Haematological changes and adverse events associated with <scp>BNT162b2 mRNA COVID</scp>‐19 vaccine in patients receiving clozapine—Findings from an audit

Lim, Shuli; Liew, Emily; Leo, Amy; Ng, Boon Tat; Lee, Jimmy

doi:10.1111/acps.13443

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…A total of 12 articles met the inclusion and exclusion criteria for this rapid review. Eight articles were case reports, [16][17][18][19][20][21][22][23] 3 were prospective observational studies, 5,24,25 and 1 was a cross-sectional study. 26 The PRISM diagram is included in the Supplementary Materials (Supplemental Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Imai et al noted leukopenia and neutropenia after the first dose of the Pfizer vaccine. 17 After the second dose with a recurrence of decreased WBC and neutrophil counts, they decided to Hansbauer 16 Case study 1 35 M Imai 17 Case study 1 44 F Kersting 18 Case study 1 27 M Knöchel 19 Case study 1 42 M Lim 25 Prospective observational study 121 N/A N/A Makhlouf 20 Case study 1 62 M Moga 26 Cross-sectional study 49 clozapine subjects Mean age = 51.51 42.9% F, 57.1% M Takaki 21 Case study 1 45 F Thompson 22 Case study 1 51 M Tomita 23 Case study 2 20; 22 F Veerman 5 Prospective Takaki et al also noted a decrease in WBC and neutrophil counts after each of the 2 doses of vaccination. 21 They monitored the subjects with close lab monitoring and did not have to adjust clozapine dosing.…”

Section: Effects Of Covid-19 Vaccine Dosesmentioning

confidence: 99%

“…In the prospective studies, hematologic parameters and blood levels were reported, but no specific actions were mentioned. 5,25 Leukopenia was the most commonly mentioned adverse effect after the first dose, affecting seven subjects. This adverse effect persisted in 8 subjects after the second dose.…”

Section: Effects Of Covid-19 Vaccine Dosesmentioning

confidence: 99%

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A Rapid Review of the Effects of the COVID-19 Vaccine Among Individuals Taking Clozapine

Das,

Sawyer,

Bagla

2024

J Clin Psychopharmacol

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Background The COVID-19 pandemic prompted the rapid development of vaccines to combat the virus. Several COVID-19 vaccines have proven effective in preventing infection, hospitalization, and death. Vaccination has been especially recommended for vulnerable populations, such as individuals with psychiatric illnesses who face increased risks due to comorbidities and socioeconomic factors. This rapid review identifies and analyzes the effects of COVID-19 vaccines among individuals taking clozapine. Methods The review included articles from PubMed, OVID, Clinical Key, Web of Science, and Google Scholar, published between September 2020 and December 2023. Inclusion criteria were peer-reviewed journals, English language, patients on clozapine receiving a COVID-19 vaccine, and documented vaccine-related adverse effects. Results Twelve articles were included, consisting of 8 case reports, 1 cross-sectional study, and 3 prospective observational studies, involving 298 subjects, with 9 subjects from case reports. After the first vaccine dose, 27 of 248 subjects experienced adverse effects, with 1 case report advising a temporary halt and dose reduction of clozapine. The subject in this case was admitted in a delirious state 4 days after vaccination with repeated falls and urinary incontinence; active infectious and neurologic etiologies were ruled out. Second dose data were available for 261 subjects, with 31 reporting adverse effects. Adverse effects included hematological changes, delirious state, seizures, and fever. Conclusions The review suggests that individuals on clozapine receiving COVID-19 vaccines may experience adverse effects. Clozapine levels and immune system interactions should be monitored in these cases.

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Section: Resultsmentioning

confidence: 99%

Section: Effects Of Covid-19 Vaccine Dosesmentioning

confidence: 99%

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A Rapid Review of the Effects of the COVID-19 Vaccine Among Individuals Taking Clozapine

Das,

Sawyer,

Bagla

2024

J Clin Psychopharmacol

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“…In addition, there is no consistent evidence of additional risk for hematological adverse events in patients treated with clozapine after COVID-19 vaccination. 47…”

Section: Introductionmentioning

confidence: 99%

Outcome of COVID-19 mRNA Vaccination in Patients Treated With Clozapine WHO Previously Went Through SARS-COV-2 Infection

Moga

Petric

Miron

et al. 2023

American Journal of Therapeutics

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Background: The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had multiple consequences for the health care system, especially for patients with mental illnesses. Schizophrenia patients particularly appear to have a higher risk of complications due to coronavirus-19 . Clozapine remains the gold standard for treatment-resistant schizophrenia (TRS). However, the COVID-19 pandemic had an important negative impact on clozapine treatment, mainly because of its administration protocol, which was very difficult to follow during the restrictions imposed in the pandemic, and its side effects in patients with COVID-19 infection. Vaccination is an effective method of avoiding SARS-CoV-2 infection or its severe complications, especially in susceptible populations. Data on adverse events after vaccination against COVID-19 are limited, both in the general population and in schizophrenia patients.Study Question: The study aimed to investigate the safety of COVID-19 vaccination in patients treated with clozapine for hematological parameters. Study Design:We conducted an analytical cross-sectional study between July 1, 2021, and June 30, 2022. We compared 2 groups of COVID-19 vaccinated patients who had previously experienced SARS-CoV-2 infection: The first group was treated with clozapine, whereas the second group was treated with other antipsychotics.Measures and outcomes: The primary objective was to identify granulocytopenia, leukocytopenia, and lymphocytopenia. The results were measured after the second dose of the Pfizer-BioNTech vaccine.

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Vaccination and clozapine use: a systematic review and an analysis of the VAERS database

Aksar,

Lutz,

Wagner

et al. 2024

Eur Arch Psychiatry Clin Neurosci

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Haematological changes and adverse events associated with BNT162b2 mRNA COVID‐19 vaccine in patients receiving clozapine—Findings from an audit

Cited by 6 publications

References 7 publications

A Rapid Review of the Effects of the COVID-19 Vaccine Among Individuals Taking Clozapine

A Rapid Review of the Effects of the COVID-19 Vaccine Among Individuals Taking Clozapine

Outcome of COVID-19 mRNA Vaccination in Patients Treated With Clozapine WHO Previously Went Through SARS-COV-2 Infection

Vaccination and clozapine use: a systematic review and an analysis of the VAERS database

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