COVID-19 Vaccines: Side-effects from Common to Uncommon

Vaccines, the lifesaver for millions worldwide, are intended to fight against infection but can cause few side-effects from ordinary to rare. The same has been considered with Covid-19 patients during mass vaccination worldwide. 

Since the Corona virus is infecting almost all age group people worldwide, it becomes mandatory to get vaccinated at the earliest to protect a million lives globally.

WHO has reported more than fifty Covid-19 vaccine candidates under trial. Covid vaccine shots have already been given to millions of people worldwide and India alone has crossed a million shots of vaccination. As vaccination speed up, side-effects from it become alarming globally. In its training module on adverse events of vaccine, WHO said that while following proper guidelines, the adverse events that occur are safe.

Also mentioned, not all adverse events are related to vaccination. Some side-effects occur for a reason like the content present in the vaccine, manufacturing defect in administration device, or immunization error like the reuse of needle, while others may be due to anxiety or fear of vaccine administration.

Vaccines approved for Emergency Use

Covid-19 has affected majority of individuals on earth, it become mandatory to get the recovery result soon, to avoid any further damage. Keeping this into consideration, some of the vaccines have been approved for emergency use, which although does not results 100% but are effective to some extent that relief people. The vaccines are listed below : 

• Oxford Uni-AstraZeneca vaccine 
• Moderna
• Pfizer-BioNTech
• Sputnik V (Gamaleya)

Table 1: List of vaccines including date approved for emergency use and their side effects.

These vaccines are listed with their approaches on which they are based upon along with no. of doses required, efficacy, their storage at a particular temperature and their side effects.

The Oxford University-AstraZaneca vaccine

AstraZeneca vaccine is a recombinant vaccine that shows its 70.4% efficacy in preventing infections which are symptomatic; according to interim data, 30 out of 5,807 people, who got the two-doses of Covid-19 vaccine has shown to be safe. It stimulates an immune response in people of all ages, including the age over-55s. The MHRA (The UK’s Medicines and Health-care products Regulatory Agency) approved the use of two full doses, which was found to be 62% effective.

At least two participants in AstraZeneca’s phase 3 trial experienced transverse myelitis, an inflammatory syndrome that affects the spinal cord, after receiving its experimental COVID-19 vaccine.

The Moderna vaccine

The mRNA-1273 vaccine from US company Moderna is the second vaccine that has been approved by the FDA for emergency use with 94.50% effectiveness in preventing Covid-19 disease. The side-effects were only from mild to moderate and did not last long. However, patients with severe allergies to any vaccine ingredient should not get vaccinated as few patients experienced an allergic reaction after a previous dose of this vaccine. Numerous points before administration of this drug need to be focussed like

• Although this vaccine shows high effectiveness in clinical trials among people of different age, sex, race and ethnicity and amongst persons with underlying medical conditions but individuals having fever, bleeding disorder, or having a blood thinner, who are immunocompromised or are on a medicine that affects the immune system and those who are pregnant or planning to become pregnant are advised to inform about their conditions before vaccination.

The Biontech-Pfizer vaccine

The Corona vaccine BNT162b2 was the first vaccine approved for emergency use by U.S. Food and Drug administration on 11th December 2020 with 95% effectiveness in preventing COVID-19 disease, which showed no serious side-effects and the same efficacy was also observed in defined groups like age, sex, ethnicity, race, and pre-existing conditions.  How-ever some patients had also shown severe allergic reaction immediately after the injection, so before vaccination, few points need to be focused on like

• Is the vaccine authorized to be given in population having 16 years of age and older.  

• Covid-19 Patients who are on immunosuppressive therapy, who had an immunocompromising condition or pregnant were excluded with the exception of those having controlled HIV infection as data’s of vaccine safety and efficacy in these groups are not currently available. 

• It has been reported that patients without contradictions to vaccines can be administered Covid-19 vaccine but should be counselled about vaccine safety and efficacy. These have been reported and needs to be clear on it.

The Sputnik V Vaccine

The vector vaccine Gam-COVID-Vac (Sputnik V) was first approved in Russia in early August 2020 without waiting for Phase III trials results, for its emergency use, showing the efficacy of 91.4%, based on the final control point analysis of data obtained 21 days after administering the first dose. There have been considerable reservations worldwide for the vaccine as the Russian government issued an emergency use just after a phase II trial and high in Russia. According to the Russian health ministry, only the common side-effects after  vaccination such as headaches or fever, have been registered. There have been no reports of severe side effects following the Sputnik V vaccination.

Nevertheless, Sputnik V is already being used in Russia and many other countries, including Belarus, the United Arab Emirates (UAE), India, Brazil, and Argentina. 

Apart from these drugs launched recently, there are many more drugs awaited for the Covid-19 treatment. The Indian based vaccines which have received green signal for emergency use in India are Covaxin and Covidshield.

Table 2: Comparison of Covaxin and Covidshield vaccine.

Individuals with a history of allergy, immune-compromised patients, pregnant, and bleeding disorders cannot receive this vaccine. 

Some of the common side-effects seen are fatigue, redness, swelling at the injection site, fever, nausea.

Are patients facing serious side-effects of Covid-19 vaccines?

Reports from CDC (Centre for disease control and prevention) discussed side-effects after Covid-19 vaccination, which is from mild to moderate and subsidizes in few days. Serious side-effects are rarely seen after vaccine shot. The most common side-effects are redness, swelling or pain at the injection site, fatigue, fever, headache, muscle pain, nausea, etc.

 According to Union Health Ministry, a total of 7,86,842 people, including healthcare and frontline workers, were vaccinated in the world's largest vaccination drive against Covid-19, where 580 cases reported non-serious adverse reactions like fever, headache, nausea, redness, etc. followed by 10 cases of hospitalization and 4 cases of death, in which 2 cases are not related to vaccination, while post-mortem report yet to prepare for other 2 cases. With the mild adverse events, some of the severe reactions like anaphylaxis, which is an allergic reaction, can sometimes become fatal. 21 out of 4400 people in the US reported anaphylaxis after receiving Pfizer vaccination, but most of them show pre-existing allergies.

No reasons to avoid Covid-19 vaccines due to minor side-effects

Covid-19 vaccines with minor side-effects are pretty good, somewhat been affected seriously by the coronavirus. However, the health authorities and manufacturers have warned about reactions to immune-compromised people, pregnant women, and those having a history of allergy as without accurate information; the reactions can worsen.

Some facts about Common vaccines 

Immunization with vaccines for common diseases like measles, diphtheria, severe diseases like polio, hepatitis, and tetanus also shows adverse events. Most side-effects are mild shows redness or mild allergy to the severe reaction, which can be fatal or cause a severe allergic reaction. 

To better understand few adverse events ranging from standard to severity, it is useful to compare a vaccine with its associated side effects

Table 3 : Side-effects of common using vaccines

Management of vaccination's Side effect

Following proper and recommended guidelines, all vaccines used in national immunization programs are safe and effective. However, no vaccines are risk-free and adverse events occur after vaccination, which raises public concern about the vaccine. To understand the severity rate, professionals should evaluate the adverse events with specific vaccines and compare the adverse events that occur among the vaccinated and non-vaccinated populations to facilitate the response received after evaluation.

It is better to be vaccinated than not.

It is quiet understandable, that several people are expressing concerns about covid-19 vaccines as health is the priority but it is been advisable to get vaccinated for best protection, as the pandemic has made millions of people unwell followed by hospitalisation and death causing disruption worldwide. Different companies like Moderna, Biontech-Pfizer, AstraZeneca vaccine, have given evidences about the high efficacy of the vaccines with minor or rarely occurring serious side-effect against Covid-19. Healthcare authorities like WHO, Advisory Committee on Immunization Practices (ACIP) also advises for the emergency use of vaccine. Even healthcare workers have taken Covid-19 vaccine shots. 

Based on these such evidences provided so far, one should go for “vaccination without fear” out of side effects, which might or might not occur. It’s better to go for it than tolerating a huge damage and to stay safe and get best protection from Covid-19.

-Vyoma Vaish