anemia and covid 19 vaccineanemia and covid 19 vaccine

anemia and covid 19 vaccine anemia and covid 19 vaccine

COVID-19 Vaccines ). World J Methodol. Before She had a favorable clinical Can you develop anemia because of COVID-19? WebSickle cell anemia is a common cause of splenic atrophy and eventual asplenia. J. Med. The Elecsys anti-SARS-CoV-2 immunoassay (Roche, Basel, Switzerland), which is used to detect anti-SARS-CoV-2 nucleocapsid protein antibodies, produced a negative result. At 28 days, participants will receive the 2nd dose of the COVID-19 vaccine. Iron supplements and drugs that stimulate RBC production may also sometimes be recommended. Epub 2021 Nov 10. Thank you for submitting a comment on this article. Adverse events, including severe allergic reactions, after COVID-19 vaccination are rare but can happen.For this reason, everyone who receives a COVID-19 vaccine is monitored by their vaccination provider for at least 15 minutes. In this patient, antibodies against the SARS-CoV-2 spike protein were detected both before and after the HSCT. There have been case reports of de-novo aplastic anaemia after vaccination, but SARS-CoV-2 infection itself seems to pose the greatest risk for this occurring. Our study objective is to assess whether iron deficiency anaemia in young women impairs their immune response to the COVID-19 vaccine, and whether iron Donnini I., Scappini B., Guidi S., Longo G., Bosi A. HHS Vulnerability Disclosure, Help Am. Analysis of COVID-19 Vaccine Type and Adverse Effects Following A 2021 study of people hospitalized with COVID-like symptoms found that those who tested positive for COVID-19 were more likely to have anemia than those who tested negative. Patients 2, 3, and 4 experienced severe hemolysis with 2 to 4 g/dL hemoglobin decrease. Yes. EBioMedicine. We also wish to thank Dr. Takashi Ozaki and Mr. Masaya Morimoto from Kinan Hospital for their helpful diagnostic support. A Case of Autoimmune Hemolytic Anemia Following COVID-19 Messenger Ribonucleic Acid Vaccination. An official website of the United States government. We report a case of severe AA that arose after the administration of a COVID-19 vaccine (the Pfizer-BioNTech mRNA vaccine), which was treated with allogeneic hematopoietic stem cell transplantation (HSCT). The Covid-19 vaccines are very good at reducing the risk of hospitalization and death for the person who gets vaccinated. Good morning! Viallard J.F., Boiron J.M., Parrens M., Moreau J.F., Ranchin V., Reiffers J., et al. The https:// ensures that you are connecting to the No relevant conflicts of interest to declare. For a short time, it reduces the risk of Histological findings of the bone marrow biopsy specimen at diagnosis. Tao Z, et al. Gadi SRV, Brunker PAR, Al-Samkari H, Sykes DB, Saff RR, Lo J, Bendapudi P, Leaf DE, Leaf RK. mRNA-1345 is a single messenger RNA (mRNA) sequence encoding for a stabilized prefusion F glycoprotein, using the same lipid nanoparticles as the companys No internal bleeding was found. Symptoms of submucosal fibroids include: 3. Epub 2021 Oct 3. doi: 10.7759/cureus.15035. Rehabilitation Committee of Hematological Diseases, Chinese Association of Rehabilitation Medicine;; Chinese Society of Hematology, Chinese Medical Association. Anemia is associated with severe illness in COVID‐19: A retrospective cohort study. COVID-19 Young N.S. It found that people who were readmitted were more likely to have had moderate to severe anemia while they had COVID-19. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Acquired severe aplastic anemia after H1N1 influenza virus vaccination successfully treated with allogeneic bone marrow transplantation. Blood 2021; 138 (Supplement 1): 4141. doi: https://doi.org/10.1182/blood-2021-145532. Sue. Anemia during SARS-CoV-2 infection is associated with rehospitalization after viral clearance. 1. Federal government websites often end in .gov or .mil. None of these patients were previously transfused in the past year. Tacrolimus and short-term methotrexate were used as a prophylaxis against graft-versus-host disease (GVHD). Epub 2022 Oct 29. WebNow scheduling COVID-19 vaccine appointments for ages 12+ Schedule a vaccine appointment COVID-19 vaccine FAQs. When your child has aplastic anemia, their bodys bone marrow isnt making enough white and red blood cells or platelets (cells that help their blood clot). 1 The transplanted cells collected from the donor's bone marrow were transfused into the patient after the removal of red blood cells and plasma. Learn more about the connection between tinnitus and COVID-19, and what you can, You may have heard claims that green tea prevents or cures COVID-19. (2021). A 73-year-old male patient with a medical history of hypertension, diabetes mellitus on insulin therapy, hyperlipidemia, coronary artery bypass grafting, and iron deficiency anemia received the first dose of Pfizer-BioNTech COVID-19 vaccination on 21 st, 2021. The disease causes fever and chills and in severe cases anemia, seizures, and respiratory problems. Patients with AA after COVID-19 infection were also reported [16,17]. Nurse getting ready to administer a vaccine. Symptoms. Accessibility Similar disease flares may be anticipated in other complement-mediated disorders, such as complement-mediated hemolytic uremic syndrome, cold agglutinin disease, catastrophic antiphospholipid syndrome, and HELLP syndrome.17 As SARS-CoV-2 leads to a severe inflammatory state, the benefits of vaccinating patients with PNH likely outweigh the risks; however, clinicians and patients should be aware of this serious adverse effect, and patients should be educated to report any symptoms postvaccination. This type of anemia is called anemia of inflammation. I have zero history of anemia. Smoking may cause the opposite of anemia symptoms elevated hemoglobin levels. We avoid using tertiary references. Sonnweber T, et al. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Covid-19 Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know. He had an 1 g/dL hemoglobin decrease on laboratory tests 3 days following his first vaccination. Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. -. COVID-19 A 2021 review of 5 studies included a total of 9,623 people hospitalized with COVID-19. Its important to note that most of the research into outcomes for COVID-19 and anemia has been done in hospitalized individuals. Please check for further notifications by email. Eighteen days after vaccination, ecchymosis appeared on the injection site of insulin. Lets look at why and what you can do about it. Complete your request online or contact us by phone. Suriawinata E, et al. Immunothrombotic dysregulation in COVID-19 pneumonia is associated with respiratory failure and coagulopathy, Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19, Direct activation of the alternative complement pathway by SARS-CoV-2 spike proteins is blocked by factor D inhibition, Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine, Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine, How I treat paroxysmal nocturnal hemoglobinuria, SARS-CoV-2 infection depends on cellular heparan sulfate and ACE2, Disturbed sialic acid recognition on endothelial cells and platelets in complement attack causes atypical hemolytic uremic syndrome, Heparan sulphate identified on human erythrocytes: a Plasmodium falciparum receptor, Anti-complement treatment for paroxysmal nocturnal hemoglobinuria: time for proximal complement inhibition? The clinical presentation is heterogeneous, ranging from compensated forms without anemia to severe disease. 2022 Nov 4;4(1):288-90. doi: 10.1002/jha2.602. Hello @stellm. Inclusion in an NLM database does not imply endorsement of, or agreement with, Iron Info For Frequent Donors | Red Cross Blood Services. 2021;138:293298. vaccine Chen C, et al. (2021). What are the treatment options for anemia and COVID-19? Contribution: G.F.G. 2021 Dec 22;9(3):e0096521. Wraith D.C., Goldman M., Lambert P.H. This work was supported by National Institutes of Health, National Heart, Lung, and Blood Institute grants R01 HL 133113 (R.A.B.) Available vaccines have proven highly safe and effective. (2022). To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. The pathogenetic mechanisms by which vaccines cause the development of autoimmune disease are still unclear. This case suggests that the measurement of vaccine antibody titers before and after allogeneic HSCT may provide clues to the pathogenesis of vaccine-related autoimmune diseases. staining (x400) showed the replacement of hematopoietic cells by fat and a few nucleated cells. I'm not sure if getting the Moderna vaccine was the cause, but for the first time in my 71 year life my RBC count, just tested, is below the lowest low range. 2021;107(2):173-180. Sue. Chimerism analysis performed on day 29 after the HSCT revealed complete chimerism in the peripheral blood. Research has found that COVID-19 with anemia is associated with more severe symptoms in people hospitalized for COVID-19. Taiwan also ranks fourth-highest for coverage rates of at least one COVID-19 vaccine dose and third-highest in terms of vaccine boosters administered. After the patient's hematopoietic stem cells were replaced through HSCT, his AA improved despite the presence of anti-SARS-CoV-2 antibodies. Intern Med. Lee E.J., Cines D.B., Gernsheimer T., Kessler C., Michel M., Tarantino M.D., et al. However, it is possible that he had some other (possibly unrecognized) infection that caused this sometimes iron is depleted in the body while the system is fighting an infection. There are no funding sources associated with the writing of this manuscript. and transmitted securely. Individuals without access to the internet or who are unable to schedule their appointment online can call toll free 2-1-1 or (877) 211-6277 for assistance. Monitoring Anemia with COVID-19 It's been found that, in general, people who have COVID-19 often have significantly reduced hemoglobin levels, especially with severe disease. We are not medical professionals, and cannot give medical advice, but we can tell you what has worked for us, point you to resources, and help you to be and informed consumer and your own best advocate with your care providers. To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. The development of various autoimmune diseases has been reported after COVID-19 infections or vaccinations. Rinsho Ketsueki. 8600 Rockville Pike WebKey points about aplastic anemia. Heavy and prolonged menstrual bleeding between or during periods. His iron, ferritin and red blood cell count is extremely low. (2019). COVID; COVID vaccine; autoimmune hemolytic anemia; hematology oncology; hemolysis; rheumatology. In conclusion, the administered SARS-CoV-2 mRNA vaccine may have contributed to the pathogenesis of AA in this case. COVID-19 Vaccine Type and Adverse Effects Following Between December 2020 and June 2021 there were identified 53 patients with autoimmune hematological disease that completed SARS-Cov2 vaccination. Three patients developed Hb levels below 7 with anemic syndrome and platelets below 50,000 but without purpuric syndrome; they received the same treatment as patients with autoimmune thrombocytopenia and reached complete remission too. FOIA Autoimmune cytopenias can be trigger by vaccines and viral infections by involving molecular mimicry and circulating immune complexes, including SARS-Cov2. Patient 2 is a 45-year-old man with a 20-year history of PNH. Blood. Adult patients 18 years or older with autoimmune thrombocytopenia, Evans syndrome and autoimmune hemolytic anemia who completed SARS-Cov2 vaccination. Anemia, sometimes severe (caused by heavy bleeding) For original data, please e-mail the corresponding author. Can You Get a COVID Vaccine If You Have Beta Thalassemia? Hemolysis is not increased with addition of the SARS-CoV-2 spike protein S1 to PNH erythrocytes. Another 2021 study of 137 people with COVID-19 found that participants with anemia were 8.2 times more likely than participants without anemia to have severe pneumonia. All COVID-19 vaccines available in the U.S. are safe for people with sickle cell disease. 1,2 Billions of doses of vaccine have been administered worldwide. Sue. However, most cases of COVID-19 with anemia have been reported in people who were hospitalized due to COVID-19. The gray boxes indicate the titers of antibodies against the SARS-CoV-2 spike protein (log scale). eCollection 2023 Feb. Jacobs JW, Booth GS, Guarente J, Schlafer D, Zheng L, Adkins BD. Coronavirus We are a community of people living with a wide variety of conditions and diseases, trying to live our best lives, and to help each other along the way by sharing our experiences. EDTA added to serum serves as an inhibitor of hemolysis. They can include: Anemia can happen with COVID-19, typically due to increased levels of inflammation in the body. Akrami M, Hosamirudsari H, Faraji N, Behnush B, Goudarzi F, Hesari E, Akbarpour S, Najafi A, Nateghi S. Indian J Med Microbiol. Prognostic role of anemia in COVID-19 patients: A meta-analysis. Covid-19 Vaccine efficacy and iron deficiency: an intertwined pair? Gloria F. Gerber, Xuan Yuan, Jia Yu, Benjamin A. Y. Cher, Evan M. Braunstein, Shruti Chaturvedi, Robert A. Brodsky; COVID-19 vaccines induce severe hemolysis in paroxysmal nocturnal hemoglobinuria. She presented to a local hospital, where she was noted to have a 3 g/dL hemoglobin decrease and received 2 units of packed red blood cells. Brito S, Ferreira N, Mateus S, Bernardo M, Pinto B, Loureno A, Grenho F. Cureus. The patient developed acute GVHD (skin grade 1), which was ameliorated with a topical