With input from Dr Monica Vasudev

1433: Local reaction to Modernas COVID-19 vaccine

 

In a letter published in the New England Journal of Medicine, the authors have suggested that local reaction may appear up to 11 days after vaccination and symptoms can persist for as long as 11 days. In an analysis of 12 patients who exhibited delayed reaction after the first dose of the vaccine, it was reported that the median time to onset of the delayed reaction was 8 days and the symptoms resolved after a median of 6 days. 

It was not necessary that the local reaction will appear at the site of injection. In a 40-year-old woman, papules were seen on her palm and fingers which were reportedly due to the vaccine shot. In another 43-year-old male, urticarial plaques were seen on his elbows. Several patients were unnecessarily prescribed medications for the treatment. It has been noted that almost 84% of individuals receiving Moderna vaccine displayed some muscle soreness or tenderness, and 0.8% of patients in the initial vaccine trial reported a delayed injection-site reaction on or after 8 days. Delayed adverse reactions including erythema, induration and tenderness were seen less frequently (0.2% of patients) after the second dose. The symptoms usually resolved within 5 days. The recipients of the vaccine reported that any immediate signs would disappear, however a reaction would reappear within 4 to 11 days after the first dose, persisting for 2 to 11 days. Five of the 12 patients reported grade 3 plaques, with a diameter at least 10 cm. Some individuals also reported systemic reactions associated with the vaccine. 

 

CDC guidelines on safety precautions for fully vaccinated people.

 

1. The CDC is slated to release recommendations for vaccinated individuals stating that

a. Vaccinated people try to only socialize with other vaccinated people at home

b. They should continue to wear masks elsewhere along with observing other safety measures, such as social distancing

 

1435: Antibodies stimulated by exposure to South Africa’s dominant coronavirus variant can prevent infection by other virus variants

 

In a South African laboratory study, the findings conclude that COVID-19 vaccines based on the B.1.351 (or 20H/501Y.V2) might protect against other virus variants prevalent in different parts of the world. Professor at the National Institute for Communicable Diseases, Penny Moore said, ‘the antibody response from the 501Y.V2 variant was only reduced threefold against the first-wave virus, whereas the response from the first-wave virus was reduced nine-fold against 501Y.V2.’ A study published by the same group in Nature Medicine showed that antibodies to the virus strain previously circulating in South Africa doesnt neutralize the now-dominant B.1.351/501Y.V2 variant. (https://go.nature.com/3bcU4zt). Vaccine manufacturers including Pfizer, AstraZeneca and Johnson & Johnson were already making vaccines based on the B.1.351/501Y.V2 variant. It has been suggested that by the end of 2021, most of the vaccine manufacturers would have adapted their shots to the mutated strain. The researchers have said that this would happen, "not because they are specifically worrying about the virus coming from South Africa ... but because key mutations in the 501Y.V2 are actually also present in many other variants".

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA