Introduction: Safe and efficacious vaccines against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), would contribute to contain the COVID-19 pandemic. In this study, we examined this question that if there is an association between the incidence of side effects and the COVID-19 breakthrough infections. Material and Methods: This descriptive-analytical cross-sectional study was conducted for two months from June 22 to August 22, 2021. The study method was complete enumeration and 1474 healthcare workers who were medical staff of seven hospitals in Tehran and were vaccinated with one of the AstraZeneca, Covaxin, Sputnik V, and Sinopharm vaccines. Two main questions of this questionnaire were the occurrence or non-occurrence of any side effects after receiving the vaccines and the presence or absence of COVID-19 infection after vaccination. Results: According to the results obtained, in recipients vaccinated with Sinopharm vaccine, the group that reported at least one side effects after receiving the vaccine had a significantly higher COVID-19 infection than the group reported no side effects after vaccination (P<0.001) (RR=4.55). Also in whole sample study Participants who have reported one or more side effect after COVID-19 vaccination, had 3.7 times higher risk of breakthrough infection than others (P<0.001); However Among those vaccinated with AstraZeneca, Covaxin and Sputnik vaccines, no significant difference was observed between the groups with and without side effects after vaccination in terms of later COVID-19 infection. Conclusion: It seems that participants who have reported one or more side effect after COVID-19 vaccination, had times higher risk of breakthrough infection than others.

Objectives: This study aimed to compare four COVID-19 vaccines for their potential extensive side effects and the relationship between the side effects and age, body mass index (BMI), and history of COVID-19 infection. Methods: This cross-sectional study was conducted from June to August 2021 among 1474 healthcare workers of seven selected hospitals in Tehran, Iran. All the subjects were vaccinated (91.7% received two doses and 8.3% received one dose) with one of four vaccines, Sputnik, Covaxin, AstraZeneca, and Sinopharm, at least 10 days before the study. The incidence of 47 side effects was measured after vaccination. Results: Over half of the participants (59.4%; n = 876) were 20–29 years of age, with the mean and average BMI being 26.1±9.0 and 23.5±3.4, respectively; 36.0% (n = 530) were previously diagnosed with COVID-19. There was no significant relationship between age and the incidence of side effects for AstraZeneca, Sputnik, and Covaxin; however, the occurrence of side effects of Sinopharm was significantly higher (p < 0.001) among younger healthcare workers. There was no significant relationship between BMI and the incidence of side effects for all four vaccines. However, in the group with a history of COVID-19 disease, health care workers vaccinated with the Sinopharm vaccine showed significantly (p < 0.001) more complications. The occurrence rate of at least one adverse effect and referral to medical centers for AstraZeneca, Sputnik, Covaxin, and Sinopharm vaccines were 24.9–93.9%, 18.2–86.0%, 14.8–77.0%, and 3.5–37.2%, respectively. The highest and lowest rates were found for AstraZeneca and Sinopharm showing a significant (p < 0.001) difference. The most commonly observed side effects for the AstraZeneca vaccine included fever (64.4%), fatigue (62.5%), and muscle pain (59.9%); for Sputnik muscle pain (59.8%), fever (49.5%), and fatigue (49.5%); for Covaxin fever (49.2%), topical reaction (41.0), and fatigue (34.4%); and for Sinopharm fever (18.7%), topical reaction (17.9%), and fatigue (16.6%). Inactivated virus vaccines (Sinopharm and Covaxin) showed a lower (39.7%) occurrence rate of side effects compared to viral vector vaccines (AstraZeneca and Sputnik; 90.6%). The most likely time for the vaccines to exert side effects was the first 24 hours after vaccination. Conclusions: We found no significant relationship between age, BMI, history of COVID-19 disease, and the incidence of side effects in healthcare workers vaccinated with any of the four vaccines. All four vaccines are safe and have controlled side effects.

Background Ulnar longitudinal deficiency (ULD) has been reported to be 1 in 100,000 live birthsCase presentation a 57-year-old healthy man with a fracture of the right medial malleolus was referred to our Orthopedic Center. Upon physical examination, a congenital abnormality in the patient's right upper extremity was observed. It was markedly shortened, pronated, and internally rotated. Radiological investigations revealed radiohumeral synostosis along with a complete absence of ulna and carpal bones, as well as shortened and bowed radius. Besides, only the thumb and the first metacarpal bone were present in the hand, and the wrist deviated towards the ulna. Taking into account the patient’s clinical findingsConclusion it is concluded that he likely falls under type D of Cole and Manske’s classification and type V of Goldfarb’s.

Mycobacterium marinum causes sporadic skin infection. It mostly appears on extremities with erythematous or bluish papule or nodule at the inoculation site, usually after skin abrasions are exposed to contaminated water or fish. A 43-year-old male patient with no prior medical history noticed the appearance of red lesions on the back of his left shoulder 2 years earlier. Various physicians visited the patient and misdiagnosed as contact dermatitis. Physical examination revealed polycyclic livid plaques with irregular hyperkeratosis on the back of his left shoulder. Eventually it was reported he carried a fishing net on his shoulder near the time lesions appeared. So, with suspicion of Mycobacterium marinum, skin biopsies were performed and histopathology showed epidermis with acanthosis and parakeratosis. The dermis showed severe infiltration of neutrophils and lymphoplasma cells with the presence of few giant cells and poorly defined granulomas indicating acute or chronic necrotizing granulomas. Within three weeks of starting treatment with oral clarithromycin, rifampin and co-trimoxazole, signs of improvement began. The manifestation of this disease and its site of involvement in this patient was very rare among previous case reports, so it was considered necessary to be reported.