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1.
Rev. esp. patol ; 57(1): 42-47, ene.-mar. 2024. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-EMG-539

RESUMO

Subsequent to mass vaccination programs against COVID-19, diverse side effects have been described, both at the injection site, such as pain, redness and swelling, and systemic effects such as fatigue, headache, muscle or joint pain. On rare occasions, a lymphadenopathic syndrome may develop, raising the clinical suspicion of a lymphoproliferative disorder. We present the case of a 30-year-old woman who developed self-limiting left axillary lymphadenopathy following COVID-19 vaccination. To date, only seven similar cases with a complete clinicopathological description have been published, and fourteen cases have been notified to the European adverse events databases (Eudravigilance) in relationship with vaccination against COVID-19. It is important to be aware of this potential complication when a lymphadenopathic syndrome develops following vaccination, to avoid unnecessary treatment. (AU)


Tras la vacunación masiva frente a la COVID-19 se han comenzado a describir diversos efectos adversos incluyendo efectos locales en el lugar de la inyección, como dolor, enrojecimiento, hinchazón, etc., y efectos sistémicos como fatiga, dolor de cabeza, dolor muscular o articular. Más infrecuentemente se pueden desarrollar cuadros linfadenopáticos sospechosos clínicamente de proceso linfoproliferativo. Presentamos el caso de una mujer de 30 años que desarrolló linfadenopatía axilar izquierda tras la vacunación contra la COVID-19 con hallazgos histopatológicos de linfadenopatía necrotizante de tipo Kikuchi y resolución espontánea. Hasta el momento se han publicado 7 casos con descripción clinicopatológica completa en la literatura y notificado 14 casos en la Red Europea de Farmacovigilancia en relación con la vacunación. Es importante tener en cuenta esta entidad en linfadenopatías sospechosas de procesos linfoproliferativos en este contexto, para evitar un tratamiento innecesario. (AU)


Assuntos
Humanos , Feminino , Adulto , Infecções por Coronavirus/epidemiologia , Vacinação em Massa/efeitos adversos , Linfadenite Histiocítica Necrosante
2.
Rev. esp. patol ; 57(1): 42-47, ene.-mar. 2024. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-229921

RESUMO

Subsequent to mass vaccination programs against COVID-19, diverse side effects have been described, both at the injection site, such as pain, redness and swelling, and systemic effects such as fatigue, headache, muscle or joint pain. On rare occasions, a lymphadenopathic syndrome may develop, raising the clinical suspicion of a lymphoproliferative disorder. We present the case of a 30-year-old woman who developed self-limiting left axillary lymphadenopathy following COVID-19 vaccination. To date, only seven similar cases with a complete clinicopathological description have been published, and fourteen cases have been notified to the European adverse events databases (Eudravigilance) in relationship with vaccination against COVID-19. It is important to be aware of this potential complication when a lymphadenopathic syndrome develops following vaccination, to avoid unnecessary treatment. (AU)


Tras la vacunación masiva frente a la COVID-19 se han comenzado a describir diversos efectos adversos incluyendo efectos locales en el lugar de la inyección, como dolor, enrojecimiento, hinchazón, etc., y efectos sistémicos como fatiga, dolor de cabeza, dolor muscular o articular. Más infrecuentemente se pueden desarrollar cuadros linfadenopáticos sospechosos clínicamente de proceso linfoproliferativo. Presentamos el caso de una mujer de 30 años que desarrolló linfadenopatía axilar izquierda tras la vacunación contra la COVID-19 con hallazgos histopatológicos de linfadenopatía necrotizante de tipo Kikuchi y resolución espontánea. Hasta el momento se han publicado 7 casos con descripción clinicopatológica completa en la literatura y notificado 14 casos en la Red Europea de Farmacovigilancia en relación con la vacunación. Es importante tener en cuenta esta entidad en linfadenopatías sospechosas de procesos linfoproliferativos en este contexto, para evitar un tratamiento innecesario. (AU)


Assuntos
Humanos , Feminino , Adulto , Infecções por Coronavirus/epidemiologia , Vacinação em Massa/efeitos adversos , Linfadenite Histiocítica Necrosante
3.
Rev. neurol. (Ed. impr.) ; 77(10): 229-239, 16 - 30 de Noviembre 2023. tab, graf
Artigo em Inglês, Espanhol | IBECS | ID: ibc-227592

