Two years into the global vaccination campaign, important questions about COVID-19 vaccines and autoimmune disorders have arisen. A growing number of reports have documented associations between vaccination and autoimmunity, and research is needed to elucidate the nature of these linkages as well as the mechanisms and causal directions (i.e., whether persons with no history of autoimmune disorders may experience them upon vaccination or persons with autoimmune disorders may experience exacerbation or new adverse events, autoimmune or not, post-vaccination). This scoping review will follow Arksey and O'Malley's framework, which is enhanced by Levac et al.'s team-based approach, to address the relationship between COVID-19 vaccinations and autoimmune disorders. Moreover, it will explore the evidence informing the consensus of care concerning COVID-19 vaccinations in people experiencing these disorders. Data from refereed articles and preprints will be synthesized through a thematic analysis. A subgroup analysis will compare the findings according to the previous existence of autoimmune disorders, presence of co-morbidities, vaccine type, and other potentially relevant factors. COVID-19 has triggered the largest vaccination campaign in history. Drug safety is critical to properly assess the balance of risks and benefits of any medical intervention. Our investigation should yield information useful to assist in clinical decision-making, policy development, and ethical medical practices.
Citation: Claudia Chaufan, Laurie Manwell, Camila Heredia, Jennifer McDonald. COVID-19 vaccines and autoimmune disorders: A scoping review protocol[J]. AIMS Medical Science, 2023, 10(4): 318-328. doi: 10.3934/medsci.2023025
Two years into the global vaccination campaign, important questions about COVID-19 vaccines and autoimmune disorders have arisen. A growing number of reports have documented associations between vaccination and autoimmunity, and research is needed to elucidate the nature of these linkages as well as the mechanisms and causal directions (i.e., whether persons with no history of autoimmune disorders may experience them upon vaccination or persons with autoimmune disorders may experience exacerbation or new adverse events, autoimmune or not, post-vaccination). This scoping review will follow Arksey and O'Malley's framework, which is enhanced by Levac et al.'s team-based approach, to address the relationship between COVID-19 vaccinations and autoimmune disorders. Moreover, it will explore the evidence informing the consensus of care concerning COVID-19 vaccinations in people experiencing these disorders. Data from refereed articles and preprints will be synthesized through a thematic analysis. A subgroup analysis will compare the findings according to the previous existence of autoimmune disorders, presence of co-morbidities, vaccine type, and other potentially relevant factors. COVID-19 has triggered the largest vaccination campaign in history. Drug safety is critical to properly assess the balance of risks and benefits of any medical intervention. Our investigation should yield information useful to assist in clinical decision-making, policy development, and ethical medical practices.
| [1] | Alwan NA, Burgess RA, Ashworth S, et al. (2020) Scientific consensus on the COVID-19 pandemic: We need to act now. Lancet 396: e71-e72. https://doi.org/10.1016/S0140-6736(20)32153-X |
| [2] | Centers for Disease Control and Prevention, Benefits of Getting a COVID-19 Vaccine. USA Centers for Disease Control and Prevention. (2020) . Available from: https://web.archive.org/web/20201124234740/https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html. Accessed on 12 Nov. 2023 |
| [3] | WHO, WHO Director-General's opening remarks at the media briefing on COVID-19—4 September 2020. WHO. (2020) . Available from: https://web.archive.org/web/20200906210508/https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---4-september-2020. Accessed on 12 Nov. 2023 |
| [4] | Velikova T, Georgiev T (2021) SARS-CoV-2 vaccines and autoimmune diseases amidst the COVID-19 crisis. Rheumatol Int 41: 509-518. https://doi.org/10.1007/s00296-021-04792-9 |
| [5] | Vogel G, Couzin-Frankel J (2023) Studies probe COVID-19 shots' link to rare symptoms. Science 381: 18-19. https://doi.org/10.1126/science.adj5607 |
| [6] | Rocco A, Sgamato C, Compare D, et al. (2021) Autoimmune hepatitis following SARS-CoV-2 vaccine: May not be a casuality. J Hepatol 75: 728-729. https://doi.org/10.1016/j.jhep.2021.05.038 |
| [7] | McShane C, Kiat C, Rigby J, et al. (2021) The mRNA COVID-19 vaccine—A rare trigger of autoimmune hepatitis?. J Hepatol 75: 1252-1254. https://doi.org/10.1016/j.jhep.2021.06.044 |
| [8] | Nguyen S, Bastien E, Chretien B, et al. (2022) Transverse myelitis following SARS-CoV-2 vaccination: A pharmacoepidemiological study in the world health organization's database. Ann Neurol 92: 1080-1089. https://doi.org/10.1002/ana.26494 |
| [9] | Nushida H, Ito A, Kurata H, et al. (2023) A case of fatal multi-organ inflammation following COVID-19 vaccination. Leg Med 63: 102244. https://doi.org/10.1016/j.legalmed.2023.102244 |
| [10] | Moon H, Suh S, Park MK (2023) Adult-onset type 1 diabetes development following COVID-19 mRNA vaccination. J Korean Med Sci 38: e12. https://doi.org/10.3346/jkms.2023.38.e12 |
| [11] | British Society for Rheumatology, Principles for COVID-19 Vaccination in Musculoskeletal and Rheumatology for Clinicians. UK British Society for Rheumatology. (2022) . Available from: http://arma.uk.net/covid-19-vaccination-and-msk/. Accessed on 20 Jul. 2023 |
| [12] | Curtis JR, Johnson SR, Anthony DD, et al. (2023) American College of Rheumatology Guidance for COVID-19 vaccination in patients with rheumatic and musculoskeletal diseases: Version 5. Arthritis Rheumatology 75: E1-E16. https://doi.org/10.1002/art.42372 |
| [13] | Canadian Rheumatology Association, CRA GRADE Recommendation on Covid-19 Vaccination and Feedback Survey. Canada Canadian Rheumatology Association. (2021) . Available from: https://rheum.ca/resources/cra-grade-recommendation-on-covid-19-vaccination-and-feedback-survey/. Accessed on 20 Jul. 2023 |
| [14] | Public Health Agency of Canada, Immunization of persons with chronic diseases: Canadian Immunization Guide. Canada Public Health Agency of Canada. (2023) . Available from: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-7-immunization-persons-with-chronic-diseases.html. Accessed on 20 Jul. 2023 |
| [15] | Cooper GS, Stroehla BC (2003) The epidemiology of autoimmune diseases. Autoimmun Rev 2: 119-125. https://doi.org/10.1016/S1568-9972(03)00006-5 |
| [16] | Wraith DC, Goldman M, Lambert PH (2003) Vaccination and autoimmune disease: What is the evidence?. Lancet 362: 1659-1666. https://doi.org/10.1016/S0140-6736(03)14802-7 |
| [17] | Rodríguez Y, Rojas M, Beltrán S, et al. (2022) Autoimmune and autoinflammatory conditions after COVID-19 vaccination. New case reports and updated literature review. J Autoimmun 132: 102898. https://doi.org/10.1016/j.jaut.2022.102898 |
| [18] | Guo M, Liu X, Chen X, et al. (2023) Insights into new-onset autoimmune diseases after COVID-19 vaccination. Autoimmun Rev 22: 103340. https://doi.org/10.1016/j.autrev.2023.103340 |
| [19] | Moody R, Wilson K, Flanagan KL, et al. (2021) Adaptive immunity and the risk of autoreactivity in COVID-19. Int J Mol Sci 22: 8965. https://doi.org/10.3390/ijms22168965 |
| [20] | Chen Y, Xu Z, Wang P, et al. (2022) New-onset autoimmune phenomena post-COVID-19 vaccination. Immunology 165: 386-401. https://doi.org/10.1111/imm.13443 |
| [21] | Mahroum N, Elsalti A, Alwani A, et al. (2022) The mosaic of autoimmunity—Finally discussing in person. The 13th international congress on autoimmunity 2022 (AUTO13) Athens. Autoimmun Rev 21: 103166. https://doi.org/10.1016/j.autrev.2022.103166 |
| [22] | Agmon-Levin N, Paz Z, Israeli E, et al. (2009) Vaccines and autoimmunity. Nat Rev Rheumatol 5: 648-652. https://doi.org/10.1038/nrrheum.2009.196 |
| [23] | Pellegrino P, Clementi E, Radice S (2015) On vaccine's adjuvants and autoimmunity: Current evidence and future perspectives. Autoimmun Rev 14: 880-888. https://doi.org/10.1016/j.autrev.2015.05.014 |
| [24] | Jara LJ, Vera-Lastra O, Mahroum N, et al. (2022) Autoimmune post-COVID vaccine syndromes: Does the spectrum of autoimmune/inflammatory syndrome expand?. Clin Rheumatol 41: 1603-1609. https://doi.org/10.1007/s10067-022-06149-4 |
| [25] | Seida I, Seida R, Elsalti A, et al. (2023) Vaccines and autoimmunity—from side effects to ASIA syndrome. Medicina 59: 364. https://doi.org/10.3390/medicina59020364 |
| [26] | Bellastella G, Cirillo P, Carbone C, et al. (2022) Neuroimmunoendocrinology of SARS-CoV-2 infection. Biomedicines 10: 2855. https://doi.org/10.3390/biomedicines10112855 |
| [27] | Allen DW (2022) Covid-19 lockdown cost/benefits: A critical assessment of the literature. Int J Econ Bus 29: 1-32. https://doi.org/10.1080/13571516.2021.1976051 |
| [28] | Bzdok D, Dunbar RIM (2020) The neurobiology of social distance. Trends Cogn Sci 24: 717-733. https://doi.org/10.1016/j.tics.2020.05.016 |
| [29] | Loades ME, Chatburn E, Higson-Sweeney N, et al. (2020) Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry 59: 1218-1239.e3. https://doi.org/10.1016/j.jaac.2020.05.009 |
| [30] | Sikali K (2020) The dangers of social distancing: how COVID-19 can reshape our social experience. J Community Psychol 48: 2435-2438. https://doi.org/10.1002/jcop.22430 |
| [31] | Jara LJ, López-Zamora B, Ordoñez-González I, et al. (2021) The immune-neuroendocrine system in COVID-19, advanced age and rheumatic diseases. Autoimmun Rev 20: 102946. https://doi.org/10.1016/j.autrev.2021.102946 |
| [32] | Kempuraj D, Selvakumar GP, Ahmed ME, et al. (2020) COVID-19, mast cells, cytokine storm, psychological stress, and neuroinflammation. Neuroscientist 26: 402-414. https://doi.org/10.1177/1073858420941476 |
| [33] | Ortega MA, García-Montero C, Fraile-Martinez O, et al. (2022) Immune-mediated diseases from the point of view of psychoneuroimmunoendocrinology. Biology 11: 973. https://doi.org/10.3390/biology11070973 |
| [34] | Arksey H, O'Malley L (2005) Scoping studies: towards a methodological framework. Int J Soc Res Method 8: 19-32. https://doi.org/10.1080/1364557032000119616 |
| [35] | Levac D, Colquhoun H, O'Brien KK (2010) Scoping studies: advancing the methodology. Implement Sci 5: 69. https://doi.org/10.1186/1748-5908-5-69 |
| [36] | Peh WC, Ng KH (2008) Basic structure and types of scientific papers. Singapore Med J 49: 522-525. |
| [37] | Shea BJ, Hamel C, Wells GA, et al. (2009) AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol 62: 1013-1020. https://doi.org/10.1016/j.jclinepi.2008.10.009 |
| [38] | Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3: 77-101. https://doi.org/10.1191/1478088706qp063oa |
| [39] | Thomas J, Harden A (2008) Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 8: 45. https://doi.org/10.1186/1471-2288-8-45 |
| [40] | Justino DCP, Silva DFO, da Silva Costa KT, et al. (2022) Prevalence of comorbidities in deceased patients with COVID-19: A systematic review. Medicine 101: e30246. https://doi.org/10.1097/MD.0000000000030246 |
Claudia Chaufan, Laurie Manwell, Camila Heredia, Jennifer McDonald. COVID-19 vaccines and autoimmune disorders: A scoping review protocol[J]. AIMS Medical Science, 2023, 10(4): 318-328. doi: 10.3934/medsci.2023025
DownLoad: