COVID-19 vaccination produces exercise-responsive SARS-CoV-2 specific T-cells regardless of infection history

Background:The mobilization and redistribution of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)specific T-cells and neutralizing antibodies(nAbs)during exercise is purported to increase immune surveillance and protect against severe coronavirus disease 2019(COVID-19).We sought to determine if COVID-19 vaccination would elicit exercise-responsive SARS-CoV-2 T-cells and transiently alter nAb titers.Methods:Eighteen healthy participants completed a 20-min bout of graded cycling exercise before and/or after receiving a COVID-19 vaccine.All major leukocyte subtypes were enumerated before,during,and after exercise by flow cytometry,and immune responses to SARS-CoV-2 were determined using whole blood peptide stimulation assays,T-cell receptor(TCR)-βsequencing,and SARS-CoV-2 nAb serology.Results:COVID-19 vaccination had no effect on the mobilization or egress of major leukocyte subsets in response to intensity-controlled graded exercise.However,non-infected participants had a significantly reduced mobilization of CD4+and CD8+naive T-cells,as well as CD4+central memory T-cells,after vaccination(synthetic immunity group);this was not seen after vaccination in those with prior SARS-CoV-2 infection(hybrid immunity group).Acute exercise after vaccination robustly mobilized SARS-CoV-2 specific T-cells to blood in an intensity-dependent manner.Both groups mobilized T-cells that reacted to spike protein;however,only the hybrid immunity group mobilized T-cells that reacted to membrane and nucleocapsid antigens.nAbs increased significantly during exercise only in the hybrid immunity group.Conclusion:These data indicate that acute exercise mobilizes SARS-CoV-2 specific T-cells that recognize spike protein and increases the redistribution of nAbs in individuals with hybrid immunity.

Covid-19 vaccination in pregnancy and placental pathology

Objective:To describe and determine the association between Covid-19 vaccination in pregnancy and placental pathology.Methods:Conducted in a tertiary hospital in Medan,Indonesia,from April 30th 2022 to June 30th 2022,this single-center cross-sectional study involved Covid-19 vaccinated and unvaccinated women with singleton full-term pregnancies delivering live fetuses via cesarean section.Maternal characteristics,placental pathologies,and the placental index were documented at enrollment.The association between Covid-19 vaccination status and placental pathology was assessed.Results:The study enrolled 200 pregnant women,including 110 vaccinated women and 90 unvaccinated women.No significant differences were observed in birthweight(P=0.48),placental index(P=0.48),and placental pathology findings[intervillous bleeding(P=0.20),increased syncytial knots(P=0.83),chorangiosis(P=0.13),villous stromal edema(P=0.13),vascular dilation and congestion(P=0.13),and vascular wall thrombus(P=0.71)]between the vaccinated and unvaccinated groups.Conclusions:This study revealed no statistically significant association between Covid-19 vaccination and placental pathology.The findings support the safety of Covid-19 vaccination during pregnancy,in regards to changes of the placental pathology.

COVID-19 Vaccination Uptake and Associated Factors in Selected Communities in Two Southwestern States in Nigeria

Introduction: COVID-19 vaccine uptake and acceptance have been a major global concern due to the prevalent misinformation and disinformation that has characterized the vaccine rollout worldwide. This study aimed to assess COVID-19 vaccine uptake and acceptance, and associated factors among selected community members in two states in southwestern Nigeria. Method: We conducted a cross-sectional study using a multistage sampling technique. Fifty catchment settlements of 10 health facilities in each of Oyo and Ogun States targeted for a COVID-19 infection prevention and control intervention were randomly selected. Four households were targeted per settlement. All households that refused access were replaced, to ensure a minimum of four households randomly selected per settlement. The primary household decision-maker was interviewed in each household. Information elicited included respondents’ sociodemographic characteristics, health history, knowledge, risk and benefit perception about the COVID-19 vaccine, vaccine uptake, and willingness to be vaccinated. The study was conducted from July–August 2021. Data were analyzed using SPSS IBM version 23. Result: Four hundred household decision-makers were surveyed in Oyo and Ogun states, after replacement. The mean age of the respondents was 43.0 ± 11.0 years. The majority, 346 (86.5%) had heard about COVID-19 vaccination, but only 47 (13.6%) had received a COVID-19 vaccination. Of the 299 respondents who reported not receiving a COVID-19 vaccination, 166 (55.5%) were willing to be vaccinated. In univariate analysis, respondents who were female had tertiary education, perceived that COVID-19 vaccines are free and accessible, perceived that COVID-19 vaccines have minimal side effects, and perceived higher benefits of COVID-19 vaccination had higher odds of being vaccinated. In contrast, younger respondents, respondents with higher knowledge scores on COVID-19 preventive measures, and with chronic illness had lower likelihoods of being vaccinated. In multivariate analysis, only the respondent’s age, perception score on COVID-19 vaccine benefits, knowledge score on IPC measures, and positive response on accessibility and safety were significant after adjusting for other factors. Conclusion: COVID-19 vaccine uptake rate as well as willingness to receive vaccination were low in the study setting. There is an urgent need for policymakers to embark on well-designed campaigns to address barriers to COVID-19 vaccination to increase vaccine uptake.

