Abstract
The opinion I put forward in this paper is that attention must continue to be paid to clinical observations compatible with a detrimental effect of anti-SARS-CoV-2 in certain diseases of immunological nature. Using the example of the atypical thrombocytopenic thromboses caused by adenoviral-vector-based vaccines, I argue that usual post-marketing pharmacovigilance programs may fail in identifying very rare vaccine-related disorders. Since the robust protective immunity induced by mRNA vaccines is related to their distinct capacity to induce strong stimulation of T follicular helper cells, I suggest that the safety of mRNA vaccines should be further assessed by appropriately designed epidemiological and mechanistic studies focusing on lymphoproliferative and autoimmune diseases in which T follicular helper cells were found to play a key role.
Highlights
Vaccines against the SARS-CoV-2 virus have proven to be very effective in preventing severe forms of the COVID-19 disease
The NVX-CoV2373 vaccine from Novavax is devoid of polyethylene glycol, and no anaphylactic reactions were reported with this product [2]
We suggest that still unidentified, rare complications of mRNA vaccination might result from the distinct capacity of lipid nanoparticle-encapsulated, nucleosidemodified mRNA vaccines to hyperactivate the T follicular helper cells (TFHs), which are essential for the formation of germinal centers [8]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The objective of this article is to encourage studies designed to confirm or rule out the cause-and-effect relationship between vaccination and very rare complications. Guillain–Barré syndrome was recognized as another very rare complication of adenoviral-vector-based vaccination.
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