Chronic Fatigue and Dysautonomia following COVID-19 Vaccination Is Distinguished from Normal Vaccination Response by Altered Blood Markers, Boege...

[LarsSG]

Abstract
SARS-CoV-2 mRNA vaccination can entail chronic fatigue/dysautonomia tentatively termed post-acute COVID-19 vaccination syndrome (PACVS). We explored receptor autoantibodies and interleukin-6 (IL-6) as somatic correlates of PACVS.

Blood markers determined before and six months after first-time SARS-CoV-2 vaccination of healthy controls (N = 89; 71 females; mean/median age: 39/49 years) were compared with corresponding values of PACVS-affected persons (N = 191; 159 females; mean/median age: 40/39 years) exhibiting chronic fatigue/dysautonomia (≥three symptoms for ≥five months after the last SARS-CoV-2 mRNA vaccination) not due to SARS-CoV-2 infection and/or confounding diseases/medications.

Normal vaccination response encompassed decreases in 11 receptor antibodies (by 25–50%, p < 0.0001), increases in two receptor antibodies (by 15–25%, p < 0.0001) and normal IL-6.

In PACVS, serological vaccination–response appeared significantly (p < 0.0001) altered, allowing discrimination from normal post-vaccination state (sensitivity = 90%, p < 0.0001) by increased Angiotensin II type 1 receptor antibodies (cut-off ≤ 10.7 U/mL, ROC-AUC = 0.824 ± 0.027), decreased alpha-2B adrenergic receptor antibodies (cut-off ≥ 25.2 U/mL, ROC-AUC = 0.828 ± 0.025) and increased IL-6 (cut-off ≤ 2.3 pg/mL, ROC-AUC = 0.850 ± 0.022).

PACVS is thus indicated as a somatic syndrome delineated/detectable by diagnostic blood markers.

https://www.mdpi.com/2076-393X/11/11/1642

 

[Kalliope]

Great to see some data on this matter. I'm uncertain on whether or not to take further vaccines, even though the first 3 covid vaccines went fine. How about you?

Just adding the conclusion from the paper:

5. Conclusions
The fraction of vaccinated persons suffering from PACVS is unknown. Current estimates assume an incidence of 0.02%, amounting to 40,000 affected persons in Germany alone. These patients are currently not treated appropriately for several reasons: (i) The number of unreported cases is high because diagnostic criteria are not established. It is not even generally accepted that the syndrome exists. (ii) The number of false-positive cases is high because PACVS is similar to various diseases and syndromes unrelated to vaccination. Moreover, sequelae of undetected SARS-CoV-2 infections could be erroneously blamed on SARS-CoV-2 vaccination. Due to these factors, PACVS is currently not/rarely diagnosed in terms of a somatic disease. Instead, PACVS cases tend to be classified as psychosomatic or discarded as irrelevant or imaginary.

Our study may help to improve this unsatisfactory situation in two ways: We provide evidence of PACVS as a somatic disease by linking a clinical phenotype with specific pathognomonic alterations in serological markers; thus, we suggest diagnostic criteria for an objective discrimination of PACVS from the healthy post-vaccination condition. These criteria may not be sufficiently specific to separate PACVS from all confounding diseases or for the diagnosis of PACVS in clinical health care. However, the proposed laboratory diagnostic can act as a stringent rule-out criterion, allowing future PACVS studies to focus on the probable cases.
Great care was taken to exclude possible confounders from this study (Figure S3). However, inclusion as defined by the symptoms listed in Table S2 was less focused. As a consequence, the PACVS phenotype emerging from the present study is heterogeneous and probably encompasses more than one clinical entity. We believe that one objective of future studies should be to draw a clearer and more differentiated clinical picture of PACVS and to use the suggested biomarker signature for patient stratification in a prospective study setting.

 

[Trish]

Great to see some data on this matter. I'm uncertain on whether or not to take further vaccines, even though the first 3 covid vaccines went fine. How about you?

We already knew that a small proportion of vaccinated people are being made sick by the vaccine. It's good that there is research on this, and it's not being dismissed as anxiety etc.

This paper does not, however, given any clue to how common or rare
PACVS is, as it's not an epidemiological study. The patients were identified via social media.

Other studies that are large epidemiological studies show that the vaccines have greatly reduced rates of hospitalisation and death from catching covid, and although they don't completely prevent people catching covid, their likelhood both of serious illness and of Long Covid are reduced.

One thing we can never know is whether any individual who is made sick by the vaccine might also be predisposed to have been badly affected by the infection if they hadn't been vaccinated.