Revaccination after Acute Kidney Injury Associated with Prior COVID-19 Vaccination: Case Report

Background: Acute kidney injury associated with proteinuria has been reported following vaccination against SARS-CoV-2 several times since 2021. Decisions about subsequent revaccination in these patients have been difficult because of the uncertainty of the consequences of doing so, and the absence of publications to help determine whether revaccination may be considered safe or not. Purpose: We present a case report of a 59-year-old Canadian man who developed severe acute kidney injury associated with moderate proteinuria following his first COVID-19 vaccine with the Moderna vaccine (an mRNA vaccine). He required haemodialysis for 2 weeks, which was initiated when his creatinine reached 1002 μmol/l. A kidney biopsy showed changes consistent with acute tubular necrosis. The patient was cautioned that repeat vaccination might result in further kidney injury which might be irreversible. However, he badly wanted to attempt a second COVID-19 vaccination, to facilitate a family vacation across several countries in Europe, at a time when travel restrictions were in place in many countries for persons who had not completed a course of vaccines. Method: Following deliberations, the patient chose to try a different type of Covid-19 vaccine. On this occasion, he was vaccinated with the Novavax vaccine (a subunit COVID-19 vaccine). Following this, close monitoring of his urine to detect proteinuria and blood testing for acute kidney injury were carried out on days 1, 3, 7, and 60 after vaccination. Furthermore, a year after his repeat vaccination, his kidney function and urinalysis were again assessed. Result and Conclusions: The patient did not develop acute kidney injury or worsening proteinuria following repeat vaccination. It remains unclear if acute kidney injury with proteinuria is caused by Covid-19 vaccination, or simply an incidental association. This case report suggests that it is may be reasonable for patients with acute kidney injury after COVID-19 vaccination to consider trying a different type of vaccine. In situations where a new virulent strain of virus emerges or in patients at risk of severe complication from infection, it may be reasonable to consider revaccination following appropriate counselling with close monitoring of renal function.

COVID-19 Vaccination Status and Severe Outcomes among Patients Hospitalized for COVID-19 in West Africa, Togo, 2021

Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to describe the impact of COVID-19 vaccination on the prognosis of hospitalized patients. Methods: This was a retrospective cohort study of patients admitted to the Centre Hospitalier Régional Lomé Commune (Togo) between June 1, 2021 and May 31, 2022. Primary outcomes (admission to the intensive care unit and death) were presented with frequency and proportion. Mortality rates were presented by sociodemographic and clinical characteristics and compared by appropriate statistical tests. Factors associated with inpatient death were described by performing a Cox proportional hazard regression. Results: A total of 604 patients were hospitalized (50.0% women). The mean age was 54.03 ±17.1 years. Only 55 patients were fully vaccinated (9.1%). ICU admission was significantly more frequent in unvaccinated patients than in vaccinated ones (63.0% vs. 38.2%;p Conclusion: COVID-19 vaccination had a significant benefit for patients with COVID-19 infection in terms of reducing the risk of death. Based on real-world data from sub-Saharan Africa, this information can help optimize the benefit of COVID-19 vaccination by raising community awareness and increasing vaccine coverage while reducing hesitancy.