corticosteroid alone. UConn will no longer require students to receive the COVID Sustainable Health Development in the Post-pandemic Era: Taiwan Its unclear if and how anemia affects people with milder COVID-19 symptoms who dont require hospitalization. Patrizio A., Ferrari S.M., Antonelli A., Fallahi P. A case of Graves' disease and type 1 diabetes mellitus following SARS-CoV-2 vaccination. The vaccine developers report that some people experience pain where they were injected; body aches; headaches or fever, The literature search focusing on COVID-19 vaccine administration in patients with asplenia did not yield any results. Aplastic anemia (AA) is an immune-mediated bone marrow failure syndrome. Iron and iron-related proteins in COVID-19. People with sickle cell anemia are at increased risk for serious COVID-19 infections. The Pfizer/BioNTech and Moderna vaccines that have proven so effective against Covid-19 use RNA the instructions our cells use to produce proteins. eCollection 2022 Nov. Babakhanlou R, Kadia T, Chien K, Sasaki K, Thompson PA. EJHaem. There is significant evidence that AA is an immune-mediated condition, mainly based on the effectiveness of immunosuppressive therapy against AA. This is especially important if you are older or Hemasphere. He was admitted to our hospital due to progressive pancytopenia (Supplementary Table 1). 2023 Jan 14;44(1):19-25. doi: 10.3760/cma.j.issn.0253-2727.2023.01.004. When inflammation is present, the bodys absorption and movement of iron is disrupted. Tarawneh O., Tarawneh H. Immune thrombocytopenia in a 22-year-old post Covid-19 vaccine. parameters. Because the function of RBCs is to deliver oxygen, having anemia means that the organs and tissues of your body arent getting enough oxygen. Older age, Black or African American race, higher subjective social status, asthma, and anemia were associated with lower odds of reporting adverse Anemia can affect your weight, whether due to its impact on your appetite and activity levels or its underlying cause. N. Engl. Do you have a history of anemia or another blood disorder? We report a case of severe AA that arose after the administration of a COVID-19 vaccine (the In your husband's place, I would not assume it was related to the vaccine and keep looking for the cause. the contents by NLM or the National Institutes of Health. BMT, bone marrow transplantation; COVID-19, coronavirus disease 2019; CyA, cyclosporine A; TAC, tacrolimus. 2022 Jun 7;157(6):844-851. doi: 10.1093/ajcp/aqab210. Does Anemia Cause Weight Loss or Weight Gain. 2022 Mar;17(3):403-413. doi: 10.2215/CJN.12250921. Unauthorized use of these marks is strictly prohibited. Thanks, I checked the VAERS data could not find any reports of iron deficiency after vaccine. Bethesda, MD 20894, Web Policies SARS-CoV-2 Infection in Aplastic Anaemia. He saw his physician and she suspected some type of internal bleeding based on the blood test, He had an upper and lower endoscopy. 8600 Rockville Pike Bethesda, MD 20894, Web Policies Please enable it to take advantage of the complete set of features! We report a case of severe AA that arose after the administration of a COVID-19 vaccine I fed him an iron rich diet the week prior to him giving blood. The mRNA vaccines against SARS-CoV-2 have a novel mechanism of action. Panel A: Hematoxylin and eosin (H.E.) S.C. has served on advisory boards for Alexion and Sanofi-Genzyme, and her institution has received research funding on her behalf from Takeda. Avenoso D., Marsh J.C.W., Potter V., Pagliuca A., Slade S., Dignan F., et al. However, in general, AA is not recognized as a vaccine-related adverse event [12]. Malnutrition likely plays a role. The viral protein spike from SARS-Cov2 has mimicry between the Ankyrin-1 in the erythrocyte surface, and has been linked as one of the pathogenesis pathways of autoimmune hemolytic anemia secondary to COVID-19 (Br J Haematol 2020;190:e92-e93 and Blood 2020;136:suppl8,138001). Anemia can happen in people who have COVID-19. Twelve with autoimmune hemolytic anemia, 5 secondaries to previous COVID-19 and 7 preexisting. Addition of 40% aNHS with various concentrations of the spike protein to type O-positive erythrocytes from a patient with PNH (49% PNH red blood cell clone: 25% type III and 24% type II cells) and type O-positive erythrocytes from a healthy control, incubated at 37C for 1 hour. Patient 1 is a 25-year-old man diagnosed with PNH 6 months prior in the setting of hemoglobinuria and had limited disease manifestations not requiring PNH-directed therapy. It is important to follow up closely this kind of patients after SARS-CoV2 vaccination, we suggest weekly complete blood counts, and a short courses of high dose dexamethasone can induce curable responses if treatment is advised. intravenous iron carboxymaltose before vaccination, no intravenous iron carboxymaltose before vaccination, percentage of antibodies that remain bound to beads. 2022 Dec;133:102915. doi: 10.1016/j.jaut.2022.102915. 2023 Healthline Media LLC. An official website of the United States government. WebAplastic anemia (AA) is an immune-mediated bone marrow failure syndrome. The site is secure. Nurse getting ready to administer a vaccine. This case suggests that the measurement of vaccine antibody titers before and after allogeneic HSCT may provide clues to the pathogenesis of vaccine-related autoimmune diseases. Sound Bites: UConn no longer requires COVID-19 vaccination Is there a particular reason why he is donating so frequently? They also have higher death rates. Covid-19 Vuille-Lessard E., Montani M., Bosch J., Semmo N. Autoimmune hepatitis triggered by SARS-CoV-2 vaccination. Thrombocytopenia following Pfizer and Moderna SARS-CoV-2 vaccination. Further evaluations in large cohorts are warranted to elucidate the associations between AA and SARS-CoV-2 vaccines. Garnier A, Bourgeois AL, Guillaume T, Peterlin P, Jullien M, Coste-Burel M, Bn MC, Chevallier P. EJHaem. Data are shown as mean standard error of the mean of duplicate wells. Severe pancytopenia triggered by recombinant hepatitis B vaccine. Clipboard, Search History, and several other advanced features are temporarily unavailable. Would you like email updates of new search results? https://bioiron.org/news/iron-stories/normal-iron-hemoglobin-levels-covid19-vaccination.aspx. Connect with thousands of patients and caregivers for support, practical information, and answers. In this patient, antibodies against the SARS-CoV-2 spike protein were detected both before and after the HSCT. His symptoms resolved after 5 days. He began feeling more tired over the next two months. No internal bleeding was found. Federal government websites often end in .gov or .mil. Rev. 2 Cureus. For example, it has been reported that vaccine-derived antibodies may exhibit structural similarities with autoantibodies [18,19]. COVID-19 vaccines induce severe hemolysis in paroxysmal Patients were aged 25 to 63 years, had PNH granulocyte clones of 80%, and had not received transfusions in the past year. She was also part of a clinical trial with danicopan, an oral complement factor D inhibitor. Let's look at why and how to get support to stop drinking: While not as serious as other causes of chest pain, anemia-related chest pain can be a sign that your current treatment plan isn't working. Beta Thalassemia Discussion of the hematologic complications of vaccination for severe acute respiratory syndrome coronavirus-2 (COVID-19) has primarily focused on the development of vaccine-associated immune thrombosis with thrombocytopenia (VITT). Am J Clin Pathol. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Aplastic anemia occurs when your bone marrow doesn't make enough red and white blood cells, and platelets. [Chinese consensus on severe acute respiratory syndrome coronavirus-2 vaccination in adult patients with hematological diseases (2023)]. Anemia of inflammation can also happen with a variety of other conditions associated with inflammation in the body, including autoimmune diseases and cancer. Some of the side effects that occur after vaccination, such as fever, muscle aches and pain, and fatigue, may resemble symptoms related to an underlying condition. Vaccines often underperform in Africa compared to high-income countries. Going to a Cleveland Clinic location? Bergman P, Blennow O, Hansson L, Mielke S, Nowak P, Chen P, Sderdahl G, sterborg A, Smith CIE, Wullimann D, Vesterbacka J, Lindgren G, Blixt L, Friman G, Wahren-Borgstrm E, Nordlander A, Gomez AC, Akber M, Valentini D, Norlin AC, Thalme A, Bogdanovic G, Muschiol S, Nilsson P, Hober S, Lor K, Chen MS, Buggert M, Ljunggren HG, Ljungman P, Aleman S; COVAXID-collaborator group (shown separately). There are "de novo" and relapsed autoimmune diseases in patients with COVID-19 that includes autoimmune thrombocytopenia, Evans syndrome and autoimmune hemolytic anemia among others (Hematology 2021;26:225-239 and Curr Rheumatol Rev 2021;17:193-204). D-dimer was elevated to 0.73 g/mL fibrinogen-equivalent units from 0.21 g/mL. Careers. Intern Med. Patient 1 had a presumptive thrombotic manifestation. Clipboard, Search