Medical Case Reports

Severe post-vaccinal complications could be driven by an overactive immune response. In a new case series , recently published in Cureus, three rheumatic disease patients with low disease activity needed hospitalization and new biological treatments, and one patient died after her 4th dose of SARS-CoV-2 mRNA vaccine. Cytokine analysis showed elevated levels of IL-1β, IL-6, IL-17, and TNF-α, indicating a cytokine storm, possibly triggered by IL-6 amplification (IL-6 Amp). This mechanism involves excessive IL-6 production through a feedback loop activated by simultaneous stimulation of NF-κB and STAT3 pathways Case 1: Acute Exacerbation of Interstitial Pneumonia in an 80-Year-Old Woman An 80-year-old woman with a history of rheumatoid arthritis (RA) had been in remission for five years thanks to a regimen including subcutaneous tocilizumab (TCZ-SC) and tacrolimus. However, after receiving the Pfizer-BioNTech vaccine, she developed severe dyspnea requiring oxygen. Her CT scan revealed new...

Chronic viral shedding, a condition where the virus continues to be released from an individual's body long after the initial infection, has been observed in many infectious diseases, including COVID-19.  In such cases, individuals may remain asymptomatic or experience only mild symptoms while the virus persists. It remains detectable in repeated tests over an extended period and can still infect others even in nasal swab is negative (which happens quite often ). This was evident in our study.    Recent research by Conway et al. (2024) highlights the possibility of chronic SARS-CoV-2 infection, extending over several months and potentially years. Other studies have documented prolonged asymptomatic infections and extended viral shedding in moderate to severe beyond hospital discharge. Analysis of sequencing data on UK samples taken between 2 November 2020 and 15 August 2022 lead to estimates that 0.1–0.5% of infections may become persistent with typically rebounding high ...

A recent study found significant destruction in ribosomal RNA structures after vaccination, a phenomenon that was enhanced by serial shots. This destruction led to massive inhibition of translation and transcription, affecting intra/inter neural signaling transfer and lipid metabolism. These processes are related to the aging process, and the destruction was identified even six months after vaccination. The cases described in cited papers include: 82-year-old female with colorectal cancer in remission: Complications of vaccination: abdominal pain, appetite loss, constipation, anemia, anorexia. Cancer relapsed after vaccination, leading to her death (patient 6 in Tanaka et al, 2022 : Archives of Clinical and Biomedical Research) 85-year-old female with esophageal cancer in remission: Complications of vaccination: dysphasia.  Cancer relapsed after vaccination, along with suspected microembolus in the brain, causing symptoms of memory loss, hoarseness, and dysphagia, leading to her de...

In early January 2023, it become known that the CDC's near real-time surveillance system (the Vaccine Safety Datalink containing health records of more than 12 million Americans) detected a possible increase in ischemic stroke in people 65 and older who recently got one of Pfizer’s ( BioNTech)  updated  booster shots.  It found that 130 seniors had the stroke within 21 days of the shot ( compared with days 22-44 following vaccination ).  This 'met the statistical criteria to prompt additional investigation', the CDC statement said.  CDC officials used an alternative methodology to conduct a different analysis in the VSD database but could not replicate the finding.  They also checked the Center for Medicare and Medicaid Services system, containing 83.9 million individuals, and the Veterans Affairs database, with nine million people. Neither dataset indicated an increased risk of ischemic stroke following a bivalent vaccine.  A large study of updated (...

Several studies reported that COVID-19 vaccine effectiveness (VE) and relative vaccine effectiveness (rVE) against severe COVID-19 outcomes can turn negative after a few months.   One  recently published paper (data analyzed were from 8 December 2020 to 30 June 2021) concludes that For Doses 1 and 2 of ChAdOx1 and Dose 1 of BNT162b2, VE/rVE reached zero by approximately Days 60–80 and then went negative. By Day 70, VE/rVE was –25% (95% CI: –80 to 14) and 10% (95% CI: –32 to 39) for Doses 1 and 2 of ChAdOx1 (see Figure). The same trend was observed for BNT162b2 although it seemed to provide a better protection. Another not-yet published paper found that vaccine effectiveness was waning for all studied doses, including the 4th booster that worked for 90 days. Among health-care workers who had not had previous SARS-CoV-2 infection , time-specific vaccine effectiveness decreased from 52% (95% CI, 45 to 58) during the first 5 weeks after vaccination to −2% (95% CI,...

