International School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Zabludowicz Center for autoimmune diseases, Sheba Medical Center, Ramat-Gan, Israel.
Front Immunol. 2022 Jul 5;13:872683. doi: 10.3389/fimmu.2022.872683. eCollection 2022.
Despite their proven efficacy and huge contribution to the health of humankind, vaccines continue to be a source of concern for some individuals around the world. Vaccinations against COVID-19 increased the number of distressed people and intensified their distrust, particularly as the pandemic was still emerging and the populations were encouraged to be vaccinated under various slogans like "back to normal life" and "stop coronavirus", goals which are still to be achieved. As fear of vaccination-related adverse events following immunization (AEFIs) is the main reason for vaccine hesitancy, we reviewed immune and autoimmune AEFIs in particular, though very rare, as the most worrisome aspect of the vaccines. Among others, autoimmune AEFIs of the most commonly administered COVID-19 vaccines include neurological ones such as Guillain-Barre syndrome, transverse myelitis, and Bell's palsy, as well as myocarditis. In addition, the newly introduced notion related to COVID-19 vaccines, "vaccine-induced immune thrombotic thrombocytopenia/vaccine-induced prothrombotic immune thrombotic thrombocytopenia" (VITT/VIPITT)", is of importance as well. Overviewing recent medical literature while focusing on the major immune and autoimmune AEFIs, demonstrating their rate of occurrence, presenting the cases reported, and their link to the specific type of COVID-19 vaccines represented the main aim of our work. In this narrative review, we illustrate the different vaccine types in current use, their associated immune and autoimmune AEFIs, with a focus on the 3 main COVID-19 vaccines (BNT162b2, mRNA-1273, and ChAdOx1). While the rate of AEFIs is extremely low, addressing the issue in this manner, in our opinion, is the best strategy for coping with vaccine hesitancy.
尽管疫苗已被证实具有疗效，并为人类健康做出了巨大贡献，但它们仍然是全球一些人关注的焦点。针对 COVID-19 的疫苗接种增加了感到不适的人数，并加剧了他们的不信任，尤其是在大流行仍在出现的情况下，人们被鼓励接种各种口号下的疫苗，如“恢复正常生活”和“阻止冠状病毒”，这些目标仍有待实现。由于对疫苗接种后不良反应（AEFI）的恐惧是疫苗犹豫的主要原因，我们特别审查了免疫和自身免疫性 AEFI，尽管非常罕见，但它们是疫苗最令人担忧的方面。在其他方面，最常接种的 COVID-19 疫苗的自身免疫性 AEFI 包括神经学方面，如格林-巴利综合征、横贯性脊髓炎和贝尔氏麻痹，以及心肌炎。此外，与 COVID-19 疫苗相关的新概念“疫苗诱导的免疫性血栓性血小板减少症/疫苗诱导的促血栓形成免疫性血小板减少症”（VITT/VIPITT）也很重要。我们综述了最近的医学文献，重点关注主要的免疫和自身免疫性 AEFI，展示它们的发生率，报告的病例及其与特定类型的 COVID-19 疫苗的关系，这是我们工作的主要目的。在这篇叙述性综述中，我们展示了当前使用的不同疫苗类型及其相关的免疫和自身免疫性 AEFI，重点介绍了 3 种主要的 COVID-19 疫苗（BNT162b2、mRNA-1273 和 ChAdOx1）。虽然 AEFI 的发生率极低，但我们认为，以这种方式解决这个问题是应对疫苗犹豫的最佳策略。
