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anaphylaxis after COVID-19 vaccination is rare



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anaphylaxis after COVID-19 vaccination is rare 
and has occurred 
at a rate of approximately 5 cases per one million vaccine doses administered. Anaphylaxis, a severe 
type of allergic reaction, can occur after any kind of vaccination. Symptoms include the feeling of 
suffocation, airway obstruction, rapid heartbeat, anxiety, and redness, which may be accompanied by 
vomiting. 
Thrombosis with thrombocytopenia syndrome (TTS) after J&J/Janssen COVID-19 
vaccination is rare
and has occurred in approximately 4 cases per one million doses administered. 
TTS is a rare but serious adverse event that causes blood clots in large blood vessels and low platelets 
(blood cells that help form clots). 
Guillain-Barré Syndrome (GBS) in people who have received 
the J&J/Janssen COVID-19 vaccine is rare.
GBS is a rare disorder where the body’s immune 
system damages nerve cells, causing muscle weakness and sometimes paralysis. GBS has largely 
been reported in men ages 50 years and older. Myocarditis and pericarditis 
after COVID-19 
vaccination are rare. 
Myocarditis is inflammation of the heart muscle, and pericarditis is 
inflammation of the outer lining of the heart. A review of vaccine safety found a small but increased 
risk of myocarditis after mRNA COVID-19 vaccines, highest after the second dose of an mRNA 
vaccine among males. 
The initial mechanism for SARS-CoV-2 infection is viral binding to the membrane-bound 
form of angiotensin-converting enzyme 2 (ACE2) by a protein expressed in the viral coat, termed 
SPIKE (S protein) followed by its priming by the serine protease TMPRSS2 mediating virus uptake. 
ACE2 is a membrane-bound peptidase that is expressed in all tissues but is especially represented in 
lung, heart, vessels, kidney, brain, and gut. Cardiovascular tissues or generally cells that express 
ACE2, including lung cells, are at risk for SARS-CoV-2 infection. Among cardiovascular 
complications, COVID-19 can be associated with myocarditis, pericardial effusion, and pericarditis. 
The diagnosis of myocarditis cannot be based only on troponin elevation, and additional evidence is 
often lacking. Most cases can be labeled as clinically suspected cases. Myocardial injury is prevalent 
among patients hospitalized with COVID-19. Moreover, troponin elevation among patients 
hospitalized with COVID-19 is associated with higher risk of mortality. In the setting of pericardial 
diseases, there are two possible different scenarios to consider: 1) the patient being treated for 
pericarditis who subsequently becomes infected with SARS-CoV-2, and 2) the patient with COVID-
19 who develops pericarditis or pericardial effusion. In both conditions clinicians may be doubtful 
regarding the safety of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, colchicine, 
and biological agents such as anti-IL1 agents (e.g., anakinra), that are mainstay of therapy for 
refractory cases. Although there is a warning on the use of NSAIDs in the setting of COVID-19 
infection that require additional investigation, most treatments for pericarditis, including 
corticosteroids, colchicine, and anakinra medicine do not appear contraindicated in the setting of 
COVID-19 infection. Nevertheless, when corticosteroids and anakinra medicines are used, a careful 
monitoring of possible superimposed bacterial infections is warranted. On this basis, pericarditis 
treatments should not be discontinued in patients on treatment when indicated to control the disease. 
In conclusion, heart and vessels are potential targets for COVID-19. 
Ideally, a vaccine will: produce the same immune protection which usually follows natural 
infection but without causing disease, generate long lasting immunity so that the person is protected 
if they are exposed to the antigen several years after vaccination and interrupt the spread of infection 
by preventing carriage of the organism in the vaccinated person. 
Vaccines need to be safe and the risk from any side effects should be much lower than the benefit of 
preventing deaths and serious complications of the disease. Multiple studies and reviews of data from 


532 
vaccine safety monitoring systems continue to show that vaccines are safe. COVID-19 vaccines are 
safe, and getting vaccinated will help protect you against developing severe COVID-19 disease and 
dying from COVID-19. You may experience some mild side effects after getting vaccinated, which 
are signs that your body is building protection. 
Τhe most promising approach of fighting COVID-19 and restraining the course of this 
pandemic is indisputably the universal vaccination of the population with safe and effective vaccines. 
However, besides the common and usually mild side effects of the authorized vaccines, some rare, 
major adverse reactions are increasingly being reported worldwide during the post marketing 
surveillance phase of vaccines’ circulation, such as anaphylaxis, vaccine-induced thrombotic 
thrombocytopenia, myopericarditis and Guillain-Barr ́e syndrome. Despite rare cases with 
complications from COVID-19 vaccines, the net benefit-risk ratio shows a clearly favorable balance 
towards COVID-19 vaccination for all age and sex groups. Vaccine adverse events should be 
identified early and monitored closely. As many aspects of these adverse effects remain still obscure 
for the medical community and the relevant stakeholders, it is also highly important to be promptly 
reported. Nonetheless, these complications should not constitute a reason to change the vaccine policy 
and further studies are needed to alleviate concerns and reluctance to COVID-19 vaccinations. 
References: 
 
1.
https://www.acc.org/latest-in-cardiology/articles/2021/02/05/19/37/covid-19-as-a-possible-
cause-of-myocarditis-and-pericarditis
 
2.
https://www.sciencedirect.com/science/article/pii/S2589936821000694 
3.
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/overview-COVID-
19-vaccines.html
 
4.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8078878/#:~:text=Reported%20side%2Def
fects%20were%20minor,than%20after%20the%20first%20dose

5.
https://www.slideshare.net/ICRInstituteForClini/covid19-vaccines-side-effects-concerns
 
6.
https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update73_covid-
19-vaccines-and-immune-response.pdf?sfvrsn=7902cc35_5
 
7.
https://www.youtube.com/watch?v=zoHOigIp94Q
 
8.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-
vaccines/explainers
 
9.
https://www.unicef.org/armenia/en/stories/side-effects-covid-19-vaccines
 


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