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Previous COVID-19 infection, previous cross infection, and post-COVID-19 vaccination adverse effect

1 Medical Academic Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. D. Y. Patil University, Pune, Maharashtra, India

Date of Submission12-May-2021
Date of Decision12-Jun-2021
Date of Acceptance22-Jun-2021

Correspondence Address:
Pathum Sookaromdee,
Medical Academic Center, Bangkok
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_348_21

How to cite this URL:
Sookaromdee P, Wiwanitkit V. Previous COVID-19 infection, previous cross infection, and post-COVID-19 vaccination adverse effect. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2022 Dec 7]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=337702

Dear Sir,

New vaccines are already available for COVID-19 prevention. Important considerations regarding the new vaccine are efficacy and safety. The different observations regarding postvaccination efficacy and adverse effect are reported. In a recent report, the previous COVID-19 infection, regardless of symptom, results in a higher neutralizing antibody response.[1] Regarding this observation, a higher antibody titer also means a higher concentration and there might be an impact on viscosity. The postvaccination clot is an emerging important postvaccination problem that might relate to previous COVID-19 infection.[2]

The high adverse reaction to new COVID-19 vaccine might exist in a country with high asymptomatic infection. In addition, there might also be an effect of background cross reaction immunity. For example, the dengue antibody is an important antibody that can cross react to SARS–CoV-2.[3] In one hand, there might be a low incidence of COVID-19 in a setting with high dengue prevalence such as tropical Indochina. Since local people might have dengue immunity that acts as a cross immunity to COVID-19, a vaccination should induce a higher antibody titer and there might be a higher incidence of postvaccination adverse reaction. Indeed, in an area with high dengue incidence, Indochina, the local report (https://covid-19.kapook.com/view238376.html) shows a higher rate of adverse effect. The reported rate is equal to 0.0147% or 147 per 1,000,000, which is significant higher than that reported in the USA.[4] It is recommended that screening for previous COVID-19 infection might be useful.[2] Planning for the adjustment of vaccine dose is an interesting area of research. In addition, in an area with chance of cross immunity background among local population, the study on effect of local cross immunity and planning for vaccine dose adjustment is also merited for researching.

Here, the author mentions that previous COVID-19 infection or dengue cross reaction immunity might contribute to postvaccination adverse reaction which is higher in Indochina than in the USA. Another suggestion is for vaccine dose adjustment. Nevertheless, for vaccination campaign, the countries with high prevalence of dengue infection have not reported a trend of higher postvaccination adverse reaction than nonendemics yet. To conclude a higher postvaccination adverse reaction, the background level should be taken into account in order to verify whether the occurrence of blood clot in vaccinee and nonvaccinee is different. It cannot directly compare the adverse reaction rates between Indochina and the USA, because the health conditions and medical resources are different in the two countries. To our knowledge, in the vaccine clinical trial phase one and two, the dose amount has been delicately studied to recommend the optimal. Hence, the main ideas in this letter are interesting for further researching.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Saadat S, Tehrani ZR, Logue J, Newman M, Frieman MB, Harris AD, et al. Binding and neutralization antibody titers after a single vaccine dose in health care workers previously infected with SARS-CoV-2. JAMA 2021;13:1467-9.  Back to cited text no. 1
Wiwanitkit V. COVID-19 vaccine, immune response, previous asymptomatic infection and blood clots 2021. Available from: https://www.bmj.com/content/372/bmj.n699/rr-2.[Last accessed on 2021 Jun 08].  Back to cited text no. 2
Ulrich H, Pillat MM, Tárnok A. Dengue fever, COVID-19 (SARS-CoV-2), and antibody-dependent enhancement (ADE): A perspective. Cytometry A 2020;97:662-7.  Back to cited text no. 3
CDC COVID-19 Response team; food and drug administration. Allergic reactionsincluding anaphylaxis after receipt of the first dose of Pfizer-BioNTech COVID-19 Vaccine – United States, December 14-23, 2020. MMWR Morb Mortal Wkly Rep 2021;70:46-51.  Back to cited text no. 4


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