Chronic Inflammatory Demyelinating Polyradiculoneuropathy with Diplopia Caused by an Alternative Coronavirus Disease 2019 Vaccine.

Vaccination

Should women undergoing in vitro fertilization treatment or who are in the first trimester of pregnancy be vaccinated immediately against COVID-19

Safety of SARS-CoV-2 mRNA vaccines and effects of immunosuppressive drugs on adverse reactions in patients with rheumatic diseases

SARS-CoV-2 vaccination in heart transplantation: What we do and do not know

Safety of COVID-19 vaccination in patients with polyethylene glycol allergy: A case series

Updated International Society of Geriatric Oncology COVID-19 working group recommendations on COVID-19 vaccination among older adults with cancer

Reply to “How important is the second dose of the COVID-19 mRNA vaccine?”

COVID-19 vaccines in pregnancy.

The COVID-19 Pandemic in 2021: Avoiding Overdiagnosis of Anaphylaxis Risk While Safely Vaccinating the World

The occurrence of chronic inflammatory demyelinating polyneuropathy (CIDP) related to coronavirus disease 2019 (COVID-19) has rarely been reported. We describe two patients who were diagnosed with CIDP after COVID-19 vaccination. A 72-year-old man presented with a progressive tingling sensation and weakness below both knees for two weeks. He had been vaccinated against COVID-19 (mRNA-1273 vaccine) a month before the appearance of symptoms. Demyelinating polyneuropathy was observed in the nerve conduction studies (NCS). Intravenous immunoglobulin (IVIg) was administered under the diagnosis of Guillain-Barré syndrome (GBS), and his symptoms were improved. However, his symptoms relapsed at 10 weeks from the onset. Oral prednisolone, azathioprine, and IVIg were administered as treatment. The second case was a 50-year-old man who complained of a bilateral leg tingling sensation and gait disturbance lasting four weeks. He had received the Ad26.COV2.S vaccine against COVID-19 five weeks prior. Demyelinating polyneuropathy was observed in the NCS. He was treated with oral prednisolone, azathioprine, and IVIg for CIDP because his symptoms had lasted for more than 12 weeks from the onset. A causal relationship has not been established between COVID-19 vaccination and CIDP; however, CIDP may follow COVID-19 vaccination. As CIDP treatment is different from that for GBS, clinicians should closely monitor patients diagnosed with GBS associated with COVID-19 whether they deteriorate after initial treatment.

Acute transverse myelitis after BNT162b2 vaccination against COVID-19: Report of a fatal case and review of the literature

Observations on improving COVID-19 vaccination responses in kidney transplant recipients: heterologous vaccination and immunosuppression modulation

COVID-19 mRNA Vaccine Short-Term Safety in Patients With Inflammatory Bowel Disease

129th ENMC International Workshop: Clinical Trials for Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Multifocal Motor Neuropathy, 27th October 2004, Schiphol airport, The Netherlands

Study questionDo mRNA and viral vector coronavirus disease 2019 (COVID-19) vaccines detrimentally affect semen parameters?Summary answerThe semen parameters following COVID-19 vaccination did not reflect any causative detrimental effect from vaccination.What is known alreadyBased on a still debatable observation of detrimental effect of COVID-19 infection on male fertility, unfounded claims in the social media suggested a potential association between COVID-19 vaccine and male infertility. To date, only two reports on the possible effect of COVID-19 mRNA vaccines on semen quality are available. First, a study on semen samples from 75 fertile men analyzed only 1-2 months after vaccination concluded that semen parameters following vaccine were predominantly within the normal WHO reference ranges. Secondly, in 45 men comparison of semen before and after COVID-19 mRNA vaccine showed no significant decreases in any sperm parameter.Study design, size, durationThis prospective study performed at a tertiary public fertility center included 101 men undergoing ART from January 2018 and December 2021. For each man we compared semen parameters before and after the COVID-19 vaccination: 78% of men received mRNA vaccines (78% Pfizer, 22% Moderna), 20% viral vector vaccines (70% AstraZeneca, 30% Johnson & Johnson), and 2% a mixed formulation. Post-vaccine samples were obtained at a median of 2.3 + 1.5 months after the second dose.Participants/materials, setting, methodsSemen analysis was performed according to WHO guidelines. Medians and interquartile ranges (IQRs) were reported for all parameters. The impact of COVID-19 vaccine on endpoints (semen volume, concentration, motility) was evaluated by Wilcoxon rank sum test to perform paired comparison of pre- and post-vaccination semen parameters. We also evaluated the following covariates: age, BMI, smoke habit, days of sexual abstinence, and frequency of ejaculations. Analyses were carried out by MedCalc® software.Main results and the role of chancePre-vaccination samples were obtained after a median abstinence period of 4 days (IQR 3-5) and post-vaccination samples after a median of 3 days (IQR 3-4, p = 0.004). Pre-vaccination median sample volume, sperm concentration, progressive motility, and total motile sperm count (TMSC) were 3.0 ml (IQR 2.2-4.0), 25.0 million/ml (IQR 11.4-38.0), 50% (IQR 40-60) and 34.8 million (IQR 11.6-68.8), respectively. After the second vaccine dose, the median sample volume significantly decreased to 2.6 ml (IQR 1.9-3.5, p = 0.036), whereas the median sperm concentration, the progressive motility, and TMSC significantly increased to 43.0 million/ml (IQR 17.0-86.5, p < 0.0001), 56% (IQR 40-65, p = 0.022) and 54.6 million (IQR 18.9-105.6, p < 0.0001), respectively. Thirty-four patients were oligospermic before the vaccine (mean concentration 7.8 + 4.3 million/ml), and also in this subset of patients we observed a significant increase of the median sperm concentration, progressive motility, and TMSC (p = 0.001, p = 0.002, p = 0.001, respectively) in post-vaccine semen samples respect to the pre-vaccine ones. Finally, we analyzed separately patients who received a mRNA vaccine and those who received a viral vector vaccine, and we confirmed the aforementioned results again in these two groups.Limitations, reasons for cautionSmall sample size, short follow-up, no healthy control group, no evaluation of male reproductive potential i.e., by comparing outcomes of ART cycles before and after vaccination. Nevertheless, this work was preceded by only two other reports published on this issue, and it includes more than twice as many patients enlisted.Wider implications of the findingsIn agreement with literature, COVID-19 vaccination does not reduce sperm quality and for the first time we demonstrated that this applies to both mRNA and viral-vector vaccines. The known individual variation in semen and the reduced abstinence time before the post-vaccine sample collection may explain the increases in sperm parameters.Trial registration numbernot applicable