As fewer and fewer people opt for additional boosters of COVID-19 vaccine, are those who never had vaccine adverse events experiencing new side effects? VAERS reports many uneventful vaccinations even with extra doses given too soon after previous ones. Yet there are cases such as  abdominal pain , or Addisonian crisis  after the 5th dose. One case of systemic adverse reactions (14%, out of 7 respondents) was self-reported after the 5th booster in a survey-based study . The study also showed higher incidence of cutaneous reactions after 3rd vs 2nd dose of the same vaccine.  89 out of  234  vaccinated individuals  (38%)   who filled out  a web-based survey in Turkey  reported  at least one cutaneous adverse event related to the vaccination.  The responders cumulatively received 771 doses.  The mean number of vaccine dosages was 3.29 ± 0.76 (minimum:1, maximum:5). Sixty‐six (28.2%) cases had at least one accompanying systemi...

59-year-old male got vaccinated with the first two doses of  Pfizer/BioNTech COVID-19 vaccine in March 2021 . He received the recommended initial (third dose) and 2nd (fourth dose) booster shots following the CDC guidelines.  CDC strengthened its recommendation on the 1st booster shot for individuals who are 18 years and older in the end of November 2021 , if they were 6 months after their initial Pfizer or Moderna series or 2 months after their initial J&J vaccine. Following  FDA’s regulatory action, on March 29 2022, external icon CDC updated its recommendations to allow all people over the age of 50 who received an initial booster dose at least 4 months ago to be eligible for another mRNA booster to increase their protection against severe disease from COVID-19.  external icon , today, CDC is updating its recommendations to allow certain immunocompromised individuals and people over the age of 50 who received an initial booster dose at least 4 months ago ...

72% relative risk reduction, but very modest absolute risk reduction was observed for 4 vs 3 doses of COVID-19 vaccine (administered 4 months ago or earlier) in Israel. SARS-CoV-2 infection was detected among 4058 residents who received the fourth dose of the vaccine vs 4370 among residents who received 3 doses, yielding cumulative incidences of 17.6% vs 24.9%. There were 217 hospitalizations for COVID-19 of mild-to-moderate severity among the 4-dose recipients compared with 493 among the 3-dose recipients , yielding cumulative incidences of 0.9% and 2.8%, respectively.  The corresponding numbers of COVID-19 hospitalizations for severe illness were 108 and 259 , and the respective cumulative incidences were 0.5% and 1.5%. There were 39 COVID-19 related deaths among the fourth dose recipients vs 85 deaths among the 3-dose recipients, yielding a cumulative mortality of 0.2% vs 0.5% . The estimated effectiveness of the fourth dose against the Omicron variant found in this current stud...

COVID-19 vaccines reduce hospitalization and death, but they don't completely eliminate it. Why are not we studying the fatal cases, to help those not protected by the existing vaccines? Latest report from Public Health Ontario mentions 24 individuals 70 years of age and older that died from COVID-19 despite receiving 4 doses of COVID-19 vaccines. Yes, this is a much smaller number compared to the number of people who died after 3 doses, but since many vulnerable individuals  have already died from COVID-19 and many of vaccine-sensitive/virus vulnerable persons were not able to get additional shots, isn't it time to look into this instead of keeping increasing the number of mandated doses?  REFERENCE ENHANCED EPIDEMIOLOGICAL SUMMARY Confirmed Cases of COVID-19 Following Vaccination in Ontario: December 14, 2020 to March 27, 2022