RESUMO

Introducción La cefalea es un síntoma frecuente en la fase aguda de la enfermedad por coronavirus 2019 (COVID-19) y también uno de los efectos adversos más comunes tras la vacunación. En ambos casos, la fisiopatología de la cefalea parece estar relacionada con la respuesta inmunitaria del huésped y podría presentar similitudes. Nuestro objetivo fue comparar el fenotipo clínico y la frecuencia de los síntomas asociados y los síntomas de inicio en pacientes con cefalea relacionada con la COVID-19 y cefalea relacionada con la vacuna de la COVID-19. Sujetos y métodos Se realizó un estudio de casos y controles. Se incluyó a pacientes con infección confirmada por COVID-19 y receptores de la vacuna de la COVID-19 que experimentaron un nuevo inicio de cefalea. Se administró un cuestionario estandarizado que incluyó variables demográficas, antecedentes previos de cefaleas, síntomas asociados y variables relacionadas con la cefalea. Ambos grupos se emparejaron por edad, sexo y antecedentes previos de cefaleas. Se realizó un análisis de regresión multivariante. Resultados Un total de 238 pacientes cumplieron con los criterios de elegibilidad (143 pacientes con cefalea relacionada con la COVID-19 y 95 sujetos con cefalea relacionada con la vacuna de la COVID-19). Los pacientes con cefalea relacionada con la COVID-19 presentaron una mayor frecuencia de artralgia, diarrea, disnea, dolor torácico, expectoración, anosmia, mialgia, odinofagia, rinorrea, tos y disgeusia. Además, los pacientes con cefalea relacionada con la COVID-19 experimentaron una duración diaria más prolongada de la cefalea y describieron la cefalea como la peor que habían experimentado. Los pacientes con cefalea relacionada con la vacuna de la COVID-19 experimentaron con más frecuencia dolor en la región parietal, fonofobia y empeoramiento de la cefalea por movimientos de la cabeza o de los ojos. Conclusión ... (AU)


INTRODUCTION Headache is a frequent symptom at the acute phase of coronavirus disease 2019 (COVID-19) and also one of the most frequent adverse effects following vaccination. In both cases, headache pathophysiology seems linked to the host immune response and could have similarities. We aimed to compare the clinical phenotype and the frequency and associated onset symptoms in patients with COVID-19 related-headache and COVID-19 vaccine related-headache. SUBJECTS AND METHODS A case-control study was conducted. Patients with confirmed COVID-19 infection and COVID-19-vaccine recipients who experienced new-onset headache were included. A standardised questionnaire was administered, including demographic variables, prior history of headaches, associated symptoms and headache-related variables. Both groups were matched for age, sex, and prior history of headache. A multivariate regression analysis was performed. RESULTS A total of 238 patients fulfilled eligibility criteria (143 patients with COVID-19 related-headache and 95 subjects experiencing COVID-19 vaccine related-headache). Patients with COVID-19 related-headache exhibited a higher frequency of arthralgia, diarrhoea, dyspnoea, chest pain, expectoration, anosmia, myalgia, odynophagia, rhinorrhoea, cough, and dysgeusia. Further, patients with COVID-19 related-headache had a more prolonged daily duration of headache and described the headache as the worst headache ever experienced. Patients with COVID-19 vaccine-related headache, experienced more frequently pain in the parietal region, phonophobia, and worsening of the headache by head movements or eye movements. CONCLUSION. Headache caused by SARS-CoV-2 infection and COVID-19 vaccination related-headache have more similarities than differences, supporting a shared pathophysiology, and the activation of the innate immune response. The main differences were related to associated symptoms. (AU)


Assuntos
Humanos , Cefaleia/fisiopatologia , /epidemiologia , Vacinação em Massa/efeitos adversos , /imunologia , Imunidade , Viroses , /efeitos adversos
6.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 58(3): 125-133, may.-jun. 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-221954

RESUMO

Introduction: BNT162b2 (BioNTech and Pfizer) is a nucleoside-modified mRNA vaccine that provides protection against SARS-CoV-2 infection and is generally well tolerated. However, data about its efficacy, immunogenicity and safety in people of old age or with underlying chronic conditions are scarce. Purpose: To describe BNT162b2 (BioNTech and Pfizer) COVID-19 vaccine immunogenicity, effectiveness and reactogenicity after complete vaccination (two doses), and immunogenicity and reactogenicity after one booster, in elders residing in nursing homes (NH) and healthy NH workers in real-life conditions. Methods: Observational, ambispective, multicenter study. Older adults and health workers were recruited from three nursing homes of a private hospital corporation located in three Spanish cities. The primary vaccination was carried out between January and March 2021. The follow-up was 13 months. Humoral immunity, adverse events, SARS-CoV-2 infections, hospitalizations and deaths were evaluated. Cellular immunity was assessed in a participant subset. Results: A total of 181 residents (mean age 84.1 years; 89.9% females, Charlson index ≥2: 45%) and 148 members of staff (mean age 45.2 years; 70.2% females) were surveyed (n:329). After primary vaccination of 327 participants, vaccine response in both groups was similar; ≈70% of participants, regardless of the group, had an antibody titer above the cut-off considered currently protective (260BAU/ml). This proportion increased significantly to ≈ 98% after the booster (p<0.0001 in both groups). Immunogenicity was largely determined by a prior history of COVID-19 infection. Twenty residents and 3 workers were tested for cellular immunity. There was evidence of cellular immunity after primary vaccination and after booster. (AU)


Introducción: La vacuna BNT162b2 (BioNTech y Pfizer) es una vacuna de ARNm modificado con nucleósidos que proporcionó protección contra la infección por el SARS-CoV-2 y generalmente fue bien tolerada. Sin embargo, los datos sobre su efectividad y seguridad en personas de edad avanzada o con enfermedades crónicas subyacentes son escasos. Objetivo: Describir la inmunogenicidad, efectividad y seguridad de esta vacuna tras la vacunación completa (dos dosis), y la inmunogenicidad y reactogenicidad tras un refuerzo, en ancianos residentes en hogares geriátricos y trabajadores sanos de estos lugares en condiciones reales. Métodos: Estudio observacional, ambispectivo y multicéntrico. Se reclutaron ancianos y trabajadores sanitarios de tres hogares geriátricos de ancianos de un grupo hospitalario de entidad privada situados en tres ciudades españolas. La vacunación primaria se realizó entre enero y marzo de 2021. El seguimiento fue de 13 meses. Se evaluó la inmunidad humoral, los eventos adversos, las infecciones por SARS-CoV-2, las hospitalizaciones y las muertes. Se evaluó la inmunidad celular en un subconjunto de participantes. Resultados: Se registraron datos de 181 residentes (edad promedio 84,1 años; 89,9% mujeres, índice de Charlson ≥2: 45%) y 148 trabajadores (edad promedio 45,2 años; 70,2% mujeres) (n:329). Tras la primera dosis a 327 de los participantes, la respuesta a la vacuna en ambos grupos fue similar; ≈70% de los participantes, independientemente del grupo, tuvieron un título de anticuerpos por encima del corte considerado actualmente como protector (260 BAU/ml). Esta proporción aumentó significativamente a ≈ 98% después del refuerzo (p<0,0001 en ambos grupos). La inmunogenicidad se determinó en gran medida por los antecedentes de infección por COVID-19. Se analizó la inmunidad celular de 20 residentes y 3 trabajadores. Hubo evidencia de inmunidad celular después de la vacunación primaria y después del refuerzo. (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Pandemias , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/tratamento farmacológico , Vacinação em Massa/efeitos adversos , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Hospitais Privados , Instituição de Longa Permanência para Idosos , Envelhecimento
8.
Pharm. pract. (Granada, Internet) ; 21(2): 1-8, abr.-jun. 2023. tab
Artigo em Inglês | IBECS | ID: ibc-222800

RESUMO

Objectives: Sexual satisfaction is a sign of a healthy sex life, and is associated with global well-being, personal, and interpersonal factors. No previous research studying the association of fear of COVID-19 and coronavirus vaccine with female sexual satisfaction has been found in Lebanon. The main objective of our study was to assess the association between COVID-19 vaccination, fear of COVID-19, and female sexual satisfaction. Methods: This was a cross-sectional study conducted between June 2021 and February 2022 using a sample of community dwelling participants. 239 Lebanese women aged 18 to 45, residing in Lebanon participated in the study. Due to the restrictions on gatherings and the risky side of face-to-face interviews, we created the survey on Google forms. The link was shared among the participants and sent to all governorates of Lebanon (Beirut, Mount Lebanon, North, South, and Bekaa) using the snowball technique. Results: After adjusting the correlations over all variables, being ever infected by COVID-19 did not show a significant correlation with the sexual satisfaction scale score. However, the intake of the COVID-19 vaccine was significantly associated with more contentment (r=0.13). Older age was significantly associated with less communication (r=-0.12) and less overall sexual satisfaction (r=-0.12), whereas being married was significantly associated with more contentment (r=0.25), communication (r=0.20), compatibility (r=0.16), relational concern (r=0.28), personal concern (r=0.25) and overall sexual satisfaction (r=0.27) scores. Higher household crowding index (lower socioeconomic status) was significantly associated with lower overall sexual satisfaction score (r=-0.14) and lower subscales scores (except contentment). Higher anxiety was significantly associated with lower relational concern (r=-0.17) and personal concern (r=-0.16) scores. (AU)


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/tratamento farmacológico , Vacinação em Massa/efeitos adversos , Sexualidade , Satisfação Pessoal , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Pandemias , Líbano
11.
Tohoku J Exp Med ; 259(4): 263-271, 2023 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-36642506

RESUMO

The third and fourth doses of the vaccine against coronavirus disease 2019 (COVID-19) were widely administered in Japan since December 2021. Currently, however, data are scarce regarding acute adverse events with the third and fourth doses. The present study reports the profiles of acute adverse events after the third and fourth COVID-19 vaccine doses, seen at the site of a mass vaccination center in Japan. Between December 2021 and July 2022, 267,515 individuals received the third, and 32,934 received the fourth COVID-19 vaccine dose at the mass vaccination center, of whom 442 recipients of the third (0.19%), and 22 recipients of the fourth (0.07%) dose reported acute adverse events and were examined by doctors on site. The most common diagnosis was vasovagal syncope/presyncope (incidence: 0.01-0.10%), followed by other miscellaneous complaints, acute allergic reactions (0.05-0.005%), and anaphylaxis (< 0.005%). Vasovagal syncope/presyncope occurred most frequently in recipients in those in their 20s, whereas acute allergic reactions were most frequent in those in their 40s. Both reactions were more frequent in women than men. The peak occurrence of vasovagal syncope/presyncope was earlier than 15 min after the injection, whereas that of acute allergic reaction was later than 15 min after the injection. The incidence of acute allergic reactions appeared to differ between various vaccine manufacturers, whereas that of vasovagal syncope/presyncope did not. These real-world data may benefit the safe and efficient implementation of mass vaccination campaigns for citizens who want to receive COVID-19 vaccines now and in the future.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Hipersensibilidade , Síncope Vasovagal , Feminino , Humanos , Masculino , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Japão/epidemiologia , Vacinação em Massa/efeitos adversos , Síncope , Vacinação/efeitos adversos
12.
Br J Clin Pharmacol ; 89(3): 967-981, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36480113

RESUMO

Vaccines have had a tremendous impact on reducing the burden of infectious diseases; however, they have the potential to cause adverse events following immunization (AEFIs). Prelicensure clinical trials are limited in their ability to detect rare AEFIs that may occur in less than one per thousand individuals. While postmarketing surveillance systems have shown COVID-19 mRNA vaccines to be safe, they led to the identification of rare cases of myocarditis and pericarditis after COVID-19 vaccination that were not initially detected in clinical trials. In this narrative review, we highlight concepts of vaccine pharmacovigilance during mass vaccination campaigns and compare the approaches used in the context of myocarditis and pericarditis following COVID-19 vaccination to historical examples. We describe mechanisms of passive and active surveillance, their strengths and limitations, and how they interacted to identify and characterize the safety signal of myocarditis and pericarditis after COVID-19 mRNA vaccination. Articles were synthesized from a PubMed search using relevant keywords for articles published on vaccine surveillance systems and myocarditis and pericarditis after COVID-19 vaccination, as well as the authors' collections of relevant publications and grey literature reports. The global experience around the identification and monitoring of myocarditis and pericarditis after COVID-19 mRNA vaccination has provided important lessons for vaccine safety surveillance and highlighted its importance in maintaining public trust in mass vaccination programmes in a pandemic context.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Miocardite , Pericardite , Vacinas , Humanos , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Vacinação em Massa/efeitos adversos , Miocardite/induzido quimicamente , Miocardite/epidemiologia , Pericardite/epidemiologia , Pericardite/etiologia , Farmacovigilância , RNA Mensageiro , Vacinação
14.
Science ; 376(6590): 227-228, 2022 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-35420947

RESUMO

Pandemic propels international efforts to understand incidence of rare side effects.


