"Abstract
The frail, elderly population is often characterized by poor immunogenicity post COVID-19 mRNA vaccination. 'Inflame-ageing' and 'immune-senescence' are pathogenetic mechanisms that might explain this phenomenon. Complex interplay with cytokines and microbiota is also implicated in this inflammatory cascade. The above mentioned population, although very important from immunologic perspective, has barely been included in the mRNA vaccination clinical trials."
Main Text
"Interestingly, recent in vitro studies indicate that vaccine-related SARS-CoV-2 spike protein considerably reduces the DNA damage repairing proteins, which are essential for efficient V(D)J recombination in adaptive immunity. In this way, vaccines weaken the reactions of adaptive immune system and suggest a probable adverse event of spike protein-based vaccines; mutations of such repair proteins appear to trigger oncogenic process. Moreover, recent published data revealed an excess of risk of serious adverse effects related to mRNA-based COVID-19 vaccines and underlined the necessity of harm–benefit analyses, in order to stratify risk. More specifically, patients ≥65 years old have been linked with a higher rate of post-vaccination hospitalizations, death, and life-threatening outcomes, than populations age 18–64 years (relative risk estimates among 1.49 99% CI [1.44–1.55] and 8.61 99% CI [8.02–9.23]). Moreover, when compared with influenza vaccines, COVID-19 vaccines yielded raised relative risks for allergic reactions, arrhythmia, general cardiovascular events, coagulation, hemorrhages, constitutional, gastrointestinal, ocular, sexual organs reactions, and, in particular, thromboembolic events. In a nationwide mass vaccination background, including and elderly participants [sic], the BNT162b2 vaccine was connected with an excess risk of myocarditis (11.0 events per 100,000 persons) and of other severe adverse outcomes, including myocardial infarction, pericarditis, arrhythmia, deep vein thrombosis, pulmonary embolism, intracranial hemorrhage, and thrombocytopenia.
Interestingly, recent data on autopsies of patients 46–75 years old documented the development of myocarditis as a fatal complication following mRNA-based anti-SARS-CoV-2 vaccination up to 20 days prior to their death. Importantly, none of the dead patients had COVID-19 before vaccination.
Considering myocardial infarction, its incidence, after COVID-19 vaccination, increased significantly among patients aged >85 years when compared with younger arms (1400 and 28 per 100,000 person years, respectively)... Likewise, acute kidney injury occurred most frequently in elderly patients after the COVID-19 vaccines.
In frail elderly people there is a recognized connection between DNA repair defects, genomic instability, oxidative stress, and age-related disorders including malignancies. In this regard, beyond reduced response to COVID-19 vaccinations, both 'inflamm-ageing' and 'immune-senescence' induce an increased susceptibility of the elderly to malignancies, infectious diseases, autoimmune or cardiovascular disorders, and dementia. Therefore, the latter data suggest that vaccine-related SARS-CoV-2 spike protein may inhibit adaptive immunity and emphasize the possible adverse events of full-length spike-based vaccination."
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