What are the effects after vaccination (post-vaccination)?

From the Guidelines

Post-vaccination management should prioritize monitoring for side effects and allowing the body to build immunity, with consideration of the patient's underlying health conditions and medications, as outlined in the study by 1. When considering post-vaccination care, it's essential to take into account the individual's health status, including any existing comorbidities or immunosuppressive therapies they may be undergoing.

• For patients on immunosuppressive therapies, such as corticosteroids, disease-modifying antirheumatic drugs (DMARDs), or biologic agents, the timing and dosage of these medications may need to be adjusted around the time of vaccination to optimize the immune response, as suggested by 1.
• The study by 1 recommends tapering corticosteroids to less than 10 mg/day prior to vaccination and withholding methotrexate (MTX) for at least two weeks before and after vaccination.
• Additionally, patients on anti-tumor necrosis factor (TNF) agents, interleukin (IL)-17 blockers, or Janus kinase (JAK) inhibitors may require special consideration, with recommendations to withhold these medications for a specified period before and after vaccination, as outlined in the study by 1. Common post-vaccination symptoms, such as soreness at the injection site, mild fever, fatigue, headache, and muscle aches, can be managed with over-the-counter medications like acetaminophen or ibuprofen, and typically resolve within 1-2 days.
• It's crucial to seek medical attention if severe symptoms occur, such as high fever, severe headache, difficulty breathing, or symptoms that worsen or persist beyond a few days, as noted in the study by 1. Overall, post-vaccination care should be individualized, taking into account the patient's unique health status and medications, to ensure the best possible outcome and minimize potential complications, as emphasized by the study by 1.

From the Research

Post-Vaccination Reactions

• Anaphylaxis is a rare, serious hypersensitivity reaction following vaccination, which is rapid in onset and characterized by multisystem involvement 2.
• The estimated incidence of anaphylaxis is 1.3 per million vaccine doses administered for all vaccines and 1.6 per million doses for IIV3 (trivalent) influenza vaccine 2.
• Adverse reactions to vaccines are commonly reported but most of them are nonspecific mild events, whereas vaccine-related anaphylaxis is considered a rare event, with an incidence rate equal to 1.3 cases per million vaccine doses administered 3.

COVID-19 Vaccination

• COVID-19 vaccines have been used to counteract the global COVID-19 pandemic, but adverse reactions have been reported, such as injection-site pain, muscle ache, fever, palpitation, and chest discomfort 4.
• The release of inflammatory cytokines, such as interleukin (IL)-6 and IL-1β, is a potential mechanism for post-vaccine side-effects 4.
• High-intensity exercise, alcohol, tobacco smoking, and baths promote inflammatory cytokines, such as IL-6, which may exacerbate the adverse reactions after vaccination 4.

Prevention of Adverse Reactions

• Use of prophylactic acetaminophen and ibuprofen may reduce the incidence of adverse reactions in young infants receiving DTwP vaccine, but no benefits have been demonstrated for this vaccine when evaluated in children aged 4-6 years, or with any other vaccine currently in use 5.
• Individuals at high risk for seizures may, however, warrant special consideration for the use of prophylactic acetaminophen and ibuprofen 5.

Diagnosis of Post-Vaccination Adverse Reactions

• The diagnosis of spontaneous allergic reactions, skin occurrences, vascular, blood, endocrine and heart events, respiratory reports, gastrointestinal, hepatic and kidney events, reproductive and pregnancy issues, and muscle events, as well as ear, eye, neurologic and psychiatric events following mRNA vaccination against COVID-19, have been reported 6.
• The mRNA strategies, side effects associated with the spike protein based LNP-mRNA vaccine and its adjuvants, as well as evidence for all the possible dangerous roles of the spike protein, have been discussed 6.