Table 1.
A brief summary of studies addressing immune and autoimmune side effects of COVID-19 vaccines.
| Side effect | Vaccine | Authors | Study population | Conclusions |
|---|---|---|---|---|
| Neurological Autoimmunity | Pfizer (BNT162b2) | Trimboli et al. (205) | 1 case of GBS after receiving the second dose of BNT162b2 COVID-19 vaccine | Authors believe that the clinical and laboratory findings including the lack of overt trigger are consistent with a causal association between GBS and Pfizer® anti-SARS-CoV-2 vaccine |
| Bouattour et al. (50) | 1 case of GBS after 1st dose of BNT162b2 vaccine | A patient who developed GBS 7 days after receiving the first dose of Pfizer-BioNTech COVID-19 vaccine | ||
| Shapiro Ben David et al. (52) | Retrospective cohort study in the second largest health maintenance organization in Israel, diagnosis code for GBS after receiving at least 1 vaccine dose | In this cohort study, which included 702 patients, only 1 needed short medical care for relapse of previous syndrome, which represents a minimal risk. | ||
| Garcia-Grimshaw et al. (54) | Analysis of cohort of 3,890,250 Hispanic/Latinx recipients of the BNT162b2 mRNA vaccine (613,780 of for incident GBS occurring within 30 days from vaccination | Among recipients of the BNT162b2 mRNA vaccine, GBS may occur at the expected community-based rate | ||
| Shasha et al. (53) | Individuals ≥16 years vaccinated with at least one dose of BNT162b2 | No association was found between vaccination, Bell’s palsy, herpes zoster or GBS. This study adds reassuring data regarding the safety of the BNT162b2 vaccine. | ||
| Garcia-Grimshaw et al. (76) | Prospective observational cohort of 700,000 patients from a database of all systemic and neurologic adverse events following immunization | Non-serious events occurred in less than 1% of recipients, while serious ones occurred in only 33 (0.005%) recipients, suggesting that the vaccine is not only effective but also safe | ||
| Waheed et al. (49) | 1 case of GBS presenting after 1st vaccine | An 82 y/o female who presented 2 weeks after vaccination with difficulty in walking | ||
| Nishiguchi et al. (22) | 1 case of MFS presenting after 1st vaccine | Authors report the first case of COVID-19 vaccination-associated MFS. However, it is difficult to deny that this result may be a coincidence in time, and therefore, no cause-and-effect relationship can be concluded at this time. | ||
| Razok et al. (51) | 1 case of GBS presenting after 2nd vaccine | The patient presentd with acute flaccid paralysis (AFP) after receiving the COVID-19 vaccine. | ||
| Miyaue et al. (75) | 1 case of LETM presenting after 1st vaccine | This case meets the criteria for a “probable” AEFI, considering the following features: (i) the onset of neurological symptoms occurred within a week after vaccination; (ii) the patient had no previous neurological symptoms after other vaccines, nor symptoms suggestive of prior infection; and (iii) no other cause of LETM was identified on a thorough diagnostic evaluation. | ||
| Colella et al. (96) | 1 case of Bell’s palsy after 1st vaccine | Although a causal relationship cannot be established for most rare adverse events, the timing and mode of onset of the palsy strongly suggests that it was related to BNT162b2 vaccine injection. | ||
| Shibli et al. (98) | Population based study in Israel comparing expected cases of Bell’s palsy with number of cases after 1st and 2nd vaccine dose | The overall observed rate of Bell’s palsy after vaccination was higher than the expected rates | ||
| Kobayashi et al (109) | 1 case of encephalitis after 1st dose, exacerbated after 2nd dose. | No evidence of causal relationship was found. | ||
| Moderna (mRNA-1273) | Masuccio et al. (56) | 1 case of GBS after 2nd vaccine | According to clinical features, a subacute GBS might be reasonably hypothesized after the administration of COVID-19 mRNA-1273 vaccine second dose, with about 6 weeks elapsing between the vaccination and the symptoms onset. | |
