Risk–benefit analysis of COVID-19 vaccines — a neurological perspective

Lau, Colleen L.; Galea, Ian

doi:10.1038/s41582-021-00606-5

Cited by 13 publications

(10 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In phase III clinical trial of the ChAdOx1-nCov-19 vector vaccine, a few cases of transverse myelitis were reported (O'Reilly, 2020; Voysey et al, 2021). Moreover, Serious neurological disorders were reported following different mRNA-based vaccination including transverse myelitis, Guillain-Barré syndrome, cranial nerve neuropathies, myelitis, and facial nerve palsy (García-Grimshaw et al, 2021;Lau & Galea, 2022;Malhotra et al, 2021;Michalik et al, 2022;Wan et al, 2022). A study reviewing case reports and case series reported the occurrence of variable central and peripheral nervous system complications in patients receiving gene-based vaccines including transverse myelitis, Guillain-Barré syndrome, and cerebral venous sinus thrombosis (Sriwastava et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

A Case Report: Multifocal Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against Covid-19

Mörz¹

2022

Preprint

View full text Add to dashboard Cite

The current report represents a case of a 77-year-old man with Parkinson’s disease who died three weeks after receiving his third COVID-19 vaccination in January 2022. The patient was first vaccinated in May 2021 with the ChAdOx1 nCov- 19 vector vaccine, followed by two more doses with the BNT162b2 mRNA vaccine in July and December 2021. The family of the deceased requested an autopsy due to the ambivalent clinical features noted before death. The underlying illness (Parkinson’s disease) was confirmed by autopsy. However, no sign of a florid COVID-19 was discovered. Meanwhile, the immunohistochemical staining of the brain and heart revealed previously undiagnosed conditions. The brain, in distinctive, revealed multifocal necrotizing encephalitis with massive inflammatory lymphocyte infiltrates. In addition, the heart showed signs of serious myocarditis. Finally, immunohistochemical staining revealed that the SARS-CoV-2 spike protein was evident in the tissues investigated. Based on these immunohistochemical findings, it appears that the inflammatory changes in the patient's brain tissues are most likely the result of immunological processes. Concurrently, the absence of SARS-CoV-2 nucleocapsid-protein was evidenced, indicating that the detected spike-protein is unrelated to a SARS-CoV-2 infection. If such an infection was the cause of the spike protein, the SARS-CoV-2 nucleocapsid protein would also be detectable. As a consequence, the confirmed presence of the spike protein had to be attributed to the previous vaccination with the BNT162b2 mRNA vaccine that the deceased patient had received.

show abstract

Section: Discussionmentioning

confidence: 99%

A Case Report: Multifocal Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against Covid-19

Mörz¹

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…223 Nevertheless, the incidence of anaphylaxis-associated with COVID-19 vaccines is comparable to that of other vaccines 246 and the benefits may outweigh the potential risks of COVID-19 vaccinations. 247,248 Unfortunately, the fear of an allergic reaction has caused vaccine hesitancy in the general public, haltering global vaccination efforts. 249 Polyethylene glycol (PEG) is an additive present in the Pfizer-BioNtech and Moderna mRNA vaccines used to prevent premature degradation of the nanoparticless, 250 and it has been suggested to be the major culprit for anaphylaxis to COVID-19 vaccines.…”

Section: Allergic Reactions To Covid-19 Vaccinesmentioning

confidence: 99%

Recent developments in the immunopathology of COVID‐19

Zhang

Sun

Wang

et al. 2022

Allergy

View full text Add to dashboard Cite

There has been an important change in the clinical characteristics and immune profile of Coronavirus disease 2019 patients during the pandemic thanks to the extensive vaccination programs. Here, we highlight recent studies on COVID-19, from the clinical and immunological characteristics to the protective and risk factors for severity and mortality of COVID-19. The efficacy of the COVID-19 vaccines and potential allergic reactions after administration are also discussed. The occurrence of new variants of concerns such as Omicron BA.2, BA.4, and BA.5 and the global administration of COVID-19 vaccines have changed the clinical scenario of COVID-19. Multisystem inflammatory syndrome in children (MIS-C) may cause severe and heterogeneous disease but with a lower mortality rate. Perturbations in immunity of T cells, B cells, and mast cells, as well as autoantibodies and metabolic reprogramming may contribute to the long-term symptoms of COVID-19. There is conflicting evidence about whether atopic diseases, such as allergic asthma and rhinitis, are associated with a lower susceptibility and better outcomes of COVID-19. At the beginning of pandemic, the European Academy of Allergy and Clinical Immunology (EAACI) developed guidelines that provided timely information for the management of allergic diseases and preventive measures to reduce transmission in the allergic clinics. The global distribution of COVID-19 vaccines and emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with reduced pathogenic potential dramatically decreased the morbidity, severity, and mortality of COVID-19. Nevertheless, breakthrough infection remains a challenge for disease control. Hypersensitivity reactions (HSR) to COVID-19 vaccines are low compared to other vaccines, and these were addressed in EAACI statements that provided indications for the management of allergic reactions, including anaphylaxis to COVID-19 vaccines. We have gained a depth knowledge and experience in the over 2 years since the start of the pandemic, and yet a full eradication of SARS-CoV-2 is not on the horizon. Novel strategies are warranted to prevent severe disease in high-risk groups, the development of MIS-C and long COVID-19.

show abstract

“…However, the seriousness of VITT from a risk-benefit perspective of COVID-19 vaccines is of relevance 6 . The risk of developing VITT is small (1 case per 26 500 to 127,300 after the first vaccine dose 7 ), while the risk of COVID-19 infection is still highly significant worldwide, having caused millions of deaths and huge morbidity, and social economic damage around the globe.…”

Section: Introductionmentioning

confidence: 99%

NETosis and thrombosis in vaccine-induced immune thrombotic thrombocytopenia

et al. 2022

View full text Add to dashboard Cite

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare yet serious adverse effect of the adenoviral vector vaccines ChAdOx1 nCoV-19 (AstraZeneca) and Ad26.COV2.S (Janssen) against COVID-19. The mechanisms involved in clot formation and thrombocytopenia in VITT are yet to be fully determined. Here we show neutrophils undergoing NETosis and confirm expression markers of NETs in VITT patients. VITT antibodies directly stimulate neutrophils to release NETs and induce thrombus formation containing abundant platelets, neutrophils, fibrin, extracellular DNA and citrullinated histone H3 in a flow microfluidics system and in vivo. Inhibition of NETosis prevents VITT-induced thrombosis in mice but not thrombocytopenia. In contrast, in vivo blockage of FcγRIIa abrogates both thrombosis and thrombocytopenia suggesting these are distinct processes. Our findings indicate that anti-PF4 antibodies activate blood cells via FcγRIIa and are responsible for thrombosis and thrombocytopenia in VITT. Future development of NETosis and FcγRIIa inhibitors are needed to treat VITT and similar immune thrombotic thrombocytopenia conditions more effectively, leading to better patient outcomes.

show abstract

Risk–benefit analysis of COVID-19 vaccines — a neurological perspective

Cited by 13 publications

References 10 publications

A Case Report: Multifocal Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against Covid-19

A Case Report: Multifocal Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against Covid-19

Recent developments in the immunopathology of COVID‐19

NETosis and thrombosis in vaccine-induced immune thrombotic thrombocytopenia

Contact Info

Product

Resources

About