RESUMEN
BACKGROUND: The working methods of the Standing Committee on Vaccination (STIKO) and its recommendations are only partially known by medical professionals and the public. OBJECTIVES: Methodology of the standard operating procedure of the STIKO, annual vaccination recommendations, normal vaccination reaction versus vaccination side effects, instructions for vaccination in case of immunodeficiency, and recommendation for COVID-19 vaccination are presented. MATERIALS AND METHODS: Presentation of the path to a vaccination recommendation, differences between recommendations and instructions for action, key statements on vaccination in immunodeficiency, and summary of the data situation on COVID-19 mRNA vaccination. RESULTS: The STIKO works purely on an evidence-based basis by systematically evaluating the existing preclinical and clinical studies results for a vaccine using the GRADE method. Only vaccination complications and vaccination injuries are notifiable. Immunodeficient patients can receive inactivated vaccines at any time, but generally not live vaccines. Based on current knowledge, the COVID-19 mRNA vaccination can be described as safe and effective. CONCLUSIONS: The STIKO vaccination recommendations are considered as the medical standard. The published current instructions for vaccination of immunodeficient patients and the recently published recommendation for COVID-19 vaccination, together with their scientific backgrounds and reasons, represent a valuable basis for medical action in the field of vaccination against infectious diseases.
Asunto(s)
COVID-19 , Humanos , SARS-CoV-2 , VacunaciónRESUMEN
A 70-year-old man with previously normal comprehensive blood counts (CBCs) was referred to our hospital for acute thrombocytopenia. Following a negative workup for secondary causes, we diagnosed immune thrombocytopenia (ITP). Aside from the influenza vaccine administered six days before presentation, there was no discernable precipitant on history. His only risk factor for ITP was untreated Helicobacter ââââââpylori diagnosed over two months prior. With treatment, the patient's platelets normalized within three days. ITP following influenza vaccination has been documented in the literature and reported to regulatory bodies. Our case indicates that individuals with untreated H. pylori infection might be particularly vulnerable to such occurrences.
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Since the end of December 2020, it has been possible to vaccinate against COVID-19. Our aim was to evaluate and compare the effectiveness of the vaccines available at the time of the mass vaccination program in Poland and also to look into the most common adverse side effects. Patients' anti-SARS-CoV-2 antibodies levels were checked before vaccination and after the first and after the second/last dose by the anti-SARS-CoV-2 QuantiVac ELISA (IgG) (EUROIMMUN MedicinischeLabordiagnostica AG; Luebeck; Germany) test. Before each blood collection, all patients filled out a questionnaire regarding experienced side effects. We observed that 100% of patients responded to the vaccinations. After the first dose, convalescents had much higher levels of anti-SARS-CoV-2 antibodies than naive patients, although after the second dose, 61 out of 162 convalescents (37.7%) had lower results than before. The comparison of immunological responses in the convalescents group after the first dose and in the naive group after the second dose showed that convalescents had higher antibody titers, which may suggest the possibility of changing the vaccination schedule for convalescents. The highest antibody titers after both the first and second doses were observed after Moderna shots. Fever was identified as a significant factor regarding higher levels of antibodies after the first and second doses of the vaccine.
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Multiple sclerosis (MS) is an autoimmune disease in which the body's immune system destroys myelin causing disruption of signals from the brain to the rest of the body. MS can be triggered by a variety of reasons. In this study, we present the case of a patient who developed neurological symptoms immediately (one day) after receiving the hepatitis B vaccine. The temporality of symptoms makes us question whether there is an association between the hepatitis B vaccine and MS. We would like to emphasize the importance of considering MS as a side effect of the hepatitis B vaccine and adding MS to the differential diagnosis of a patient who presents with neurological symptoms after receiving the hepatitis B vaccine.