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伊朗多发性硬化症患者对国药集团中国生物北京生物制品研究所有限责任公司新冠病毒灭活疫苗(BBIBP-CorV)自我报告的安全性

Self-Reported safety of the BBIBP-CorV (Sinopharm) COVID-19 vaccine among Iranian people with multiple sclerosis.

作者信息

Etemadifar Masoud, Abhari Amir Parsa, Nouri Hosein, Sigari Amirhossein Akhavan, Piran Daliyeh Seyed Mohammad, Maracy Mohammad Reza, Salari Mehri, Maleki Shiva, Sedaghat Nahad

机构信息

Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Alzahra Research Institute, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Hum Vaccin Immunother. 2022 Dec 31;18(1):2041945. doi: 10.1080/21645515.2022.2041945. Epub 2022 Feb 24.

Abstract

To affirm the short-term safety of the BBIBP-CorV (Sinopharm) COVID-19 vaccine among people with multiple sclerosis (pwMS), 517 vaccinated and 174 unvaccinated pwMS were interviewed. 16.2% of the vaccinated pwMS reported at least one neurological symptom in their respective vaccine-related at-risk periods (ARP) - a period from the first dose until two weeks after the second dose of the vaccine. In a multivariable logistic regression model, the presence of comorbidities ( = 0.01), use of natalizumab ( = 0.03), and experiencing post-vaccination myalgia ( < 0.01) predicted the development of post-vaccination neurological symptoms. One MS relapse, one COVID-19 contraction, and one ulcerative colitis flare after the first dose, and four MS relapses after the second dose of the vaccine were the only reported serious adverse events during the ARPs. To show if the vaccine provoked MS relapses, we compared the relapse rate of vaccinated pwMS in the vaccine-related ARP with the annualized relapse rate of unvaccinated pwMS in the prior year-a measure of baseline MS relapsing activity in the respective time-using a multivariable Poisson regression model accounting for possible confounders, which failed to show any statistically significant increase ( = 0.78). Hence, subject to replication-as the vaccinated and unvaccinated pwMS differed in baseline characteristics-the BBIBP-CorV vaccine does not seem to affect short-term MS activity. Furthermore, as 83.33% of the unvaccinated pwMS reported fear of possible adverse events to be the reason of their vaccination hesitancy, provision of evidence-based consultations to pwMS is encouraged. Limitations of our study briefly included lack of data for self-controlled analysis of relapse rates, possible presence of recall bias, and lack of on-site validations regarding the clinical outcomes due to the remote nature.

摘要

为确认BBIBP-CorV(国药集团)新冠疫苗在多发性硬化症患者(pwMS)中的短期安全性,对517名接种疫苗的pwMS和174名未接种疫苗的pwMS进行了访谈。16.2%的接种疫苗的pwMS在各自与疫苗相关的风险期(ARP)——从第一剂疫苗接种至第二剂疫苗接种后两周期间——报告了至少一种神经症状。在多变量逻辑回归模型中,合并症的存在(P = 0.01)、使用那他珠单抗(P = 0.03)以及接种疫苗后出现肌痛(P < 0.01)可预测接种疫苗后神经症状的发生。在ARP期间,仅报告了1例第一剂疫苗接种后发生的多发性硬化症复发、1例新冠病毒感染、1例溃疡性结肠炎发作以及4例第二剂疫苗接种后发生的多发性硬化症复发,这些是仅有的严重不良事件。为了显示疫苗是否引发了多发性硬化症复发,我们使用多变量泊松回归模型并考虑可能的混杂因素,将接种疫苗的pwMS在与疫苗相关的ARP中的复发率与未接种疫苗的pwMS上一年的年化复发率进行比较——这是各自时间段内基线多发性硬化症复发活动的一种衡量指标,结果未显示出任何统计学上的显著增加(P = 0.78)。因此,有待重复研究——因为接种疫苗和未接种疫苗的pwMS在基线特征方面存在差异——BBIBP-CorV疫苗似乎不会影响短期的多发性硬化症活动。此外,由于83.33%未接种疫苗的pwMS报告称担心可能的不良事件是其犹豫接种疫苗的原因,因此鼓励为pwMS提供基于证据的咨询。我们研究的局限性简要包括缺乏用于复发率自我对照分析的数据、可能存在回忆偏倚以及由于研究的远程性质而缺乏对临床结局的现场验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e5b/9009900/732841450c44/KHVI_A_2041945_F0001_OC.jpg

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