| Kania et al. (77) | 1 case of acute disseminated encephalomyelitis after 1st vaccination | The patient manifested a typical radiological pattern for ADEM with extensive, diffuse demyelinating lesions in the brain and along all cervical and thoracic spinal cord | ||
| Fujikawa et al. (78) | 1 case of neuromyelitis optica spectrum disorder presenting after 1st vaccination | Considering the temporal association between administration of the vaccine, onset of patient’s symptoms, and previous reports of post-vaccination NMOSD, patient’s NMOSD was triggered by the SARS-CoV-2 mRNA-1273 vaccine. | ||
| Gao et al. (79) | 1 case of LETM after 1st vaccination | The temporal relationship between vaccination and ATM in the case was clinically reasonable (48 h post-vaccination) | ||
| Cellina et al. (99) | 1 case of Bell’s palsy after 1st vaccination | The patient complained of symptoms at 12 h from the injection. The timing of Bell’s palsy onset after mRNA vaccine administration varies | ||
| Iftikhar et al. (100) | 1 case of Bell’s palsy after 2nd vaccination | This case highlights the importance of vaccine history in patients presenting to the emergency department with Bell’s palsy. COVID-19 mRNA vaccines can be considered as an additional possible risk factor in the etiology of Bell’s palsy. | ||
| Martin-Villares et al. (101) | 1 case of Bell’s palsy after 1st vaccination | Evidence of a temporal association between the vaccine administration and the facial nerve palsy is clear: Bell´s palsy appeared 2 days after the administration of the mRNA COVID-19 vaccine | ||
| Torrealba-Acosta et al. (110) | 1 case of encephalitis and Sweet syndrome after 1st dose | Though temporal relation was described, causality could not be proven | ||
| AstraZeneca (ChAdOx1) | Min et al. (66) | 2 case presentations + review of 12 published cases | The two patients shared many clinical features: pure sensory manifestations, short-latency from vaccination to onset, progression duration, and no serum antibodies against gangliosides. Sensory GBS was considered the most probable diagnosis. | |
| Oo et al. (67) | 4 case presentations + review of 15 published cases | These four cases can lend further weight to the likely causal link between COVID-19 vaccine AZ and GBS | ||
| McKean et al. (65) | 1 case of GBS following the 1st vaccination | This is the first reported case of GBS which was temporally related to the Vaxzevria vaccine in Malta. | ||
| Introna et al. (62) | 1 case of GBS following the 1st vaccination | A case of GBS presenting with papilledema as atypical onset | ||
| Allen et al. (59) | 4 cases of GBS following 1st vaccination | There was an interval of 11 to 22 days between vaccination and symptom onset. | ||
| Notghi et al. (86) | 1 case of LETM after 1st vaccination | 58-year-old man admitted to hospital 10 days after his first AstraZeneca COVID-19 vaccination with progressive neurological symptoms and signs, and investigations and imaging consistent with LETM | ||
| Pagenkopf et al. (87) | 1 case of LETM after 1st vaccination | The case of LETM presented here shows a close temporal association to COVID-19 vaccination, as symptoms occurred within 11 days post injection of first dose AZD1222, AstraZeneca | ||
| Helmchen et al. (206) | 1 case of LETM in a patient with MS after 1st vaccination | The case suggests that the vector-based COVID-19 vaccine should not be used in RRMS if mRNA vaccines are available. | ||
| Voysey et al. (81) | Evaluation of 4 controlled trials in 3 countries (11636 patients) | ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. | ||
| Hsiao et al. (84) | 1 case of acute transverse myelitis after 1st vaccination | Although they rarely occur, the association of the COVID-19 vaccine and the disease, along with other neurological complications, should not be ignored | ||
| Malhotra et al. (85) | 1 case of acute transverse myelitis after 1st vaccination | Considering an incidence of 1–4 cases per million per year, 6 an event of myelitis occurring after more than 50 million vaccine doses appears fairly acceptable | ||
