Withinput from Dr Monica Vasudev

1384: Are COVIDvaccines too risky for some people?

1.     The second dose of the vaccine appears to be more reactogenic than thefirst dose. Most symptoms occur within the first three days of receiving the doseand often resolve within a couple of days. The most common side effects appearto be pain, fatigue, headache and myalgias.

2.      It appears to be associated with the antibody response. With the firstdose, most people dont have much of a reaction. There might just be a littlebit of soreness at the injection site. Most people develop more side effectsafter the second dose. Probably after the first dose, the body startsdeveloping an antibody response or an immune response. When the second dose isgiven, the body is ready to act against the antigen provided by the vaccine. Thisleads to an inflammatory response from the body.

3.      The side effects like pain or fatigue are not allergies. Theyrenormal side effects of the vaccine.

4.      Most allergic reactions will occur within 30 minutes of vaccineadministration. They present with urticaria or hives, angioedema and wheezing. Oneor two of these symptoms along with a low blood pressure or fast heart rate isanaphylaxis.

5.      The new data shows that anaphylaxis appears to be not as common aspreviously thought.

6.      The frequency of anaphylaxis is around five cases per milliondoses of the Pfizer vaccine and nearly 2.8 cases per million doses of theModerna vaccine.

7.      People have allergies to several allergens. Food products, petdander, venom to bees, or even latex, none are contraindicated. Even if one hasanaphylaxis to these products, he can safely get the mRNA vaccines.

8.      The only major contraindication to the mRNA vaccines is if one hashad an immediate allergic reaction to the first dose of the vaccine or if onehas had such a response to a component of the vaccine previously. This includespolyethylene glycol. This is a component of both the vaccines and some people mayreact to it.

9.      Another contraindication is if one has had anaphylaxis topolysorbate. Polysorbate can cross-react with polyethylene glycol.

(MedpageToday)

1385: The U.K. variant of coronavirusis probably more fatal and leads to more hospitalizations compared tonon-variant coronavirus cases, suggest data published on a British governmentwebsite. The report stated that therewas increased severity of COVID-19 cases caused by the B.1.1.7 variant comparedto non-variants of concern. The B.1.1.7 cases have been reported to be 30% to70% deadlier than the actual wild-type strain.

The concerns were first raised inJanuary, when the initial data suggested that cases with B.1.1.7 were deadlierthan non-variant cases.

The London School of Hygiene &Tropical Medicine noted a relative hazard of death within 28 days of 1.58 forvariant cases compared to non-variant cases. The Imperial College London statedthat the mean ratio of case fatality for variant cases was 1.36.

Public Health England conducted amatched cohort analysis to note a death risk ratio of 1.65 for variant versusnon-variant infected people.

Public Health Scotland employedthe S-gene target failure as a proxy to ascertain variant cases. The risk of hospitalization was foundto be higher among S-gene target failure cases versus S-gene positive cases.

Intensive Care National Audit andResearch Centre (ICNARC) and QRESEARCH also noted that there was a greater risk of ICU admission forvariant cases.

Evidence thus suggest that B.1.1.7 istied to an increased risk of hospitalization and mortality compared toinfection with non-variant virus.

CDC modeling in January estimatedthat the U.K. variant would dominate in the U.S. by the end of March. A new modeling study indicatesthat the incidence of variant cases is increasing two-fold every 10 days in this country.

(Medpage Today)

Dr KK Aggarwal

President CMAAO, HCFI and Past NationalPresident IMA