COVID-19 Vaccine Still Raising Questions

The COVID-19 pandemic may be officially over. The World Health Organization (WHO) has declared that it is no longer a global health emergency. But for scientists and healthcare professionals, the story continues, especially when it comes to adverse COVID-19 vaccine reactions.

Even today, medical journals continue to publish new reports. These reports highlight rare, delayed, and sometimes serious side effects linked to COVID-19 vaccines. At DrugCard, we monitor global literature daily. Our platform automatically detects new case reports related to adverse reactions, and the COVID-19 vaccine still frequently appears.

This article highlights two recent and unusual case reports our platform has identified. These cases offer essential insights for pharmacovigilance professionals.

Case 1: Vasculitis After the Seventh COVID-19 Vaccine Dose

A 77-year-old woman on regular hemodialysis developed purpura on her arms and legs. She also had high inflammatory markers (CRP, D-dimer) and experienced a syncope attack. She was admitted to the hospital, but her symptoms worsened despite treatment.

A skin biopsy later confirmed cutaneous small vessel vasculitis (CSVV). At first, no clear cause was identified. Only later did doctors discover that she had received her seventh dose of a COVID-19 vaccine 11 days before the onset of symptoms.

After starting treatment with prednisolone, her symptoms gradually improved.

Why This Case Matters

Most vaccine-related adverse events occur after the first or second dose. This case shows that even the seventh COVID-19 vaccine dose can trigger an immune reaction.

A deeper look at her vaccination history revealed something important. Her 5th and 6th doses were bivalent vaccines targeting the original virus and Omicron BA.4/BA.5. But her 7th dose was a monovalent vaccine targeting Omicron XBB.1.5 – the first for her.

This change in vaccine type might have triggered vasculitis. The key message? Differences in vaccine composition can matter. A full COVID-19 vaccination history is essential when assessing immune-related side effects like CSVV.

Case 2: A Rare but Reversible Case of TAFRO Syndrome after COVID-19 vaccine

TAFRO syndrome is a rare disorder that causes thrombocytopenia, generalized oedema, fever, organ enlargement, and renal impairment.

Only a few published reports link TAFRO syndrome to COVID-19 vaccines, and even fewer describe a recovery after diagnosis.

In this case, an 82-year-old woman developed symptoms two weeks after receiving her second BNT162b2 mRNA COVID-19 vaccine. She experienced swelling, kidney failure, and low platelets.

After careful evaluation, she was diagnosed with TAFRO syndrome. Doctors treated her with steroids, cyclosporine, and thrombopoietin receptor agonists. A renal biopsy confirmed the diagnosis. Remarkably, the patient recovered and was discharged after several months in remission.

Why This Case Stands Out

This case is essential for two reasons:

A biopsy confirmed the diagnosis.

The patient fully recovered, which is rare in TAFRO syndrome.

TAFRO syndrome is often fatal, so this case offers valuable hope and guidance to clinicians facing similar challenges.

Key Takeaways for Pharmacovigilance Specialists

Even though the pandemic is behind us, COVID-19 vaccine adverse reactions still require close monitoring. These two cases highlight the following:

• Adverse effects can occur even after multiple doses.

• Vaccine composition matters – switching between types may trigger reactions.

• Rare syndromes like CSVV and TAFRO require more research and attention.

What’s Next?

At DrugCard, we remain committed to scanning medical literature for signs of new and rare adverse events. The COVID-19 vaccine remains an important focus.

Our goal is to support pharmacovigilance teams with real-time, relevant information. As the pandemic fades, our responsibilities do not. Monitoring COVID-19 vaccine safety is still a vital part of our work.