The Frequency and Patterns of Post-COVID-19 Vaccination Syndrome Reveal Initially Mild and Potentially Immunocytopenic Signs in Primarily Young Saudi Women

Abstract

Vaccination is the most promising approach for ending or containing the SARS-CoV-2 pandemic. However, serious post-COVID-19 vaccine reactions, including immunocytopenia (ITP) syndrome, have been increasingly reported. Several factors cause increased risks including multiple doses, age-dependent heterogeneity in immune-responses, platelet cross-reactions with microbial components, and Long-COVID syndrome. Thus, in the absence of widely available specific therapeutics, vigilance is important while more studies are needed. Using a structured questionnaire sent to different regions in Saudi Arabia, we conducted a comprehensive investigation on the frequency, rates, disease patterns, and patient demographics of post-COVID-19 vaccine side effects on febrile patients after administration three major vaccines. Results indicated that the majority of respondents administered Pfizer BioNtech vaccine (81%, n = 809); followed by AstraZeneca (16%, n = 155); and Moderna (3%, n = 34). Overall 998 participants, 74% (n = 737) showed no serious symptoms; however, 26.2% (n = 261) revealed typical syndromes. In a focused group of 722 participants, the following rates were identified: shortness of breath (20%), bruises or bleeding (18%), inattention (18%), GIT symptoms (17.6%), skin irritation (8.6%), and anosmia and ageusia (8%) were the most prominent among those who showed typical symptoms. The onset time was mostly between 1–3 days in 49% (n = 128), followed by 4–7 days in 21.8% (n = 57), 8–14 days in 16.5% (n = 43), and more than a month in 12.6% (n = 33). The onsets occurred mostly after the first, second, or both doses, 9%, 10%, and 7% of participants, respectively. The frequency of symptoms was significantly higher after Moderna® vaccine (p-value = 0.00006) and it was significantly lower in participants who received Pfizer (p-value = 0.00231). We did not find significant difference in symptoms related to differences in regions. Similarly, the region, age, sex, education, and nationality had no influence on the dose and onset timings. The findings of this study have significant clinical implications in disease management strategies, preventive measures, and vaccine development. Future vertical studies would reveal more insights into the mechanisms of post-COVID-19 vaccine syndrome.

Clinical Approach to Post-acute Sequelae After COVID-19 Infection and Vaccination

“…In this study, the prevalence increased to 83.9% among those who received booster doses [8]. A retrospective cross-sectional study found a post-COVID vaccination syndrome prevalence of 26.2% after COVID-19 vaccination, with higher rates seen in individuals who received Moderna vaccines compared to Pfizer vaccines [9]. These data indicate that post-acute sequelae after COVID-19 vaccination are clinically relevant; however, more research is required to find the true incidence and prevalence.…”

Acute epistaxis on male patient after covid vaccination by the Pfizer-BioNTech COVID-19 vaccine : Case report

“…ITP cases per 100,000 persons were 3.3, while the reporting rate for thrombocytopenia for both vaccines was 0.80. (Said K.B et al,2022).…”

“…Given our findings, it is reasonable to complete immunisation while closely monitoring CBC to detect a platelet fall as soon as feasible. (Said K.B et al,2022).…”

Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination

“…Recent findings suggest that a vaccination before an infection confers only a partial protection against PASC. In addition, new data have been published that show that the SARS-CoV-2 vaccination may cause PASC [ 5 ].…”