Assuntos
Vacinas contra COVID-19 , Vacinação em Massa , Vacinas contra COVID-19/efeitos adversos , Bases de Dados Factuais , Humanos , Vacinação em Massa/efeitos adversos , Pandemias , Risco
15.
Pharm. pract. (Granada, Internet) ; 20(2): 1-6, Apr.-jun. 2022. tab
Artigo em Inglês | IBECS | ID: ibc-210429

RESUMO

The vaccine was the only way to fight against Coronavirus-19 (COVID-19) from its statement as a pandemic till day. COVID-19 vaccines were approved by the world health organization (WHO) in December 2020. Despite a large number of studies regarding the efficacy and safety of COVID-19 vaccines, to our knowledge, there were limited studies that outlined the gender disparity towards COVID-19 vaccine adverse effects. This study aims to outline the variety of side effects among men and women after getting COVID-19 vaccines (either single or two doses). It is a cross-sectional study accomplished electronically from September to November 2021. The participants involved were 843 Health Care Workers (HCWs) from different cities in Iraq. The majority of respondents were females (664). Around 65% of males experienced adverse effects compared to 77% of females. A high frequency of severe pain was reported among females. Regarding dermatological reactions like swelling, redness and skin rash were also higher reported among female subjects. In addition to that, higher frequencies of moderate and severe systemic adverse effects and mild to moderate nausea was also reported more frequently among females. In terms of cardiopulmonary adverse effects, all the reported adverse effects were found more frequently among females. In conclusion, COVID-19 vaccines produced limited adverse effects and the majority of them were reported among women. This may be associated with hormonal and psychological factors related to them. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Pandemias , Infecções por Coronavirus/epidemiologia , Vacinação em Massa/efeitos adversos , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , 57426 , Estudos Transversais , Estudos Retrospectivos , Iraque , Inquéritos e Questionários
18.
Front Immunol ; 13: 782198, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35185881

RESUMO

Misunderstanding temporal coincidence of adverse events during mass vaccination and invalid assessment of possible safety concerns have negative effects on immunization programs, leading to low immunization coverage. We conducted this systematic review and meta-analysis to identify the incidence rates of GBS that are temporally associated with viral vaccine administration but might not be attributable to the vaccines. By literature search in Embase and PubMed, we included 48 publications and 2,110,441,600 participants. The pooled incidence rate of GBS was 3.09 per million persons (95% confidence interval [CI]: 2.67 to 3.51) within six weeks of vaccination, equally 2.47 per 100,000 person-year (95%CI: 2.14 to 2.81). Subgroup analyses illustrated that the pooled rates were 2.77 per million persons (95%CI: 2.47 to 3.07) for individuals who received the influenza vaccine and 2.44 per million persons (95%CI: 0.97 to 3.91) for human papillomavirus (HPV) vaccines, respectively. Our findings evidence the GBS-associated safety of virus vaccines. We present a reference for the evaluation of post-vaccination GBS rates in mass immunization campaigns, including the SARS-CoV-2 vaccine.


Assuntos
Vacinas contra COVID-19/efeitos adversos , Síndrome de Guillain-Barré/epidemiologia , Vacinas contra Influenza/efeitos adversos , Vacinação em Massa/efeitos adversos , Vacinas contra Papillomavirus/efeitos adversos , Alphapapillomavirus/imunologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/imunologia , Humanos , Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/imunologia , Vigilância da População , SARS-CoV-2/imunologia
19.
Int J Immunopathol Pharmacol ; 35: 20587384211065628, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34911394

