficacy, and antiviral responses to infection in vaccinated hosts remains largely unexplored, especially regarding their potential roles in protection. On the basis of current findings, we will speculate upon the suggested function of eosinophils and consider the many potential ways by which eosinophils may exert protective and pathological effects in breakthrough infections. We will also discuss how to balance vaccine efficacy with eosinophil-related risks, as well as the use of eosinophils and their products as potential biomarkers of vaccine efficacy or adverse events. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Chongqing University of Posts & Telecommunications (Natural Science Edition) is the property of Chongqing University of Posts & Telecommunications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The COVID-19 pandemic underscored the critical importance of vaccination to global health security and highlighted the potential of digital health solutions to improve immunization strategies. This article explores integrating digital health technologies with immunization programs to improve coverage, monitoring, and public health outcomes. It examines the current landscape of digital tools used in immunization initiatives, such as mobile health apps, electronic health records, and data analytics platforms. Case studies from different regions demonstrate the effectiveness of these technologies in addressing challenges such as vaccine hesitancy, logistics, and real-time monitoring of vaccine distribution and adverse events. The paper also examines ethical considerations, data privacy issues, and the need for a robust digital infrastructure to support these innovations. By analyzing the successes and limitations of digital health interventions in immunization campaigns during and after the COVID-19 pandemic, we provide recommendations for future integration strategies to ensure resilient and responsive immunization systems. This research aims to guide policymakers, health professionals, and technologists in leveraging digital health to strengthen immunization efforts and prepare for future public health emergencies. [ABSTRACT FROM AUTHOR]

Background and Objective: An unexpected batch-dependent safety signal for the BNT162b2 mRNA COVID-19 vaccine was recently identified in a nationwide study from Denmark, but the generalizability of this finding is unknown. Therefore, we compared batch-dependent rates of suspected adverse events (SAEs) reported to national authorities in Denmark and Sweden. Materials and Methods: SAE and vaccine batch data were received from national authorities in Denmark and Sweden, and analyses of heterogeneity in the relationship between numbers of vaccine doses and SAEs per batch were performed, along with comparison of SAE rates and severities for batches that were shared between the two countries. Results: Significant batch-dependent heterogeneity was found in the number of SAEs per 1000 doses for both countries, with batches associated with high SAE rates detected in the early phase of the vaccination campaign and positive correlations observed between the two countries for the severity of SAEs from vaccine batches that they shared. Mild SAEs predominated in the batches used in the early part of the vaccination roll-out, where markedly higher SAE rates per 1000 doses in Denmark for the batches that were shared between the two countries suggested that a large proportion of these SAEs were under-reported in Sweden. Conclusions: The batch-dependent safety signal observed in Denmark and now confirmed in Sweden suggests that early commercial batches of BNT162b2 may have differed from those used later on, and these preliminary and hypothesis-generating results warrant further study. [ABSTRACT FROM AUTHOR]

Background: Severe post-vaccination neurological complications are rare. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an immune-mediated polyneuropathy affecting the peripheral nerve roots, which is not well described as a post-vaccination side effect. Here, we present a rare complication of vaccination against SARS-CoV-2, reaching a diagnosis of CIDP. Case presentation: A 67-year-old diabetic male presented with lower extremity paresthesia and weakness following the third dose of the Sinopharm (BBIBP-CorV) vaccine. Despite initial dismissal as a diabetic complication, symptoms escalated, affecting all extremities. Electromyography study revealed abnormal spontaneous activity with chronic reinnervation changes, which was more significant in the lower extremities. Based on the clinical course, radiographic imaging, and laboratory data, a diagnosis of CIDP with severe axonal demyelinating features was established. Treatment with intravenous immunoglobulin (IVIg), prednisolone, and azathioprine resulted in marked improvement of the upper extremities but limited recovery in distal lower extremity muscles. Conclusion: Although CIDP is a rare complication following COVID-19 vaccination, it should be considered in the differential diagnosis. Timely diagnosis of vaccine-induced CIDP is challenging, and any delay can adversely affect treatment response in affected patients. [ABSTRACT FROM AUTHOR]

• BNT162b2 vaccine is associated with increased risk for psoriasis, colitis and polymyalgia rheumatic. • SARS-CoV-2 infection is associated with increased risk for fibromyalgia and hypothyroidism. • Vaccination programs should include risk–benefit assessment for various population groups. A large vaccination campaign was initiated worldwide in December 2020 in order to prevent infection with SARS-CoV-2 and severe Covid-19 disease. However, long-term adverse effects of vaccination remain unclear. Therefore, our objective was to examine the association between vaccination and the incidence of autoimmune diagnoses in the first year after vaccine uptake. This retrospective cohort study based on Clalit Health Services (CHS) comprehensive database compared the rates of immune-mediated diagnoses among BNT162b2 vaccinated versus unvaccinated individuals. As a reference, a secondary cohort compared individuals infected with Sars-CoV-2 versus uninfected individuals. The minimum follow-up period was 4 months. The cohorts were divided into 4 age groups (12–17, 18–44, 45–64, 65 years or older). Multivariate Cox proportional hazard regression models were applied, followed by a correction for multiple comparisons using the False Discovery Rate (FDR) method, hence accounting for the investigation of multiple clinical outcomes. Increased risk for immune-mediated diagnoses following vaccination with BNT162b2 was observed for psoriasis in all age groups (HR 1.41–1.69), colitis among patients younger than 65 years (HR 1.38–1.93), vitiligo in patients aged 45–64 (HR 2.82, 95 %CI: 1.57–5.08) and for polymyalgia-rheumatica in patients aged 65 years or older (HR 2.12, 95 % CI: 1.3–3.47). In the reference cohort, patients who were infected by Covid-19 were at increased risk for fibromyalgia (HR 1.72, 95 % CI: 1.36–2.19 in individuals aged 18–44; HR 1.71, 95 % CI: 1.31–2.22 in individuals aged 45–64), and hypothyroidism (HR 1.54, 95 % CI: 1.15–2.07 in individuals aged 65 years or older). The BNT162b2 vaccine was associated with increased risk (though rare) for psoriasis, colitis and polymyalgia rheumatica. These findings should be considered as a part of the risk–benefit assessment when planning future vaccination programs for various population groups. [ABSTRACT FROM AUTHOR]

Background: To date, multiple cases of adverse reactions to COVID-19 vaccines have been reported worldwide. Alopecia areata (AA) is an uncommon type of adverse reaction reported in some articles and has a significant social and psychological impact on patients. Our study aimed to review the AA and COVID-19 vaccine literature. Methods: This systematic review was conducted by searching for articles on AA following COVID-19 vaccines in international databases such as Embase, MEDLINE, PubMed, Web of Knowledge, and Ovid from December 2019 to December 30, 2023. We included studies that provided data for AA patients following COVID-19 vaccination with at least one dose. Data on sex, age, country/region of origin, vaccine type, days between vaccination and symptom presentation, manifestations of AA, trichoscopy and histopathological findings, treatment, and outcomes were included. Results: In total, 579 explored studies were identified and assessed, and 25 articles with a total of 51 patients were included in the review. Twenty-seven (52.9%) patients developed new-onset AA following receiving the COVID-19 vaccine, and AA recurrence or exacerbation occurred after receiving the COVID-19 vaccine in 24 (47.1%) patients with preexisting disease. Five vaccines were reported to cause AA in all cases. The Pfizer vaccine (45.1%) was the most frequently reported, followed by the ChAdOx1 nCoV-19 vaccine (27.5%), Moderna mRNA-1273 (19.6%), Sinopharm (3.9%) and SinoVac (3.9%). AA occurred most frequently within one month after the 1st dose, and then, the incidence decreased gradually with time. Topical or systemic corticosteroids were used in 38 patients. Eleven patients were treated with a Janus Kinase inhibitor (jakinib) inhibitor, eight with tofacitinib, and three with an unspecified jakinib. However, 3 of the 11 patients experienced exacerbations after treatment. Conclusion: AA after COVID-19 vaccination is rare, and physicians should be aware of this phenomenon to improve early diagnosis and appropriate treatment. [ABSTRACT FROM AUTHOR]

In the digital age, operations can be improved by a wise use of information and technological tools. During the COVID-19 pandemic, governments faced various choices of vaccines possessing different efficacy and availability levels at different time points. In this article, we consider a two-stage vaccine ordering problem of a government from a first and only supplier in the first stage, and either the same supplier or a new second supplier in the second stage. Between the two stages, potential demand information for the vaccine is collected to update the forecast. Using dynamic programming, we derive the government's optimal vaccine ordering policy. We find that the government should select its vaccine supplier based on the disease's infection rate in the society. When the infection rate is low, the government should order nothing at the first stage and order from the supplier with a higher efficacy level at the second stage. When the disease's infection rate is high, the government should order vaccines at the first stage and switch to the other supplier with a lower efficacy level at the second stage. We extend our model to examine (i) the value of blockchain adoption and (ii) the impact of vaccines' side effects. [ABSTRACT FROM AUTHOR]

