Most Common COVID Shot AESI in The Arab World
Risk of Myocarditis and other AESI > Risk of COVID Hospitalizations (Part 18)
A multicenter cross country survey of COVID19 Shot recipients in 6 arab nations (n = 1,564) found 5 cases of Thrombosis after the first dose and 5 more after the second dose of the adenoviral vector (1 case per 323.9 doses): 5 cases of convulsions after the first dose and 5 more after the second dose and 5 more after the booster dose (1 case per 215.9 doses): 5 cases of Thrombocytopenia after the first dose and second dose of adenoviral vector (1 case per 323.9 doses): 18 cases of carditis/arrhythmia after the first dose and 3 cases after the second dose and booster dose (1 case per 134.9 doses): 11 cases of Auto-immune disorders after the first dose and 18 more after the second dose (1 case per 119.9 doses), as well as 1 case of Gillian-Barrie syndrome after the first dose (1 case per 1,564 recipients). 7 recipients required hospital admission after the first dose, 9 more after the second dose and 4 more after the booster dose (1 hospitalization per 78.2 recipients). Apparently, the high rate of blood clots from the adenoviral vectors is DNA leaking, infecting blood cells, binding to platelet factor 4 and instructing the body to produce autoantibodies against this particular platelet.
The more interesting part is that they found that post immunization COVID19 cases (n = 285) among virus naive recipients were inversely associated with the number of doses they received with 2.7% of cases occurring after the first dose, 10.9% of cases occurring after the second dose, and 12% of cases occurring after the booster dose. The same was somewhat true of previously infected recipients with 8% of reinfections occurring after the first dose and 46.6% of infections occurring after the second dose and booster almost evenly split. The number of post immunization COVID19 cases resulting in hospitalization increased between the first Pfizer dose (0 cases), second Pfizer dose (2 cases) and booster (7 cases) while the proportion of infected recipients of each dose also increased from 3.5% after the first dose (n = 631), to 6.8% after the second dose (n = 612) and 7.8% after the booster dose (n = 308). This pattern also repeats between the first dose (6.9%) and second dose (19.9%) of the Sputnik VF (n = 73) as well as the first and second dose of both Sinovac and Sinopharm. The authors do not come up with explanation for this inverse relationship between dose uptake and infection rate in the discussion section only noting that they were ‘uncertain’ why this occurs since ‘the second dose causes tenfold increase in antibody levels, a stronger T-cell response, as well as more changes in the immune cells. However, they fail to note that this is not a novel result. As I summarized in my answer last year to What makes the mRNA COVID-19 vaccines so effective? this study is now one of several to find evidence of immune tolerance and antibody dependent enhancement of disease with each subsequent dose albeit it is the smallest observational study to do so in between the primary series doses with similar studies having sample sizes with tens of thousands and millions of participants and not finding evidence of immune tolerance and antibody dependent enhancement until a few months after the first or second booster dose.