RESUMO

OBJECTIVES: Vaccination rollout against COVID-19 has started in developed countries in early December 2020. Mass immunization for poor or low-income countries is quite challenging before 2023. Being a lower-middle-income country, Bangladesh has begun a nationwide COVID-19 vaccination drive in early February 2021. Here, we aimed to assess the opinions, experiences, and adverse events of the COVID-19 vaccination in Bangladesh. METHODS: We conducted this online cross-sectional study from 10 February 2021, to 10 March 2021, in Bangladesh. A self-reported semi-structured survey questionnaire was used using Google forms. We recorded demographics, disease history, medication records, opinions and experiences of vaccination, and associated adverse events symptoms. RESULTS: We observed leading comorbid diseases were hypertension (25.9%), diabetes (21.1%), heart diseases (9.3%), and asthma (8.7%). The most frequently reported adverse events were injection site pain (34.3%), fever (32.6%), headache (20.2%), fatigue (16.6%), and cold feeling (15.4%). The chances of having adverse events were significantly higher in males than females (p = 0.039). However, 36.4% of respondents reported no adverse events. Adverse events usually appeared after 12 h and went way within 48 h of vaccination. Besides, 85.5% were happy with the overall vaccination management, while 88.0% of the respondents recommended the COVID-19 vaccine for others for early immunization. CONCLUSION: According to the present findings, reported adverse events after the doses of Covishield in Bangladesh were non-serious and temporary. In Bangladesh, the early vaccination against COVID-19 was possible due to its prudent vaccine deal, previous mass vaccination experience, and vaccine diplomacy.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Vacinação em Massa , Adulto , Bangladesh/epidemiologia , COVID-19/epidemiologia , COVID-19/imunologia , Vacinas contra COVID-19/efeitos adversos , Comorbidade , Estudos Transversais , Países em Desenvolvimento , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Feminino , Humanos , Masculino , Vacinação em Massa/efeitos adversos , Pessoa de Meia-Idade , Satisfação do Paciente , Avaliação de Programas e Projetos de Saúde , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
20.
Front Immunol ; 12: 740048, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34777351

RESUMO

Background: In 2009, a new influenza A H1N1 virus emerged causing a global pandemic. A range of monovalent influenza A H1N1pdm09 vaccines with or without adjuvants were developed. After the mass vaccination campaigns safety concerns related to H1N1pdm09 vaccines were reported. More than a decade later, reported AEFIs are still under scrutiny. We performed a systematic review aiming to synthesize the evidence on the safety of the H1N1pdm09 vaccines on reported outcomes from existing systematic reviews. Methods: Four electronic databases, PubMed, EMBASE, Epistimonikos and the Cochrane Database of Systematic Reviews were searched for articles on H1N1pdm09 vaccination published from 2009 to January 2021. Systematic reviews assessing short- or long-term adverse events after H1N1pdm09 vaccination were considered for inclusion. Data was extracted from all selected reviews. Outcomes were grouped and results from each included review were presented narratively and in tables. Results: 16 systematic reviews met the inclusion criteria. Reported outcomes were short-term events (3 reviews), fetal/pregnancy outcomes (8 reviews), Guillain-Barré syndrome (GBS) (4 reviews), narcolepsy (2 reviews) demyelinating diseases (1 review based on one study only) and inflammatory bowel disease (IBD) (1 review). Short-term serious adverse events were rare, 3 cases amongst 16725 subjects in 18 randomized controlled trials (0.018%). No deaths were reported. The risks of local events were generally higher for adjuvanted vaccines as compared to unadjuvanted vaccines. Maternal H1N1pdm09 vaccination in any trimester was not associated with an increase in preterm birth, small for gestational age, congenital malformations or fetal death. For GBS, results were conflicting. The main systematic review on narcolepsy found a 5-14-fold increased risk in children, and a 2-7- fold increased risk in adults after vaccination with Pandemrix. The attributable risk of narcolepsy one year after vaccination was 1 case per 18 400 vaccine doses in children/adolescents, and 1 case per 181 000 vaccine doses in adults. Conclusion: Adjuvanted vaccines had more local but not serious adverse events compared to unadjuvanted vaccines. Vaccination with Pandemrix was strongly associated with narcolepsy, particularly in children. No increased risks of pregnancy outcomes were seen after pandemic vaccination. The findings on GBS were inconclusive.


Assuntos
Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/efeitos adversos , Influenza Humana/prevenção & controle , Narcolepsia/etiologia , Criança , Feminino , Síndrome de Guillain-Barré/etiologia , Humanos , Vacinas contra Influenza/imunologia , Vacinação em Massa/efeitos adversos , Gravidez/imunologia , Nascimento Prematuro/etiologia , Revisões Sistemáticas como Assunto
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