Research into complaints after vaccination

There is some more research underway into long-term symptoms after a COVID-19 vaccination. For example, this week a preprint was published of a Yale study in which 42 people with post-vaccination syndrome (PVS) were compared with healthy people who are part of the Yale LISTEN Study. It is only a small research group and the research has not yet been validated. So it is too early to speak of hard research results; these are the first cautious results that Yale is now publishing. It mainly shows that there is a need for more, larger and validated research.

In mid-2024, a study was published on Post-acute COVID-19 vaccination syndrome (PVACS). The article indicates that PVACS could probably be a somatic syndrome. The article offers some recognition of the syndrome, but much additional research is still needed. Below is a brief summary of the article.

The study examined the symptoms and blood values ​​of 191 patients with suspected PVACS. They had complaints that lasted longer than 5 months after a SARS-CoV-2 mRNA vaccination. The most common symptoms were persistent fatigue and general malaise. In addition, peripheral nerve dysfunction, cardiovascular symptoms and cognitive problems.

The majority of patients (131 of 191) had symptoms consistent with multiple dysautonomia syndromes at the same time, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and small fiber neuropathy (SFN). One-third of patients even met criteria for all four of these syndromes. In contrast, 16% of patients could not be classified into any of these categories.

Based on symptom clustering, this study implies that PACVS can be seen as both a sub-form of ME/CFS and a separate new-onset syndrome. The authors state that due to the wide variation in symptoms, PVACS shares some, but not all, features of these syndromes.

Compared to healthy individuals, PACVS patients showed increased levels of inflammatory markers such as interleukin 6 and 8, and changes in certain receptor antibodies after vaccination. The authors state that these blood values ​​may help to distinguish PACVS from normal post-vaccination reactions and support that PACVS may be a somatic syndrome. Unfortunately, in this study it was not possible to relate these blood values ​​to symptoms.

Finally, in a smaller proportion of patients (26,7%), reactivation of viruses, such as herpes, was observed. Although this contributed only slightly to the overall symptoms of PACVS, it plays a more important role in other syndromes, such as long-covid. The data presented describe a chronic syndrome presumably triggered by SARS-CoV-2 mRNA vaccination. However, the clinical manifestation of this suspected syndrome is not yet well defined and can be very diverse.

Based on this study registration, the clinical presentation includes:

1. Malaise and chronic fatigue
2. Migraine-like symptoms and cognitive impairment
3. Peripheral nerve dysfunction

Authors: Anna Katherina Mundorf, et al., Clinical and Diagnostic Features of Post-Acute COVID-19 Vaccination Syndrome (PACVS), Vaccines 2024