Drug-induced sarcoidosis-like reaction three months after BNT162b2 mRNA COVID-19 vaccination:A case report and review of literature

BACKGROUND A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment(S)5.CASE SUMMARY Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging(EOB-MRI)revealed the nodule in S5 with a defect at the hepatobiliary phase,hyperintensity on diffusion weighted imaging(DWI)and hypointensity on apparent diffusion coefficient(ADC)map.Contrast-enhanced computed tomography revealed hypervascularity at the early phase,and delayed contrast-enhancement was observed at the late phase.Contrast-enhanced ultrasound(US)revealed incomplete defect at the late vascular phase.Inflammatory liver tumor,lymphoproliferative disease,intrahepatic cholangiocarcinoma(small duct type)and bile duct adenoma were suspected through the imaging studies.US guided biopsy,however,showed a noncaseating hepatic sarcoid-like epithelioid granuloma(HSEG),and histopathological analysis disclosed spindle shaped epithelioid cells harboring Langhans-type multinucleated giant cells.One month after admission,EOB-MRI signaled the disappearance of the defect at the hepatobiliary phase,of hyperintensity on DWI,of hypointensity on ADC map,and no stain at the early phase.CONCLUSION That the patient had received BNT162b2 messenger RNA(mRNA)coronavirus disease 2019 vaccination 3 mo before the occurrence of HSEG,and that its disappearance was confirmed 4 mo after mRNA vaccination suggested that the drug-induced sarcoidosis-like reaction(DISR)might be induced by the mRNA vaccination.Fortunately,rechallenge of drug-induced DISR with the third mRNA vaccination was not confirmed.

Safety,immunogenicity,efficacy,and acceptability of COVID-19 vaccination in people with multiple sclerosis:a narrative review

In the last two years,a new seve re acute res piratory syndrome coronavirus(SARS-CoV)infection has spread worldwide leading to the death of millions.Va ccination represents the key factor in the global strategy against this pandemic,but it also poses several problems,especially for vulnerable people such as patients with multiple scle rosis.In this review,we have briefly summarized the main findings of the safety,efficacy,and acceptability of Coronavirus Disease 2019(COVID-19)vaccination fo r multiple sclerosis patients.Although the acceptability of COVID-19 vaccines has progressively increased in the last year,a small but significant part of patients with multiple sclerosis still has relevant concerns about vaccination that make them hesitant about receiving the COVID-19 vaccine.Overall,available data suggest that the COVID-19 vaccination is safe and effective in multiple scle rosis patients,even though some pharmacological treatments such as anti-CD20 therapies or sphingosine I-phosphate receptor modulato rs can reduce the immune response to vaccination.Accordingly,COVID-19 vaccination should be strongly recommended for people with multiple scle rosis and,in patients treated with anti-CD20 therapies and sphingosine I-phosphate receptor modulato rs,and clinicians should evaluate the appropriate timing for vaccine administration.Further studies are necessary to understand the role of cellular immunity in COVID-19 vaccination and the possible usefulness of booster jabs.On the other hand,it is mandatory to learn more about the reasons why people refuse vaccination.This would help to design a more effective communication campaign aimed at increasing vaccination coverage among vulnerable people.

COVID-19 vaccination and associated factors in Turkish healthcare workers practicing chest medicine

Objective: To evaluate the COVID-19 vaccination status and related characteristics of Turkish healthcare workers practicing chest medicine.Methods: A cross-sectional online survey was conducted among the Turkish Thoracic Society members. The survey was started on May 17, 2021, and kept open for seven weeks. The 39-item survey included the COVID-19 vaccination status and demographic, clinical, and occupational characteristics. Results: Of 378 healthcare workers participated in the survey, 354(93.7%) reported receiving at least one dose of the COVID-19 vaccine. A total of 323(91.2%) healthcare workers received CoronaVac vs. BioNTech/Pfizer in 31(8.8%). In the CoronaVac group, 77(23.8%) contracted COVID-19 when not fully vaccinated, and 13(4.0%) when fully vaccinated;however, 16(51.6%) healthcare workers in the BioNTech/Pfizer group got COVID-19 when not fully vaccinated, but any fully vaccinated participants did not contract COVID-19(P=0.003). Regarding vaccine dosing, 328(86.8%) were fully vaccinated, while 50(13.2%) were not. Multiple regression analysis for being a non-fully vaccinated healthcare worker demonstrated a significant relationship with having any SARS-CoV-2 infection history(adjusted OR 9.57, 95% CI 3.93-23.26, P<0.001) and being a non-physician healthcare worker(adjusted OR 5.86, 95% CI 2.11-16.26, P=0.001), but a significant negative relationship with full-time working at the time of survey(adjusted OR 0.13, 95% CI 0.03-0.56, P=0.006). Conclusions: Although a majority of healthcare workers were fully vaccinated, occupational and non-occupational characteristics were related to being non-fully vaccinated. Active surveillance regarding the COVID-19 vaccination in healthcare workers is necessary to address specific parameters as barriers to vaccination.