My decision is based on my assumption from all I've read that, as an elderly and already sick person, I'm better off getting the protection of the vaccine, and taking what seems to be a much smaller risk of getting vaccine injured, given I haven't reacted badly to previous doses. I have had the latest booster without ill effect. But of course everyone's situation is different, so I'm not advising anyone else what they should do.

 

[Kalliope]

My decision is based on my assumption from all I've read that, as an elderly and already sick person, I'm better off getting the protection of the vaccine, and taking what seems to be a much smaller risk of getting vaccine injured, given I haven't reacted badly to previous doses. I have had the latest booster without ill effect. But of course everyone's situation is different, so I'm not advising anyone else what they should do.

Thank you for your (always) good reflections and I think your decision sounds very reasonable.

I saw David Putrino talked about this recently and said when discussing this with ME or Long Covid patients he leaned towards if the previous vaccinations went fine, then it might be worth getting more boosters.

I sometimes listen to This Week in Virology and prof. Vincent Racaniello however says after three doses (and perhaps one infection) there's not much more vaccinations can do. Others say take all the boosters available.

 

[Midnattsol]

I sometimes listen to This Week in Virology and prof. Vincent Racaniello however says after three doses (and perhaps one infection) there's not much more vaccinations can do. Others say take all the boosters available.

What episode does he say that in? I just want to get his reasoning. For example influenza we get new vaccinations every year despite having been vaccinated and/or having influenza previously, but with the mutation rate of covid I find it hard to compare the two. I would like to get novavax, but that's unavailable here and the currently available booster is for a variant that is already outnumbered by newer variants which is annoying to say the least. I will get the vaccine (+ influenza, and since pertussis is increasing now as well with a large outbreak in a neighboring country/Denmark I'm considering asking for that too, our national public health institute wants to offer it for free to pregnant women next year to reduce the effects of a potential outbreak).

 

[Kalliope]

What episode does he say that in?

He has said it frequently, but as far as I know just in passing and with no real elaboration.

But here's a blog post from him from 2021 (I know, old). Perhaps this is more a matter of principle?

quote:
The call for vaccine boosters in the US is another example of how some public health measures deployed during this pandemic are not based on science.

Note added after further thought: Sera from individuals who have been infected and subsequently vaccinated have broad neutralization activity against all known variants of concern. Whether boosting with existing vaccines could achieve similar breadth and potency is unknown but should be determined before giving millions of individuals a third vaccine dose.

https://virology.ws/2021/08/19/are-covid-19-vaccine-boosters-needed/

 

[Midnattsol]

He has said it frequently, but as far as I know just in passing and with no real elaboration.

But here's a blog post from him from 2021 (I know, old). Perhaps this is more a matter of principle?

quote:
The call for vaccine boosters in the US is another example of how some public health measures deployed during this pandemic are not based on science.

Note added after further thought: Sera from individuals who have been infected and subsequently vaccinated have broad neutralization activity against all known variants of concern. Whether boosting with existing vaccines could achieve similar breadth and potency is unknown but should be determined before giving millions of individuals a third vaccine dose.

https://virology.ws/2021/08/19/are-covid-19-vaccine-boosters-needed/

Since 2021 we have new variants that are as different from the 2021 versions as the 2021 were from 2020. Not really easy to make good decisions, but I'm on the same page as @Trish. Currently I'm at increased risk of serious covid due to the pregnancy, but mostly it's the long term effects that scare me (+ short term pregnancy risk such as issues with the placenta). Glad filtering the air works regardless of variant.

 

[Kalliope]

Currently I'm at increased risk of serious covid due to the pregnancy, but mostly it's the long term effects that scare me

yes, it's the long term effects that worries me too.

But most of all congrats on your pregnancy
I hope you are doing as well as can be
Exciting times!

 

[rvallee]

tend to be classified as psychosomatic or discarded as irrelevant or imaginary

Which, for all intents and purposes, is the same thing. For all the pretense coming out of medicine about "psychosomatic illness", the vast majority do not give it any respect whatsoever, and no one can tell the difference anyway without a test falsifying it. If only they did it could somehow work out, but if it actually was ever taken seriously and researched properly it would get debunked, so that's not happening.

And in the end, this is the real reason:

It is not even generally accepted that the syndrome exists.

Beliefs about illness. This underlies every other issue with this, and every consequence that follows. Science undone by belief systems from the 19th century leading to the pursuit of pseudoscience and alternative medicine woo in a mutually reinforcing echo chamber. Oh, the irony.

 

[Grigor]

So what are your thoughts on this paper? It's hard for me to understand any of it really. Partly due to PEM and partly because it's way above my head anyways.