García-Alanis Mario, Morales-Cárdenas Marisa, Toapanta-Yanchapaxi Liz Nicole, Chiquete Erwin, Núñez Isaac, Ceballos-Liceaga Santa Elizabeth, Carbajal-Sandoval Guillermo, Toledo-Salinas Carla, Mendoza-Hernández David Alejandro, Scheffler-Mendoza Selma Cecilia, Ortega-Martell José Antonio, Carrillo-García Daniel Armando, Hernández-Valdivia Noé, Gutiérrez-Romero Alonso, Galnares-Olalde Javier Andrés, Flores-Silva Fernando Daniel, Díaz-Ortega José Luis, Reyes-Terán Gustavo, López-Gatell Hugo, Cortes-Alcalá Ricardo, Pérez-Padilla José Rogelio, Arauz Antonio, García-Grimshaw Miguel, Valdés-Ferrer Sergio Iván
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico.
Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico.
Vaccines (Basel). 2022 Aug 11;10(8):1297. doi: 10.3390/vaccines10081297.
Despite the high number of vaccines administered against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide, the information on the psychological/psychiatric adverse events following immunization (AEFI) with these newly developed vaccines remains scarce.
To describe the frequency of psychological/psychiatric symptoms among recipients of five different anti-SARS-CoV-2 vaccines and to explore the factors associated with their development reported in the nationwide Mexican registry of AEFI against SARS-CoV-2.
Descriptive study of all the psychological/psychiatric symptoms, including anxiety, panic attacks, insomnia, and agitation reported to the Mexican Epidemiological Surveillance System from 21 December 2020 to 27 April 2021, among adult (≥18 years old) recipients of 7,812,845 doses of BNT162b2, ChAdOx1 nCov-19, rAd26-rAd5, Ad5-nCoV, or CoronaVac. The factors associated with their development are determined by multivariate regression analysis.
There were 19,163 AEFI reports during the study period; amongst them, 191 (1%) patients had psychological/psychiatric symptoms (median age of 41 years, interquartile range of 32-54; 149 [78%] women) for an observed incidence of 2.44 cases per 100,000 administered doses (95% confidence interval [CI] 2.12-2.82), 72.8% of psychiatric AEFIs were reported among recipients of BNT162b2. The median time from vaccination to symptom onset was 35 min (interquartile range: 10-720). Overall, the most common psychological/psychiatric symptoms were anxiety in 129 (67.5%) patients, panic attacks in 30 (15.7%), insomnia in 25 (13%), and agitation in 11 (5.7%). After adjusting for the confounding factors, the odds for developing psychological/psychiatric symptoms were higher for those concurrently reporting syncope (odds ratio [OR]: 4.73, 95% CI: 1.68-13.33); palpitations (OR: 2.47, 95% CI: 1.65-3.70), and dizziness (OR: 1.59, 95% CI: 1.10-2.28).
In our population, psychological/psychiatric symptoms were extremely infrequent AEFIs. No severe psychiatric AEFIs were reported. Immunization stress-related responses might explain most of the detected cases.
尽管全球范围内针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）接种了大量疫苗，但关于这些新研发疫苗接种后心理/精神方面不良事件（AEFI）的信息仍然匮乏。
描述五种不同抗SARS-CoV-2疫苗接种者中心理/精神症状的发生频率，并探讨墨西哥全国SARS-CoV-2 AEFI登记处报告的与这些症状发生相关的因素。
对2020年12月21日至2021年4月27日期间向墨西哥流行病学监测系统报告的所有心理/精神症状进行描述性研究，这些症状包括焦虑、惊恐发作、失眠和激动，涉及7812845剂BNT162b2、ChAdOx1 nCov-19、rAd26-rAd5、Ad5-nCoV或科兴新冠疫苗的成年（≥18岁）接种者。通过多因素回归分析确定与症状发生相关的因素。
研究期间有19163份AEFI报告；其中，191名（1%）患者出现心理/精神症状（中位年龄41岁，四分位间距32 - 54岁；149名[78%]为女性），观察到的发病率为每100000剂接种量2.44例（95%置信区间[CI] 2.12 - 2.82），72.8%的精神性AEFI报告来自BNT162b2接种者。从接种到症状出现的中位时间为35分钟（四分位间距：10 - 720分钟）。总体而言，最常见的心理/精神症状为129名（67.5%）患者出现焦虑，30名（15.7%）出现惊恐发作，25名（13%）出现失眠，11名（5.7%）出现激动。在对混杂因素进行调整后，同时报告晕厥（优势比[OR]：4.73，95% CI：1.68 - 13.33）、心悸（OR：2.47，95% CI：1.65 - 3.70）和头晕（OR：1.59，95% CI：1.10 - 2.28）的患者出现心理/精神症状的几率更高。
在我们的研究人群中，心理/精神症状是极为罕见的AEFI。未报告严重的精神性AEFI。免疫应激相关反应可能解释了大多数检测到的病例。
