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主要的严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)疫苗相关不良反应;益处大于风险。

Major severe acute respiratory coronavirus-2 (SARS-CoV-2) vaccine-associated adverse effects; benefits outweigh the risks.

作者信息

Esmaeilzadeh Abdolreza, Maleki Armin Jahani, Moradi Amirhosein, Siahmansouri Amir, Yavari Mohammad Javad, Karami Parsa, Elahi Reza

机构信息

Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran.

Cancer Gene Therapy Research Center (CGRC), Zanjan University of Medical Sciences, Zanjan, Iran.

出版信息

Expert Rev Vaccines. 2022 Oct;21(10):1377-1394. doi: 10.1080/14760584.2022.2116008. Epub 2022 Aug 24.

Abstract

INTRODUCTION

Since its emergence, there have been huge efforts to design vaccines against coronavirus disease 2019 (COVID-19) to inhibit its interpersonal spread. Global vaccine development is the most promising cost-effective method for overcoming the epidemic. However, following reports of post-vaccination thromboembolic adverse effects, there have been raising concerns about the safety profile of the COVID-19 vaccine.

AREAS COVERED

We aimed to review the recent Food and Drug Administration (FDA)-approved vaccines and identify the organ-based major complications of COVID-19 vaccines based on reliable published studies. To find high-quality and large-scale observational, clinical trial, and cohort studies, PubMED, Scholar, Embase, and Web of Science were searched using keywords: COVID-19, SARS-CoV-2, vaccine, Pfizer (BNT162b2), Johnson and Johnson (Ad26.COV2), Moderna (mRNA-1273), Oxford AstraZeneca (ChAdOx1nCoV19), Coronavac (Sinovac), BBIBP-CorV (Sinopharm), adverse effect, and complication. To include all relevant articles, backward searching was also done on similar article citations. Case reports, studies including less than 10 participants, and biased articles were excluded.

EXPERT OPINION

Based on data from high-quality and population-based studies, major adverse effects are divided into four major organ-specific groups, including cardiovascular, neurologic, hematologic, and immune-allergic side effects. The incidence of most of these side effects is not different between vaccinated and normal populations, and currently, the benefits of vaccination against COVID-19 are greater than the mortality and morbidity risks of COVID-19 infection. However, further studies, specifically systematic review and meta-analysis, are still indicated to investigate further unknown side effects of these vaccines and the existence of causality between the vaccine and reported adverse events.

摘要

引言

自2019冠状病毒病(COVID-19)出现以来,人们付出了巨大努力来设计针对它的疫苗,以抑制其人际传播。全球疫苗研发是战胜疫情最有前景且具成本效益的方法。然而,在有接种疫苗后血栓栓塞不良反应的报道后,人们对COVID-19疫苗的安全性越来越担忧。

涵盖领域

我们旨在回顾美国食品药品监督管理局(FDA)近期批准的疫苗,并基于可靠的已发表研究确定COVID-19疫苗基于器官的主要并发症。为了找到高质量和大规模的观察性研究、临床试验和队列研究,我们使用关键词“COVID-19”“严重急性呼吸综合征冠状病毒2(SARS-CoV-2)”“疫苗”“辉瑞(BNT162b2)”“强生(Ad26.COV2)”“莫德纳(mRNA-1273)”“牛津阿斯利康(ChAdOx1nCoV19)”“科兴新冠疫苗(Coronavac)”“国药新冠疫苗(BBIBP-CorV)”“不良反应”和“并发症”在PubMed、谷歌学术、Embase和科学网中进行搜索。为纳入所有相关文章,我们还对类似文章的引用进行了回溯搜索。排除了病例报告、参与者少于10人的研究以及有偏倚的文章。

专家观点

基于高质量和基于人群研究的数据,主要不良反应分为四个主要的器官特异性组,包括心血管、神经、血液和免疫过敏副作用。接种疫苗人群和正常人群中这些副作用大多数的发生率并无差异,目前,接种COVID-19疫苗的益处大于COVID-19感染的死亡和发病风险。然而,仍需要进一步研究,特别是系统评价和荟萃分析,以进一步调查这些疫苗未知的副作用以及疫苗与报告的不良事件之间因果关系的存在情况。

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