| Bonifacio et al. (60) | 5 cases of bilateral facial weakness after 1st vaccination | The incidence of five cases of the very uncommon BFP variant of GBS occurring within 2 weeks of Vaxzevria is further suggestive of an etiological link. | ||
| Hasan et al. (61) | 1 case of paresthesia and progressive weakness presenting after 1st case | No direct link could be ascertained | ||
| Kanabar et al. (63) | 2 patients with GBS presenting after 1st vaccination | Both patients described in this report had bilateral facial weakness at presentation | ||
| Maramattom et al. (64) | 7 patients who presented with GBS after 1st vaccination | Patients were in their 5th to 7th decades of life and predominantly female. All patients progressed to areflexic quadriplegia, and six of the seven cases required mechanical ventilation for respiratory failure. All seven cases had bilateral facial paresis, which usually occurs in fewer than 20% of unselected GBS cases | ||
| Tan et al. (88) | 1 case of LETM after 1st vaccination | Although TM following vaccination is rare, the temporal causality of LETM, in this case, is undeniable | ||
| Zuhorn et al. (107) | 3 cases of encephalitis, one after the 1st dose, others not mentioned | The complication of autoimmune encephalitis after ChAdOx1 nCoV-19 vaccination appears to be very rare. Clearly, the benefit of vaccination outweigh the risks | ||
| Multiple vaccine types | Kaulen et al. (207) | 21 consecutive cases of neurological autoimmunity, which occurred 3–23 days following SARS‐CoV‐2 vaccinations | A large series of neurological autoimmunity in temporal association with various SARS‐CoV‐2 vaccines (BNT162b2, ChAdOx1 and mRNA‐1273) is reported | |
| Koh et al. (103) | A prospective study at 7 acute hospitals in Singapore of hospitalized patients who were referred for neurological complaints and had COVID-19 mRNA vaccines | Over a 4-month period during which approximately 1.4 million people received the COVID-19 mRNA vaccines, authors recorded a spectrum of neurological disorders in only 457 hospitalized patients | ||
| Loo et al. (57) | A retrospective study examining all persons presenting with acute-onset polyradiculoneuropathy from January 1, 2021, to June 30, 2021 who were admitted to UK hospitals | Most cases identified in the study (87.5%) occurred after the AstraZeneca vaccine | ||
| Renoud et al. (104) | 133,883 cases of adverse drug reactions reported with mRNA COVID-19 vaccines in the World Health Organization pharmacovigilance database | When compared with other viral vaccines, mRNA COVID-19 vaccines did not display a signal of facial paralysis | ||
| Ismail et al. (80) | Review of 32 cases of CNS demyelination after all vaccine types | CNS demyelination was reported following all types of authorized COVID-19 vaccines (no protein-based vaccine was authorized at the time of writing). Neurological symptoms appeared within the first 1–2 weeks in most cases. Females comprised the majority of cases. Furthermore, more than half of the cases had history of probable or definite autoimmune diseases | ||
| Ozonoff et al. (95) | Literature review of Bell’s palsy after all types of COVID vaccines | The observed incidence of Bell’s palsy after mRNA vaccines is between 3·5-times and 7-times higher than would be expected in the general population. | ||
| Sato et al. (102) | Analysis of Bell’s palsy cases databases after mRNA vaccines | The incidence of facial nerve palsy as a non-serious AEFI may be lower than, or equivalent to, that for influenza vaccines. | ||
| Patone et al. (106) | Case series studies investigating hospital admissions from neurological complications after 1st dose of AstraZeneca or Pfizer vaccines | Authors found an increased risk of hospital admission for GBS (15–21 days and 22–28 days), Bell’s palsy (15–21 days) and myasthenic disorders (15–21 days) in those who received the ChAdOx1nCoV-19 vaccine. Second, an increased risk of hospital admission for hemorrhagic stroke (1–7 days and 15–21 days) was observed in those who received the BNT162b2 vaccine | ||
| Myocarditis | Pfizer (BNT162b2) | Barda et al. (128) | 884,828 people on a nation-wide setting | The vaccine was associated with an excess risk of myocarditis (1 to 5 events per 100,000 persons) |
| Montgomery et al. (127) | 23 male patients within the US Military Health System who experienced myocarditis after COVID-19 vaccination between January and April 2021. | The consistent pattern of clinical presentation, rapid recovery, and absence of evidence of other causes support the diagnosis of hypersensitivity myocarditis | ||
| Abu Mouch et al. (124) | 6 cases of myocarditis, which occurred shortly after BNT162b2 vaccination | Five patients presented shortly after the second vaccine dose and one patient presented 16 days after receiving his first vaccine dose | ||
| Mevorach et al. (130) | Retrospectively review data obtained from December 20, 2020, to May 31, 2021, regarding all cases of myocarditis in Israel | The incidence of myocarditis, although low, increased after the receipt of the BNT162b2 vaccine, particularly after the second dose among young male recipients. The clinical presentation of myocarditis after vaccination was usually mild. | ||
| Larson et al. (125) | 8 patients 2-4 days post mRNA-based vaccine | The temporal association between receiving an mRNA-based COVID-19 vaccine and the development of myocarditis is notable, potentially supporting the hypothesis that myocarditis could be an mRNA vaccine–related adverse reaction | ||
| Dionne et al. (131) | Case series of children younger than 19 years hospitalized with myocarditis within 30 days of BNT162b2 vaccine. | Myocarditis was diagnosed in children after COVID-19 vaccination, most commonly in boys after the second dose | ||
| Witberg et al. (129) | Nationwide Israeli cohort through Health care service database evaluating myocarditis cases after Pfizer vaccines | The estimated incidence of myocarditis was 2.13 cases per 100,000 persons; the highest incidence was among male patients between the ages of 16 and 29 years. Most cases of myocarditis were mild or moderate in severity. | ||
| Moderna (mRNA-1273) | Gargano et al. (132) | 296 million doses of administered mRNA (Pfizer and Moderna) COVID-19 vaccines up to June 11,2021 in the US. | Myocarditis reporting rates were 40.6 cases per million second doses of mRNA COVID-19 vaccines administered to males aged 12−29 years and 2.4 per million second doses administered to males aged ≥30 years | |
| UK Medicines & Healthcare products Regulatory Agency (133) | 1.5 million recipients of the first doses and approximately 1.3 million recipients of the second doses of mRNA-1273 in the UK. | The expected benefits of the vaccines in preventing COVID-19 and serious complications associated with COVID-19 far outweigh any currently known side effects in the majority of patients. | ||
| AstraZeneca (ChAdOx1) | Hung et al. (136) | 1 case of myopericarditis with pleuritis | Symptoms occurred 7 days post-vaccination, and the patient was hospitalized for 12 days with a total recovery. Due to a negative result for other etiologies, the possibility of vaccine-related myopericarditis with bilateral pleural effusion cannot be totally excluded. | |
| Multiple vaccine types | Vidula et al. (126) | Two healthy young patients with clinically suspected myocarditis after receiving an mRNA-based COVID-19 vaccine | While endomyocardial biopsy was not performed, both patients met the diagnostic criteria for clinically suspected myocarditis. The temporal association of the receipt of the vaccine and absence of other plausible causes suggest the vaccine as the likely precipitant | |
| Diaz et al. (134) | 2,000,287 individuals receiving at least 1 COVID-19 vaccination in the US | This study shows that myocarditis after vaccination is primary seen in younger male individuals a few days after the second vaccination. Pericarditis may be more common than myocarditis among older patients. | ||
| Vaccine-induced immune thrombotic thrombocytopenia (VITT) and other coagulation abnormalities | Pfizer (BNT162b2) | Maayan et al. (158) | 4 patients from two academic medical centers who developed TTP were identified from mid- February to mid- March 2021 | A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) activity should be evaluated in patients with history of aTTP before and after any vaccination, especially the SARS‐CoV‐2 vaccination |
| de Bruijn et al. (154) | 1 case report of TTP after first BNT162b2 vaccine | This is the first case report of iTTP after mRNA-based COVID-19 vaccination in a previously TTP-naïve patient. | ||
| Akiyama et al. (153) | 1 case of ITP after 1st vaccination | An extremely rare case of secondary ITP presumed to have occurred after BNT162b2 vaccination | ||
| Dias et al. (155) | 2 cases of thromboembolism after 1st vaccination | In both patients, there was no evidence of thrombocytopenia or antiplatelet antibodies, and alternative causes for cerebral venous thrombosis were found. As such, despite the temporal relation of both cases to vaccine administration, these types of cerebral venous thrombosis do not seem to be pathophysiological different from cerebral venous thrombosis not associated to SARS-CoV-2 vaccination | ||
| Ganzel et al. (156) | 1 case of ITP after 1st vaccination | May have a temporal relationship with administration of the Pfizer-BioNTech COVID-19 vaccine |
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| King et al. (157) | 1 case of ITP after 2nd vaccination | ITP should be considered a severe AE of the BNT162b2 mRNA COVID-19 vaccine. | ||
| Matsumura et al. (159) | 2 cases of ITP after 1st vaccination | Whether or not ITP is triggered by the vaccination or not is difficult to identify | ||
| Rodríguez et al. (160) | 1 case of VITT after 1st vaccination | This case meets the Brighton Collaboration case definition of VITT, with thrombocytopenia and thrombosis without prior heparin exposure | ||
| Waqar et al. (161) | 1 case of TTP after 2nd dose of vaccination | Further studies are, however, needed to verify possible associations between microangiopathic, thrombocytopenic thrombotic disorders and the administration of vaccines against COVID-19 | ||
| Yoshida et al. (162) | 1 case of TTP after 1st vaccination | The first case of acquired TTP in Japan may have been associated with the first dose of the BNT162b2 mRNA COVID-19 vaccine | ||
| Moderna (mRNA-1273) | Hines et al. (165) | 1 case of ITP after 1st vaccination | The temporal relationship of her vaccination with thrombocytopenia and abnormal liver enzymes points towards the Moderna mRNA-1273 SARS-CoV-2 vaccine as the most likely inciting factor | |
| Karabulut et al. (166) | 1 case of TTP in a patient with known ITP and TTP after 1st vaccination | The close temporal association between vaccine administration, recent COVID-19, and relapse of remitted TTP raises concern for an enhanced immune reaction to COVID-19 vaccine in the setting of recent COVID-19 and underlying autoimmune disease | ||
| Malayala et al. (167) | 1 case of thrombocytopenia after 1st vaccination | Authors attribute this thrombocytopenia and purpuric rash as the side effects of the mRNA-1273 vaccine | ||
| Su et al. (168) | 1 case of VITT in a patient with pancreatic cancer after 1st vaccination | This case study was the first to report a cancer patient who was diagnosed with VITT after mRNA-1273 vaccination | ||
| Toom et al. (169) | Patient with ITP who presented with flareup after 1st vaccination | The temporal sequence of the events suggests an exacerbation of patient’s chronic thrombocytopenia related to the receipt of the mRNA‐1273 Covid‐19 vaccine | ||
| AstraZeneca (ChAdOx1) | Greinacher et al. (139) | 11 patients in Germany and Austria with thrombocytopenia and clotting | Vaccination with ChAdOx1 nCov-19 can result in the rare development of immune thrombotic thrombocytopenia mediated by platelet-activating antibodies against PF4, which clinically mimics autoimmune heparin-induced thrombocytopenia | |
| Schultz et al. (140) | 5 patients in Norway (healthcare workers) with thrombocytopenia and clotting | Five cases occurred in a population of more than 130,000 vaccinated persons, they represent a rare vaccine-related variant of spontaneous heparin-induced thrombocytopenia | ||
| Pottegård et al. (145) | 282572 patients in Norway and Denmark who experienced clotting events after vaccination | Excess rate of venous thromboembolism, including cerebral venous thrombosis, among recipients of the Oxford-AstraZeneca covid-19 vaccine ChAdOx1-S within 28 days of the first dose | ||
| Perry et al. (144) | 99 patients from 43 hospitals in the UK with clotting and thrombocytopenia | Cerebral venous thrombosis appears to be more severe in the context of VITT | ||
| Scully et al. (141) | 23 patients who presented with thrombosis and thrombocytopenia after 1st vaccination | Testing for antibodies to platelet factor 4 (PF4) was positive in 22 patients (with 1 equivocal result) and negative in 1 patient | ||
| Multiple vaccine types | Schulz et al. (173) | 45 CVT cases occurring after 7,126,434 first vaccine doses of all types- using official statistics of 9 German states. | The findings point toward a higher risk for CVT after ChAdOx1 vaccination, especially for women | |
| Krzywicka et al. (174) | 213 European patients with CVT after any vaccination | Cerebral venous sinus thrombosis occurring after ChAdOx1 nCov-19 vaccination has a clinical profile distinct from CVST unrelated to vaccination. Only CVST after ChAdOx1 nCov-19 vaccination was associated with thrombocytopenia | ||
| Welsh et al. (170) | Case-series study of thrombocytopenia after mRNA vaccines using Vaccine Adverse Event Reporting System (VAERS) | The number of thrombocytopenia cases reported to the Vaccine Adverse Event Reporting System (VAERS) does not suggest a safety concern attributable to mRNA COVID-19 vaccines at this time | ||
| Cines et al. (175) | 4 million subjects which received any vaccine type in Europe | Cases of immune thrombocytopenia and bleeding without thrombosis that were induced or revealed after exposure to the messenger RNA (mRNA)–based vaccines produced by Moderna (mRNA-1273) and Pfizer–BioNTech (BNT162b2). The study has now highlighted three independent descriptions of 39 persons with a newly described syndrome characterized by thrombosis and thrombocytopenia that developed 5 to 24 days after initial vaccination with ChAdOx1 nCoV-19 (AstraZeneca) | ||
| Lee et al. (171) | 20 million people who have received at least one dose of Pfizer or Moderna vaccines. in the USA | The possibility that the Pfizer and Moderna vaccines have the potential to trigger de novo ITP (including clinically undiagnosed cases) cannot be excluded, albeit very rarely. Distinguishing vaccine‐induced ITP from coincidental ITP presenting soon after vaccination is impossible at this time. | ||
| Smadja et al. (172) | 361 million vaccinated people from the whole world with any vaccine type | The authors suggest that thrombotic events, including CVT, might occur in association with all three vaccines, but this hypothesis requires further investigations | ||
| Torjesen et al. (176) | Using a US electronic health records, comparing incidence of cerebral venous thrombosis in patients two weeks after a COVID-19 diagnosis with that in patients two weeks after COVDI-19 vaccination in all vaccine types | SARS-CoV-2 infection is associated with more risk for CVT than COVID-19 mRNA vaccines | ||
| Hippisley-Cox et al. (163) | Using a UK national data on covid-19 vaccination (AstraZeneca or Pfizer) and hospital admissions due to thrombocytopenia, venous thromboembolism, and arterial thromboembolism | Increased risks of hematological and vascular events that led to hospital admission or death were observed for short time intervals after first doses of the ChAdOx1 nCoV-19 and BNT162b2 mRNA vaccines. The risks of most of these events were substantially higher and more prolonged after SARS-CoV-2 infection than after vaccination in the same population. | ||
| Simpson et al. (164) | National prospective cohort estimating hematological and vascular adverse events after 1st vaccination with either AstraZeneca or Pfizer | A first dose of ChAdOx1 was found to be associated with small increased risks of ITP, with suggestive evidence of an increased risk of arterial thromboembolic and hemorrhagic events | ||
| Autoimmune hepatitis | Pfizer (BNT162b2) | Avci et al. (199) | 1 case report after 1st BNT162b2 vaccine | Although the exact cause of autoimmune reactions is unknown, an abnormal immune response and bystander activation induced by molecular mimicry is considered a potential mechanism, especially in susceptible individuals |
| Moderna (mRNA-1273) | Zin Tun et al. (202) | 1 case report of autoimmune hepatitis with Moderna vaccine+ review of other cases | This case illustrates immune-mediated hepatitis secondary to the Moderna vaccine, which on inadvertent re-exposure led to worsening liver injury with deranged synthetic function | |
| AstraZeneca (ChAdOx1) | Rela et al. (18) | 2 cases of AIH following 1st vaccination | There were no clear clinical or biochemical features apart from a chronological association to differentiate patients’ vaccine-related AIH from idiopathic AIH. | |
| Clayton-Chubb et al. (200) | 1 case of AIH following 1st vaccination | This case supports the notion of COVID-19 vaccine-triggered autoimmune phenomena irrespective of the vaccine’s mechanism of action, though this is the first report of an adenovirus-based vaccine precipitating AIH | ||
| Minimal Change Disease (MCD) | Pfizer (BNT162b2) | Lebedev et al. (185) | 1 case report after 1st BNT162b2 vaccine | The association between the vaccination and MCD is at this time temporal and by exclusion, and by no means firmly established |
| D’Agati et al. (186) | 1 case report after 1st BNT162b2 vaccine | The strong temporal association with vaccination suggests a rapid T cell–mediated immune response to viral mRNA as a possible trigger for podocytopathy | ||
| Maas et al. (187) | 1 case report after 1st BNT162b2 vaccine | This case can provide support for a potential association between the BNT162b2 vaccine and onset of MCD | ||
| Komaba et al. (188) | 1 case report after 1st BNT162b2 vaccine | Whether SARS-CoV-2 vaccines could trigger a relapse of MCD or other forms of nephrotic syndrome is currently unclear. | ||
| AstraZeneca (ChAdOx1) | Leclerc et al. (194) | 1 case of AKI due to MCD after 1st vaccination | This report suggests a potential relationship between MCD and the Oxford-AstraZeneca COVID-19 vaccine | |
| Morlidge et al. (208) | 2 cases of previous MCD patients relapsing after 1st vaccination | At 2 days after vaccination, one would assume the vaccine triggered a more generalized cytokine-mediated response. Others have postulated that symptoms after 4 days represent a rapid T cell–mediated response to viral mRNA | ||
| Anupama et al. (192) | 1 case of nephrotic syndrome after 1st vaccination | The temporal profile of nephrotic syndrome after the coronavirus disease 2019 vaccination and absence of any other precipitating factors points toward the vaccine as a possible trigger | ||
| Other autoimmune phenomena | Pfizer (BNT162b2) | Ishay et al. (204) | 8 patients presenting with de-novo or flares of existing autoimmune conditions | Authors observed that while immune phenomena may occur following vaccination, they usually follow a mild course and require modest therapy |
| Watad et al. (203) | 27 cases of immune-mediated diseases flares or new disease onset within 28-days of SARS-CoV-2 vaccination | Despite the high population exposure in the regions served by these centers, IMDs flares or onset temporally-associated with SARS-CoV-2 vaccination appear rare. Most are moderate in severity and responsive to therapy although some severe flares occurred. |