Waning of Anti-Spike IgG Antibody Titer after COVID-19 Vaccination: Myth or Reality?

This observational prospective study was conducted on 25 patients who had received a full 3-dose COVID-19 vaccination scheme with a follow-up ranging from 12 to 19 months after the last injection. The aim of the study was focused on a single biological indicator the anti-spike IgG antibody titer. The age of the patients ranged from 51 to 85 years old. 15 out 25 patients (60%) presented a comorbidity. Our data showed a persistent positive anti-spike IgG antibodies titer ranging from 105 to 5680 BAU/mL (mean: 2661 BAU/mL) in all patients. In view of these results, systematic administration of a SARS-CoV-2 vaccine booster is questionable and should be individually tailored according to the patient medical condition and the anti-spike IgG antibody level.

COVID-19 vaccination and diabetic ketoacidosis

An efficient coronavirus disease 2019(COVID-19)vaccine is urgently required to fight the pandemic due to its high transmission rate and quick dissemination.There have been numerous reports on the side effects of the COVID-19 immunization,with a focus on its negative effects.Clinical endocrinology is extremely interested in the endocrine issue that arises after receiving the COVID-19 vaccine.As was already mentioned,after receiving the COVID-19 vaccine,many clinical problems could occur.Additionally,there are some compelling reports on diabetes.After receiving the COVID-19 vaccine,a patient experienced hyperosmolar hyperglycemia state,a case of newly-onset type 2 diabetes.There has also been information on a potential connection between the COVID-19 vaccine and diabetic ketoacidosis.Common symptoms include thirst,polydipsia,polyuria,palpitations,a lack of appetite,and weariness.In extremely rare clinical circumstances,a COVID-19 vaccine recipient may develop diabetes complications such as hyperglycemia and ketoacidosis.In these circumstances,routine clinical care has a successful track record.It is advised to give vaccine recipients who are vulnerable to problems,such as those with type 1 diabetes as an underlying illness,extra attention.

Transverse myelitis caused by herpes zoster following COVID-19 vaccination:A case report

BACKGROUND Transverse myelitis(TM)is characterized by sudden lower extremity progressive weakness and sensory impairment,and most patients have a history of advanced viral infection symptoms.A variety of disorders can cause TM in association with viral or nonviral infection,vascular,neoplasia,collagen vascular,and iatrogenic,such as vaccination.Vaccination has become common through the global implementation against coronavirus disease 2019(COVID-19)and reported complications like herpes zoster(HZ)activation has increased.CASE SUMMARY This is a 68-year-old woman who developed multiple pustules and scabs at the T6-T9 dermatome site 1 wk after vaccination with the COVID-19 vaccine(Oxford/AstraZeneca([ChAdOx1S{recombinant}]).The patient had a paraplegia aggravation 3 wk after HZ symptoms started.Spinal magnetic resonance imaging(MRI)showed transverse myelitis at the T6–T9 Level.Treatment was acyclovir with steroids combined with physical therapy.Her neurological function was slowly restored by Day 17.CONCLUSION HZ developed after COVID-19 vaccination,which may lead to more severe complications.Therefore,HZ treatment itself should not be delayed.If neurological complications worsen after appropriate management,an immediate diagnostic procedure,such as magnetic resonance imaging and laboratory tests,will start and should treat the neurological complications.

