Vaccination side effects: Rare, but little researched

“Post-Vac Syndrome” is the name of a rare disease that can occur after a corona vaccination. How common is it, what are the triggers and how is it treated? Answers to important questions.

Vaccinations are considered to be the most important cornerstone in containing the corona pandemic. To a new study the Covid-19 vaccinations may have prevented up to 20 million corona deaths worldwide. as of today nearly 183 million vaccine doses administered in Germany alone. Never before have so many people been vaccinated in such a short period of time. Many people could possibly be protected from a serious course or even death.

However, there are, albeit rarely, people who have persistent severe health impairments after a Covid 19 vaccination – the so-called post-vac syndrome. Federal Minister of Health Karl Lauterbach had to concede this, too, who had to take a lot of criticism for his statement that the corona vaccinations were “free of side effects”.

What complications can occur after corona vaccinations?

In medicine, a distinction is made between vaccination reactions and vaccination side effects after a corona vaccination. The immune system usually reacts immediately after the vaccination with symptoms such as pain at the injection site, headache or fever. Vaccination reactions occur with the corona vaccines more frequently and sometimes more severely than, for example, with a flu vaccination.

One can speak of vaccination side effects or vaccination complications if symptoms after a corona vaccination go beyond the usual extent of a vaccination reaction and last for a long time. Vaccination side effects usually occur within a few days or weeks after vaccination. Examples of such serious side effects after a corona vaccination are cerebral vein thrombosis, symptoms of paralysis, inflammation of the pericardium or chronic exhaustion, but these only occur very, very rarely.

Sudden side effects, which only appear years later, have not been found in any vaccine ever developed and are not to be expected after a corona vaccination either.

What is post-vac syndrome and who is affected?

Bernhard Schieffer heads the Special consultation hour Post-Vax at the University Hospital Marburg. He compares the symptoms of Post-Vac with those of Long-Covid: Those affected often experience headaches, migraines, dizziness, nausea, but also cardiovascular problems and movement disorders. The symptoms comparable to Long-Covid usually only appear two to three weeks after the vaccination, says the doctor.

In order to create more enlightenment, the Paul Ehrlich Institute says it wants to SWR conduct a “robust epidemiological study”. The purpose of this is to characterize the symptoms expressed by patients after Covid-19 vaccination and to compare them with long-Covid findings.

Contrary to what was previously assumed, post-vac affects primarily young people who may have an accompanying immunological defect or an acute infection, says Schieffer. “In our first surveys, we see that it is mostly young women who have been active in sports and have a job who experience significant limitations in their physical and mental performance,” says the expert.

How common are vaccination complications with the new corona vaccines?

Noisy Safety report of the Paul Ehrlich Institute From the start of vaccination until March 2022, there were around 1.7 reports of suspected side effects and vaccination complications per 1000 corona vaccinations. According to the report, around 0.02 percent of those vaccinated had to deal with serious side effects. For comparison: Interpret at Long-Covid Data from a German study points out that up to 20 to 30 percent suffer from persistent symptoms six months after a corona infection. The risk of getting longer-lasting symptoms is therefore many times higher after a corona infection than after a corona vaccination.

The Paul Ehrlich Institute reports to the SWR of increasing suspected cases of post-vac syndrome. However, due to a lack of information, no risk signal can be given, since the diagnostic reliability of the reported cases cannot be assessed. In the majority of the German reports, the diagnosis was not confirmed by a doctor.

All physicians are required by law to to report serious vaccination complications to the Paul Ehrlich Institute. According to the epidemiologist Klaus Stöhr, this is often very difficult to integrate into everyday practice: a doctor needs an average of 20 to 30 minutes per patient to fill out the relevant forms, for which he does not receive adequate remuneration. For a better data situation, the Paul-Ehrlich-Institut calls on those affected to take vaccination side effects report to the institute online or by telephone. In order to diagnose and treat the symptoms, those affected should also contact a doctor immediately.

In a Database of the European Medicines Agency EMA the data sets from the EU member countries are collected. The safety report of the Paul Ehrlich Institute is published every three months, at the end of a quarter.

What is known about the causes and how can they be treated?

Bernhard Schieffer sees possible causes of serious complications in an undiscovered immunological defect or an acute infection, such as in celiac disease or Lyme disease. If such a constitution is “vaccinated” and persistent side effects occur, then the “detective work” begins for the doctors: finding out why a seemingly immunocompetent young person suddenly develops symptoms. The treatment is very individual.

According to Schieffer, the strategy is therefore to identify these people more quickly in the future, to filter them out and thus protect them better. However, further research is urgently needed for this – above all basic research in the field of virology and immunology and also in clinical research.

The question of how the symptoms are triggered is also important. Schieffer assumes that there could be parallels to Long-Covid: The underlying mechanisms are probably the same. Because when vaccinated, the body forms the spike protein of the coronavirus, which also triggers immune reactions in the body in the event of a corona infection.

Where can those affected find help?

A first point of contact for those affected is the general practitioner who is treating them. However, there are also specially set up consultation hours, such as am Fatigue center of the Berlin Charité or at the special outpatient clinic of the University Hospital Marburg, where people with serious side effects after a corona vaccination can now report. There are other contact points at University Hospital Cologne and in gain. However, such offers are still quite rare and the waiting lists are correspondingly long.

In many cities and communities, self-help groups have now been formed in which those affected can exchange ideas with each other.