Convergent self-report and objective biometric findings indicate that short-term systemic side effects of SARS-CoV-2 mRNA vaccination are associated with greater long-lasting neutralizing antibody responses. This may be relevant in addressing negative attitudes towards vaccine side effects, which are a barrier to vaccine uptake. Visual Abstract. COVID-19 Vaccine Side Effects and Long-Term Neutralizing Antibody Response: Convergent self-report and objective biometric findings indicate that short-term systemic side effects of SARS-CoV-2 mRNA vaccination are associated with greater long-lasting neutralizing antibody responses. This may be relevant in addressing negative attitudes towards vaccine side effects, which are a barrier to vaccine uptake. Background: Concern about side effects is a common reason for SARS-CoV-2 vaccine hesitancy. Objective: To determine whether short-term side effects of SARS-CoV-2 messenger RNA (mRNA) vaccination are associated with subsequent neutralizing antibody (nAB) response. Design: Prospective cohort study. Setting: San Francisco Bay Area. Participants: Adults who had not been vaccinated against or exposed to SARS-CoV-2, who then received 2 doses of either BNT162b2 or mRNA-1273. Measurements: Serum nAB titer at 1 month and 6 months after the second vaccine dose. Daily symptom surveys and objective biometric measurements at each dose. Results: 363 participants were included in symptom-related analyses (65.6% female; mean age, 52.4 years [SD, 11.9]), and 147 were included in biometric-related analyses (66.0% female; mean age, 58.8 years [SD, 5.3]). Chills, tiredness, feeling unwell, and headache after the second dose were each associated with 1.4 to 1.6 fold higher nAB at 1 and 6 months after vaccination. Symptom count and vaccination-induced change in skin temperature and heart rate were all positively associated with nAB across both follow-up time points. Each 1 °C increase in skin temperature after dose 2 was associated with 1.8 fold higher nAB 1 month later and 3.1 fold higher nAB 6 months later. Limitations: The study was conducted in 2021 in people receiving the primary vaccine series, making generalizability to people with prior SARS-CoV-2 vaccination or exposure unclear. Whether the observed associations would also apply for neutralizing activity against non-ancestral SARS-CoV-2 strains is also unknown. Conclusion: Convergent self-report and objective biometric findings indicate that short-term systemic side effects of SARS-CoV-2 mRNA vaccination are associated with greater long-lasting nAB responses. This may be relevant in addressing negative attitudes toward vaccine side effects, which are a barrier to vaccine uptake. Primary Funding Source: National Institute on Aging. [ABSTRACT FROM AUTHOR]

Vaccination is an effective way to control many infectious diseases in fish. Israeli fish farming has successfully used two vaccines over the last 30 years and has no problem with the side effects of vaccination. However, after introducing new species, a new problem emerged: these fish, after vaccination, demonstrated peritoneal lesions such as granulomas. At the same time, the fish did not show retarded growth or suffering during the fattening period. This study was conducted to establish the connection between vaccination and the appearance of granulomas. Evidence drawn from this research work and comparing vaccinated and non-vaccinated fish confirms that intraperitoneal granulomas do not impact the growth, performance, or fish fillet quality at harvest. [ABSTRACT FROM AUTHOR]

Background: The emergence of new SARS‐CoV‐2 variants and the global COVID‐19 pandemic spurred urgent vaccine development. While common vaccine side effects are well‐documented, rare adverse events necessitate post‐marketing surveillance. Recent research linked messenger RNA vaccines to thrombotic microangiopathy (TMA), a group of syndromes characterized by microvascular hemolytic anemia and thrombocytopenia. This report describes a new‐onset atypical hemolytic‐uremic syndrome (aHUS) occurring after COVID‐19 vaccination and complements recent literature. Case Presentation: A previously healthy 25‐year‐old woman developed malaise, nausea, edema, and renal dysfunction 60 days postvaccination. Laboratory findings confirmed TMA diagnosis. Genetic testing for complement system mutations was negative. Kidney biopsy supported the diagnosis, and the patient required hemodialysis. Conclusion: This case illustrates the rare occurrence of aHUS following COVID‐19 vaccination, with unique characteristics compared to previous reports. Despite the critical role of vaccination in pandemic control, emerging adverse events, such as vaccine‐related TMA, must be recognized and investigated. Additional clinical trials are imperative to comprehend the clinical features and pathophysiological mechanisms underlying TMA associated with COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

Introduction: Bell's palsy is one of the most concerning complications of the COVID vaccine that has impacted vaccine acceptance among the general population. These vaccines were introduced to provide immunity against the SARS-CoV-2 coronavirus and have been found to be quite effective. Little did we know that Bell's palsy could be one of its serious complications. Materials and Methods: We used various search engines to gather data in the form of a case series and case reports related to patients who were affected by the vaccine and had developed Bell's palsy. Results: A total of eleven case reports and 4 case series were included in the analysis. The vaccines mentioned in the case reports were Pfizer, Moderna, Sinovac, AstraZeneca, and Janssen, while the case series included Pfizer and Sinovac. The majority of patients were female and aged between 31-40 years. Rightsided laterality was observed in 45.45% of patients, left-sided laterality in 45.45% of patients, and bilateral laterality in 9.1% of patients. Three patients had a history of Bell's palsy or stroke. After treatment, three patients showed partial improvement, six patients fully recovered, and the status of two patients was unknown. Conclusions: Bell's palsy is a rare complication that can occur after receiving the COVID-19 vaccine. This review aims to increase awareness about this rare adverse event of the vaccine so that it can be properly addressed and managed. Additionally, it will serve as a foundation for future research on the administration of the COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

Copyright of Folia Pharmacologica Japonica is the property of Japanese Pharmacological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Everyone, everywhere, should have access to COVID-19 vaccines. Vaccines are a key strategy to stop escalation of the Coronavirus disease-(COVID-19) pandemic. Vaccine Myths and hesitancy can be due to lack of knowledge, false beliefs, or anti-vaccine misinformation. Unfortunately, there has been a lot of deception surrounding vaccines and their development. When deciding whether to get vaccine, it’s important to separate myths from facts. Objectives: To determine the myths regarding Covid-19 vaccine among adults. Materials and Methods: A community based cross sectional study was done for three months among adults of an urban area. Data regarding sociodemographic details and myths pertaining to Covid-19 vaccine were collected and entered in Microsoft excel and presented as frequencies and percentages. Results: 193 adults took part in study. Maximum were aged 32-38years, 80% were literates and majority of them were males. Residing in nuclear families was common. The most common myths were related to vaccine having an effect on woman’s fertility (47.67%), side effects due to vaccine (56.99%) and not requiring vaccine if already infected with Covid-19 (55.95%) and researchers rushed the development of covid-19 vaccine which makes it not trustworthy (43.52%). Majority of the study participants considered vaccines can be developed for common cold, HIV and other diseases. Conclusion: The circumstances in different parts of world varies and while vaccines may be very effective at reducing number of people getting infected, they cannot assure cent percent protection, since virus can mutate for new variants. Ending vaccination myths may also takes some time but at least can be lessened significantly if there is enough effort and collaboration from everyone. [ABSTRACT FROM AUTHOR]

This study addresses the issue of how to set a consumer price of a vaccination against an infectious disease. We especially focus on the effects of strategic behaviors of individuals within a social group. In characterizing an equilibrium level of vaccination rate, the spill-over effect of vaccination is important not only in the light of group efficiency but also from each individual's viewpoint. By constructing a simple game-theoretic model under the Nash conjecture where individuals rationally predict the resulting vaccination rate based on their own information, we analyze how the efficient vaccination subsidy is related to epidemiological as well as economic variables. In particular, we show that individuals over-react to the changes in their expectations over the virulency of a disease and also over the scale of adverse effects of vaccinations. We also discuss the necessary adjustment of a vaccination price when the public have misperception over certain epidemiological parameters. [ABSTRACT FROM AUTHOR]

The emergence of the COVID-19 pandemic has led to the rapid and worldwide development and investigation of multiple vaccines. While most side effects of these vaccines are mild and transient, potentially severe adverse events may occur and involve the endocrine system. This narrative review aimed to explore the current knowledge on potential adverse endocrine effects following COVID-19 vaccination, with thyroid disorders being the most common. Data about pituitary, adrenal, diabetes, and gonadal events are also reviewed. This review also provides a comprehensive understanding of the pathogenesis of endocrine disorders associated with SARS-CoV-2 vaccines. PubMed/MEDLINE, Embase database (Elsevier), and Google Scholar searches were performed. Case reports, case series, original studies, and reviews written in English and published online up to 31 August 2023 were selected and reviewed. Data on endocrine adverse events of SARS-CoV-2 vaccines are accumulating. However, their causal relationship with COVID-19 vaccines is not strong enough to make a definite conclusion, and further studies are needed to clarify the pathogenesis mechanisms of the endocrine disorders linked to COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Background and Aims: There has been hesitancy among people with regard to accepting vaccines, especially that of coronavirus disease‐2019 (COVID‐19). This hesitancy is aggravated by the different vaccine alternatives available and what one considers before choosing a particular vaccine. The aim of this article was to investigate some driving factors that can influence an individual's COVID‐19 vaccine preference in the presence of other alternatives, using some specific vaccine characteristics. Methods: Discrete choice questionnaire was designed using the attributes and their corresponding levels to collect data on participants' preference for a COVID vaccine over a period of 12 Weeks in Sunyani, Ghana, with the help of an observational study design. A total of 150 participants receiving Covid‐19 vaccines at the University of Energy and Natural Resources Hospital were systematically selected and interviewed. Factors considered included: Efficacy of the vaccine, credibility of the manufacturing company, side effects of the vaccine, and availability of the vaccine. Data was analyzed using the conditional probit of the discrete choice experiment (DCE). Results: Results from the study using the conditional probit of the discrete choice experiment (DCE) showed efficacy, side effects, and availability as significant attributes for preference. However, there was no preference with respect to the credibility of the manufacturing company. In addition, vaccine availability was not a dis‐utility in comparison to the alternatives that are readily available. This disutility was however higher among males than females. Conclusion: From the study, most respondents preferred a COVID‐19 vaccine that is highly efficacious or a vaccine with milder side effect or a vaccine that may not necessarily be readily available. It was also observed that dis‐utility is higher among males when it comes to vaccine not being readily available than females as the odds of a female choosing a vaccine that is readily available is much higher compared to their males counterparts. [ABSTRACT FROM AUTHOR]

This study aimed to explore the type and severity of short-term adverse reactions associated with BNT162 (Pfizer-BioNTech), mRNA 1273 (Moderna), and viral vector vaccines and to compare the incidence of post-vaccination Covid-19 infection among the Birzeit University community in Palestine. Methods: This questionnaire-based retrospective cross-sectional study was conducted among individuals who were vaccinated with at least one dose of any COVID-19 vaccine offered in Palestine during the COVID-19 pandemic. The study included participants aged 18 years and older who were vaccinated with Pfizer, Moderna, Sputnik Light, or Sputnik v. Results: A total of 558 participants who were administered COVID-19 vaccine were included in the study. Sputnik (239), Pfizer vaccine recipients (236), and Moderna vaccine recipients (83). Of the viral vector vaccine recipients, 57 (23.8%) had a post-vaccination infection, compared to 30 (12.7%) for Pfizer and seven (8.4%) for Moderna. Furthermore, the reported adverse effects in the viral victor group were higher than those in the Moderna and Pfizer groups (71.7, 66.3, and 61.9%, respectively). Chills, headache, fatigue, abdominal pain, and joint pain were significantly higher in the Viral Vector vaccine group than the Moderna and Pfizer vaccine. Vomiting, tiredness, and fatigue were significantly less likely to be complained of by Pfizer vaccine recipients compared to Moderna and Viral Vector vaccine recipients (p < 0.05). Conclusions: Breakthrough infections were associated with both viral vectors and mRNA; however, the mRNA vaccine had less reported post-vaccine infection. Furthermore, the Pfizer/BioNTech COVID-19 vaccine group reported fewer commonly reported side effects (fever, chills, headache, fatigue, muscle pain, joint pain, nausea, and dizziness), followed by the Moderna and viral vector vaccines. Females and underweight participants experienced more adverse effects with both vaccines, and fewer common side effects were reported by all participants. [ABSTRACT FROM AUTHOR]

Introduction: Vaccination hesitancy is an important barrier to vaccination among IBD patients. The development of adverse events is the main concern reported. The purpose of this monocentric study was to assess SARS-CoV-2 vaccination safety in IBD patients by evaluating the postvaccination flare risk and incidence of overall adverse events. Methods: Surveys were handed out on three consecutive months to each patient presenting at the Crohn-Colitis Centre, where they documented their vaccination status and any side effects experienced after vaccination. Dates of flares occurring in 2021 were recorded from their electronic medical records. Baseline and IBD characteristics and flare incidence were compared between the vaccinated and unvaccinated patients, and among the vaccinated population before and after their vaccination doses. The characteristics of patients who developed side effects and of those who did not were compared. Results: We enrolled 396 IBD patients, of whom 91% were vaccinated. The proportion of patients who experienced flares was statistically not different between the vaccinated and the unvaccinated population (1.8 vs 2.6 flares per 100 person-months (p=0.28)). Among vaccinated patients, there was no difference across the prevaccination, 1month post any vaccination, and more than 1month after any vaccination periods, and between the Spikevax and Cominarty subgroups. Overall, 46% of patients reported vaccination side effects, mostly mild flu-like symptoms. Conclusion: SARS-CoV-2 vaccination with mRNA vaccines seems safe, with mostly mild side effects. The IBD flare risk is not increased in the month following any vaccination. [ABSTRACT FROM AUTHOR]