Atypical progress of frozen shoulder after COVID-19 vaccination:A case report

BACKGROUND After vaccination was mandated worldwide,various adverse effects associated with the coronavirus disease 2019(COVID-19)vaccination,including shoulder pain,have been reported.Here,we report a case of new-onset shoulder pain after BNT162b2(Comirnaty,Pfizer-BioNTech)mRNA vaccination.CASE SUMMARY A 50-year-old man visited our rehabilitation center with left shoulder range of motion(ROM)limitation that had persisted for more than 5 mo.The history included no specific noteworthy events,except vaccination.The pain in the patient’s left deltoid muscle appeared 1 day after the second BNT162b2 vaccination and intensified to severe pain.The patient self-administered aspirin,with which the pain subsided immediately,whereas ROM limitation persisted.At the first visit,the patient complained of dull pain and ROM restriction of the left shoulder(flexion 130°,abduction 110°,and external rotation 40°).Among the diagnostic studies conducted for the evaluation of the shoulder,magnetic resonance imaging showed a thickened coracohumeral ligament.Nerve conduction studies and needle electromyography showed no electrodiagnostic abnormalities.The patient received comprehensive rehabilitation for 7 mo and had an overall improvement in pain and ROM of the left shoulder.CONCLUSION In this case of severe shoulder pain after COVID-19 vaccination that subsided immediately with aspirin treatment,the exact cause and mechanism of pain are unclear.However,the clinical symptoms and diagnostic workups in our report suggest the possibility that the COVID-19 vaccination triggered an immunochemical response that resulted in shoulder pathology.

Immune-mediated liver injury following COVID-19 vaccination

Liver injury secondary to vaccination is a rare adverse event that has recently come under attention thanks to the continuous pharmacovigilance following the widespread implementation of coronavirus disease 2019(COVID-19)vaccination protocols.All three most widely distributed severe acute respiratory syndrome coronavirus 2 vaccine formulations,e.g.,BNT162b2,mRNA-1273,and ChAdOx1-S,can induce liver injury that may involve immune-mediated pathways and result in autoimmune hepatitis-like presentation that may require therapeutic intervention in the form of corticosteroid administration.Various mechanisms have been proposed in an attempt to highlight immune checkpoint inhibition and thus establish causality with vaccination.The autoimmune features of such a reaction also prompt an in-depth investigation of the newly employed vaccine technologies.Novel vaccine delivery platforms,e.g.,mRNA-containing lipid nanoparticles and adenoviral vectors,contribute to the inflammatory background that leads to an exaggerated immune response,while patterns of molecular mimicry between the spike(S)protein and prominent liver antigens may account for the autoimmune presentation.Immune mediators triggered by vaccination or vaccine ingredients per se,including autoreactive antibodies,cytokines,and cytotoxic T-cell populations,may inflict hepatocellular damage through wellestablished pathways.We aim to review available data associated with immunemediated liver injury associated with COVID-19 vaccination and elucidate potential mechanisms underlying its pathogenesis.

Correlation between COVID-19 vaccination and diabetes mellitus:A systematic review

BACKGROUND Coronavirus disease 2019(COVID-19)is one of the current global public health threats and vaccination is the most effective tool to reduce the spread and decrease the severity of COVID-19.Diabetes is one of the important chronic diseases threatening human health and is a common comorbidity of COVID-19.What is the impact of diabetes on the immunization effect of COVID-19 vaccination?Conversely,does vaccination against COVID-19 exacerbate the severity of pre-existing diseases in patients with diabetes?There are limited and conflicting data on the interrelationship between diabetes and COVID-19 vaccination.AIM To explore the clinical factors and possible mechanisms underlying the interaction between COVID-19 vaccination and diabetes.METHODS We conducted a comprehensive search of PubMed,MEDLINE,EMBASE,and Reference Citation Analysis(https://www.referencecitationanalysis.com)online datab-ases,and medRxiv and bioRxiv gray literature using the keywords"SARSCoV-2","COVID-19","vaccine","vaccination","antibody",and"diabetes"individually or in combination,with a cut-off date of December 2,2022.We followed inclusion and exclusion criteria and after excluding duplicate publications,studies with quantifiable evidence were included in the full-text review,plus three manually searched publications,resulting in 54 studies being included in this review.RESULTS A total of 54 studies were included,from 17 countries.There were no randomized controlled studies.The largest sample size was 350963.The youngest of the included samples was 5 years old and the oldest was 98 years old.The included population included the general population and also some special populations with pediatric diabetes,hemodialysis,solid organ transplantation,and autoimmune diseases.The earliest study began in November 2020.Thirty studies discussed the effect of diabetes on vaccination,with the majority indicating that diabetes reduces the response to COVID-19 vaccination.The other 24 studies were on the effect of vaccination on diabetes,which included 18 case reports/series.Most of the studies concluded that COVID-19 vaccination had a risk of causing elevated blood glucose.A total of 12 of the 54 included studies indicated a"no effect"relationship between diabetes and vaccination.CONCLUSION There is a complex relationship between vaccination and diabetes with a bidirectional effect.Vaccination may contribute to the risk of worsening blood glucose in diabetic patients and diabetic patients may have a lower antibody response after vaccination than the general population.

