Covid-19 disease and SARS-COV-2 vaccines: the balance between risks and benefits

Authors

  • SAPOJNIC Nadejda IMSP Institutul de Cardiologie
  • BÎTCĂ Angela IMSP Institutul de Cardiologie
  • DURNEA Aliona IMSP Institutul de Cardiologie
  • CARAUSH Alexandr IMSP Institutul de Cardiologie
  • MOSCALU Vitalie IMSP Institutul de Cardiologie

DOI:

https://doi.org/10.52692/1857-0011.2022.1-72.17

Keywords:

vaccine, COVID-19, thrombocytopenia, thromboembolism, myocarditis

Abstract

The infection with the new SARS-CoV-2 coronavirus has caused more than 4.5 million victims worldwide, and this number continues to rise. As more than 3 billion people have been vaccinated, COVID-19 vaccines shown an excellent efficacy and an acceptable safety profile. With the availability of SARS vaccines for an increasing number of people, several sporadic cases of adverse events have been reported, suggesting a causal relationship between these two phenomena. However, when it comes to the safety profile of SARS-CoV-2 vaccines, an important issue is that these risks should be balanced against the risks of exposure to COVID-19, an infection which itself can lead to lung damage but also to thrombotic /thromboembolic events. Increased risk of hematological and vascular events leading to hospitalization or death at short intervals after the first doses of ChAdOx1 nCoV-19 and BNT162b2 vaccines has been observed. Myocarditis is a very rare side effect associated with the BNT162b2 vaccine, which is 6-folds more likely to occur after SARS-CoV-2 infection compared to the vaccine itself. 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.

Author Biographies

SAPOJNIC Nadejda, IMSP Institutul de Cardiologie

dr.st.med

BÎTCĂ Angela, IMSP Institutul de Cardiologie

dr st.med.

CARAUSH Alexandr, IMSP Institutul de Cardiologie

dr.hab st med., prof. cercet

MOSCALU Vitalie, IMSP Institutul de Cardiologie

dr.st.med, conf. cercet

References

Lund LC. et al. Post-acute effects of SARS-CoV-2 infection in individuals not requiring hospital admission: a Danish population-based cohort study. Lancet Infect Dis 2021. doi:10.1016/ s1473-3099(21)00211-5 7

Schultz NH. et al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med 2021; 384:2124-30. doi:10.1056/NEJMoa2104882

Greinacher A. et al. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med 2021;384:2092-101. doi:10.1056/NEJMoa2104840

MHRA. Coronavirus vaccine weekly summary of yellow card reporting 2021 (updated 22 April 2021). https://www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adversereactions/coronavirus-vaccine-summary-of-yellow-card-reporting

Taquest M., et al. Cerebral venous thrombosis and portal vein thrombosis: a retrospective cohort study of 537913 COVID-19 cases. EClinicalMedicine, 2021 Sep;39:101061. doi: 10.1016/j.eclinm.2021.101061.

Surveillance of myocarditis (inflammation of the heart muscle) cases between December 2020 and May 2021 (including). Press release of the Israeli Ministry of Health, June 2021 (https://www.gov.il/en/departments/news/01062021-03. opens in new tab).

Barda N., et al. Safety of the BNT162b2 mRNA Covid-19 vaccine in a nationwide setting. N Engl J Med 2021; 385:1078-1090.

Julia Hippisley-Cox., et al. Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study. BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1931 (Published 27 August 2021).

Guy Witberg., et all. Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. (2021) Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel. N Engl J Med DOI: 10.1056/NEJMoa2109730.

A. Boantă. UPDATE. Infodemia #COVID19. Informațiile false distribuite de celebrități, „influenceri” și politicieni pun în pericol respectarea măsurilor de distanțare social. Raportul de garda.ro, 24.febr, 2020.

Published

2022-04-08