Being injured during vaccination, although infrequent, can occur, and this necessitates understanding the consequences of vaccine injuries. In this study, we analyse the impact of the risk of vaccine injuries, particularly the economic importance of vaccine injury compensation insurance (VICI) programmes for the injured, which few studies have investigated. Specifically, we examine the role of VICI on individuals' vaccination decisions by integrating an imperfect vaccine into an epidemiological‐economic model in the presence and absence of such an insurance mechanism. Our findings show that the risk of being injured is a non‐negligible risk that lowers individuals' incentives to be vaccinated. The introduction of VICI largely alleviates decision‐makers' concern about vaccine injury. Furthermore, our extended discussion shows the effect of insurance in encouraging vaccination persists under some more sophisticated scenarios. [ABSTRACT FROM AUTHOR]

Introduction: Studies on the effect of vaccine type and two other vaccines other than inactivated vaccines approved in China on in vitro fertilization (IVF) pregnancy outcomes are rare. To complement and confirm the existing findings, this research aimed to investigate whether there are adverse effects of different vaccine types in females and males on reproductive function and clinical pregnancy. Methods: This retrospective study enrolled 6,455 fresh embryo transfer cycles at the First Affiliated Hospital of Zhengzhou University between May 1, 2021, and October 31, 2022. The primary outcome is the clinical pregnancy rate (CPR). At the same time, the secondary results are the number of oocytes retrieved, two pronuclei (2PN) rate, blastocyst formation rate, high-quality blastocyst rate, and semen parameters (volume, density, sperm count, forward motility rate, total motility rate, immobility rate, and DNA fragment index (DFI) rate). Results: In the comparison of ovarian stimulation indicators, no statistically significant differences (P > 0.05) were found in Gn days, endometrial thickness, 2PN rate, metaphase 2 (MII) rate, high-quality embryo rate, and blastocyst formation rate. No significant differences (P>0.05) were found in age, body mass index (BMI), education level, and semen parameters (volume, density, sperm count, forward motility rate, total motility rate, immobility rate, and DFI rate) in these four groups. The multivariate regression model showed that neither the types of vaccines nor the vaccination status of both infertile couples significantly affected clinical pregnancy. Discussion: The type of vaccine does not appear to have an unfavorable effect on ovarian stimulation, embryo development, semen parameters, and clinical pregnancy. [ABSTRACT FROM AUTHOR]

The propensity to accept vaccines and factors that affect vaccine acceptance and hesitancy will determine the overall success of the COVID-19 vaccination program. Therefore, countries need to understand the factors that influence vaccine acceptance and hesitancy to prevent further future shocks, and it is necessary to have a thorough understanding of these factors. As a result, this study aims to review selected published works in the study's domain and conduct valuable analysis to determine the most influential factors in COVID-19 vaccine acceptance and hesitancy in Ghana. The review also explored the acceptance rate of COVID-19 vaccines in Ghana. We selected published works from 2021 to April 2023 and extracted, analyzed, and summarized the findings based on the key factors that influence COVID-19 vaccine acceptance and hesitancy in Ghana, the acceptance rate in Ghana, the demographic factors that are often examined, and the study approach used to examine these factors. The study found that positive vaccination perception, safety, belief in vaccine efficacy, knowledge of COVID-19, and a good vaccine attitude influence COVID-19 vaccine acceptance in Ghana. The negative side effects of the vaccines, mistrust in the vaccine, lack of confidence in the vaccine's safety, fear, and spiritual and religious beliefs all played significant roles in influencing COVID-19 vaccine hesitancy. For this study, the COVID-19 acceptance rates observed in the reviewed articles ranged from 17.5% to 82.6%. The demographic parameters frequently included in these studies that have a significant impact include educational attainment, gender, religious affiliation, age, and marital status. The positive perceptions of the COVID-19 vaccine and concerns about its negative effects influenced Ghanaians' acceptance and hesitancy. [ABSTRACT FROM AUTHOR]