Central Retinal Vein Occlusion in Healthy Young Adults Following COVID-19 Vaccination: Case Series

Our aim is to report 4 cases of central retinal vein occlusion following COVID-19 vaccine administration. In this case series, 4 patients between 23-32 years of age presented to us with unilateral central retinal vein occlusion after 2-15 days of getting vaccinated against COVID-19. One patient was a known case of hypertension and 1 was hypothyroid. All the patients had disc swelling, flame shaped haemorrhages, dilated and tortuous blood vessels in the retina. One patient had cystoid macular edema and was treated with intravitreal ranibizumab. As there were no positive systemic risk factors or incidents, COVID-19 vaccines might have an association with the central retinal vein occlusion in these cases. .

Myocarditis after COVID-19 Vaccination

Aim: The ongoing COVID-19 pandemic is an acute medical, social, political and economic problem. Acute myocarditis is a rare complication of the widely used mRNA-based vaccines. Case Presentation: 20-year old male with no preexisting disease or cardiovascular risk factor presented in October 2021 with chest pain after receiving the second dose of the Moderna COVID-19 vaccine 2 days previously. He discharged from ward care only a few days after his initial presentation. Conclusion: Despite the meta-analysis results suggesting a higher risk of myocarditis with COVID-19 vaccination, vaccination should still be recommended because benefits of the vaccine likely outweigh its harms.

Bell’s Palsy Post COVID-19 Vaccination: A Retrospective Cross-Sectional Study in a Single Tertiary Center

Introduction: Bell’s palsy is an uncommon adverse effect of the COVID-19 vaccine that has been reported in clinical trials. Even though a few studies have linked the vaccination to Bell’s palsy, the actual mechanism is uncertain. Objectives: To describe the demographic data and COVID-19 vaccines-related data with Bell’s palsy in a tertiary centre of Malaysia, Hospital Kuala Lumpur. Methods: A retrospective cross-sectional study was observed among vaccinated recipients who developed Bell’s palsy within 60 days and sought treatment in the Otorhinolaryngology Department Hospital Kuala Lumpur, Malaysia between 1st May 2021 and 30th November 2021. The demographic data, clinical history, and vaccination history were collected from clinical records. The facial paralysis was graded according to the House-Brackmann grading system. Results: A total of 26 patients with a mean age was 38.5 years;higher incidence in younger age, below 60 years old (n = 24), specifically 18 - 30 years old (n = 11). We observed an equal number in relation to gender and onset (after the first or second dose) of facial palsy. Predominantly were Malay (n = 21) and only 6 patients had comorbidities. We found there was no difference in regard to the type of vaccine among Bell’s palsy patients;Pfizer (n = 9), followed by Sinovac (n = 9) and AstraZeneca (n = 8). Conclusion: Bell’s palsy was found to be a possible adverse event of the COVID-19 vaccine. Younger groups were noted as susceptible to this rare adverse effect. However, the benefits of vaccination outweigh the risk of Bell’s palsy, which has a good prognosis. More research with larger samples is needed to determine the true relationship between vaccination and Bell’s palsy.

Bell’s palsy after inactivated COVID-19 vaccination in a patient with history of recurrent Bell’s palsy: A case report

BACKGROUND With rapid and extensive administration of inactivated coronavirus disease 2019(COVID-19)vaccine to the general population in China,it is crucial for clinicians to recognize neurological complications or other side effects associated with COVID-19 vaccination.CASE SUMMARY Here we report the first case of Bell’s palsy after the first dose of inactivated COVID-19 vaccine in China.The patient was a 36-year-old woman with a past history of Bell’s palsy.Two days after receiving the first dose of the Sinovac Life Sciences inactivated COVID-19 vaccine,the patient developed right-side Bell’s palsy and binoculus keratoconjunctivitis.Prednisone,artificial tears and fluorometholone eye drops were applied.The patient’s symptoms began to improve by day 7 and resolved by day 54.CONCLUSION As mRNA COVID-19 vaccine trials reported cases of Bell’s palsy as adverse events,we should pay attention to the occurrence of Bell’s palsy after inactivated COVID-19 vaccination.A history of Bell’s palsy,rapid increase of immunoglobulin M and immunoglobin G-specific antibodies to severe acute respiratory syndrome coronavirus 2 may be risk factors for Bell‘s palsy after COVID-19 vaccination.

COVID-19 vaccination intention among healthcare workers in Vietnam

Objective:To assess the acceptance of coronavirus disease(COVID-19)vaccine among healthcare workers at two general hospitals in Vietnam when it is available.Methods:A cross-sectional study was conducted using a convenience sampling from January to February 2021 among 410 healthcare workers at two general hospitals in Vietnam via a selfadministered questionnaire.A multivariable regression analysis was performed to determine predictors of vaccine acceptance including the demographic factors,COVID-19 knowledge,and vaccine beliefs based on the domains of Health Belief Model.Results:Among 410 healthcare workers,76.10%showed vaccination willingness.Predictors of acceptance were determined that the group reporting as“vaccine acceptance”was more likely to be positive towards the perceived susceptibility and severity of COVID-19(OR 2.45;95%CI 1.48-4.06,P<0.05),perceived benefits of vaccination,and cues to action(OR 4.36;95%CI 2.35-8.09,and OR 5.49;95%CI 2.84-10.61,respectively,all P<0.001),but less likely to have the perceived barriers to vaccination(OR 0.19;95%CI 0.09-0.38;P<0.001)compared with the no acceptance group.Besides,people who had a good knowledge regarding the severity of illness were 3.37 times more likely to have identified as vaccine acceptance(OR 3.37;95%CI 1.04-10.86,P<0.05).The demographic factors were also associated with willingness to receive the vaccine,with participants who were staff and received COVID-19 information from relatives were less likely to accept the vaccine over those who were doctors and not receiving information from relatives(OR 0.36;95%CI 0.13-0.96,and OR 0.37;95%CI 0.17-0.78,respectively,all P<0.05).Conclusions:A rate of willingness to get vaccinated against COVID-19 was relatively high with discrepancies between occupation,receiving information from relatives,knowledge toward the severity of illness,and the elements of Health Belief Model.The findings will provide information for the management authorities to develop relevant interventions to promote COVID-19 vaccination uptake.

Intention of healthcare workers to accept COVID-19 vaccination and related factors:A systematic review and meta-analysis

Considering medical and economic burden of coronavirus disease 2019(COVID-19), a high COVID-19 vaccination coverage among healthcare workers(HCWs) is an urgent need. The aim of this systematic review and meta-analysis was to evaluate the intention of HCWs to accept COVID-19 vaccination and to identify related factors. We searched Pub Med, MEDLINE, Scopus, Web of Science, Pro Quest, CINAHL and med Rxiv until July 14, 2021. The heterogeneity between results was very high;thus, we applied a random effects model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Twenty four studies, including 50 940 HCWs, met the inclusion criteria. The overall proportion of HCWs that intend to accept COVID-19 vaccination was 63.5%(95% confidence interval: 56.5%-70.2%) with a wide range among studies from 27.7% to 90.1%. The following factors were associated with increased HCWs’ willingness to get vaccinated against COVID-19: male gender, older age, white HCWs, physician profession, higher education level, comorbidity among HCWs, vaccination against flu during previous season, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. The reluctance of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or refuse COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake.