No signal of interactions between influenza vaccines and drugs used for chronic diseases: a case-by-case analysis of the vaccine adverse event reporting system and vigibase

Abstract

The relative paucity of detected interactions does not impact on the benefit of the vaccination against influenza, which remains strongly recommended; this does not exclude that closer monitoring for selected patients exposed to concomitant chronic pharmacological therapies and affected by predisposing factors may be useful.

Influenza Vaccination and Myo-Pericarditis in Patients Receiving Immune Checkpoint Inhibitors: Investigating the Likelihood of Interaction through the Vaccine Adverse Event Reporting System and VigiBase

“…We acknowledge the limitations of our study, mainly inherent to the nature of SRSs data. VAERS and VigiBase ® are subject to reporting bias, including under-and over-reporting of adverse events, although there are not clues for major distortions, considering that serious events such as MP are less prone to under-reporting, and no specific warnings were posted by regulatory agencies, thus minimizing the existence and impact of a stimulated reporting [3,18]. We recognize the potential occurrence of subclinical myocarditis, which may be under-diagnosed/under-detected, and is thus likely to be under-reported.…”

“…ICIs were considered as the objective drugs (i.e., the one affected by the presence of another vaccine/drug), while the influenza vaccine was considered as the precipitant agent (i.e., the one causing a change on the object drug). To avoid overemphasis on the role of the vaccine, the answer to the second question was always "unknown" (knowledge on the mechanism of the interaction is hypothesized and literature data are very scarce/uncertain); in addition, questions 5, 6, and 10 were not assessable/applicable (dechallenge, rechallenge, and dose adjustments are unfeasible for vaccines considering the peculiarities of their administration), as previously performed [3]. The final summary score could reach 10 points.…”

“…However, in the recent past, potential pharmacokinetic interactions have been proposed, considering that vaccines can influence the drug metabolism via inflammatory cytokines [2]. Therefore, potential interactions between influenza vaccines and drugs used for chronic diseases (e.g., immunosuppressive agents) cannot be excluded [3]. Moreover, cases of myo-pericarditis (MP) after immunization, although rarely, are reported [4,5].…”

“…In the recent past, analysis of the spontaneous reporting systems (SRSs) has attracted considerable interest among clinicians for the accurate and timely characterization of drug-and vaccine-related risks occurring in the real world, where comorbidities and polypharmacotherapy exist. By offering a global epidemiological perspective, these pharmacovigilance studies have been pursued to test the hypothesis of potential associations, including refusing the likelihood of interactions [3,16,17], especially for rare, unexpected, and delayed AEs, such as MP.…”

COVID-19-Impfung unter Psychopharmakotherapie

“…Die Erhöhung des Carbamazepinspiegels scheint am ehesten zwischen dem 7. und 14. Tag nach der Impfung aufzutreten 44 , kann sich aber auch bereits in der ersten Woche nach der Impfung oder noch mehrere Wochen danach entwickeln 45 .…”