History, and several other advanced features are temporarily unavailable. My husband's various blood levels also declined after the vaccine. Ten patients had a fall of 50 % from basal counts and recovered spontaneously. Epub 2023 Feb 16. Zuin M, et al. 2014;13:569573. Five with Evans syndrome, all preexisting. It may also lead to problems during recovery as well. Spike Antibody Titers Evaluation after a 2-Dose Regimen of BNT162b2 Vaccination in Healthcare Workers Previously Infected with SARS-CoV-2. Weiss G, et al. I would also encourage him to slow his donations down. My husband has never had any history of anemia or low iron. Additionally on danicopan; however, 2 doses were missed immediately following vaccination. Conversely, there is quite a bit of information on the importance of not going into the vaccine with iron deficiency due to the way in which the vaccine works. The development of various autoimmune diseases has been reported after COVID-19 infections or vaccinations. Please check for further notifications by email. Would you like email updates of new search results? Nitahara Y, Nakagama Y, Kaku N, Candray K, Michimuko Y, Tshibangu-Kabamba E, Kaneko A, Yamamoto H, Mizobata Y, Kakeya H, Yasugi M, Kido Y. Microbiol Spectr. Adverse Effects in Participants With Asthma by Inhaled Corticosteroid Use eFigure. But, each time you donate blood, you lose between 220-250 mg of iron. He experienced fatigue and darkening of his urine following his first dose of the Moderna vaccine. 2023 Apr;102(4):955-959. doi: 10.1007/s00277-023-05136-2. Keywords: However, no method for assessing the relationships between vaccines and the development of autoimmune diseases has been established. Although causality was not proven in this case, further evaluations are warranted to assess the associations between vaccines and AA. Use VaxFinder.mass.gov to search for a vaccine appointment near you. After Getting a COVID-19 Vaccine Careers, Unable to load your collection due to an error. Thalassemia is an inherited blood disorder that is passed down through the parents genes. [COVID-19 vaccination for allogeneic hematopoietic stem cell recipients]. Some of the general symptoms of anemia are: Iron is a vital part of the hemoglobin thats present on RBCs. Accessibility Blood 2021; 137 (26): 36703673. With respect to its etiology, it can be idiopathic Persisting alterations of iron homeostasis in COVID-19 are associated with non-resolving lung pathologies and poor patients performance: A prospective observational cohort study. Yes. Lee NCJ, et al. See this image and copyright information in PMC. Introduction. Aplastic Anemia Get Aplastic Anemia Treatment | Cleveland Clinic Children's Killick S.B., Bown N., Cavenagh J., Dokal I., Foukaneli T., Hill A., et al. and T32 HL 007525 (G.F.G. Four of 6 patients reported fever. eCollection 2022 Jul 20. Read our, ClinicalTrials.gov Identifier: NCT04915820, Interventional Iron and COVID-19 Vaccine Response - ClinicalTrials.gov eTable 1. (2018). The administration of granulocyte-colony stimulating factor had no effect on his neutropenia. Thalassemia can cause mild or severe anemia. You can learn more about how we ensure our content is accurate and current by reading our. As seen in patients 3 and 6, a proximal complement inhibitor, such as danicopan, may prevent breakthrough hemolysis precipitated by the vaccine; however, it is equally possible that the stronger immune response after the second vaccine dose was primarily responsible for the breakthrough hemolysis in patient 3. I'm hoping it's not tied to the vaccine. In patients with severe disease, deposition of terminal complement and microthrombosis have been observed in the lung, skin, kidney, and heart.14 Recently, we demonstrated that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein leads to amplification of the alternative pathway of complement on cell surfaces through competition with complement factor H (CFH) for binding heparan sulfate.5 Thus, in vitro, the SARS-CoV-2 spike protein can convert an inactivator surface to an activator surface on nucleated cells. 2021 Nov;61(11):3267-3271. doi: 10.1111/trf.16672. The most common adverse effects following the vaccination are flu-like symptoms such as soreness, fatigue, myalgia, headache, chills, fever, joint pain, nausea, muscle spasm, sweating, dizziness, flushing, feelings of relief, brain fogging, anorexia, localized swelling, decreased sleep quality, itching, tingling, diarrhea, nasal stuffiness,

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