Thread by @angryhacademic

What evidence have we got for vaccine induced #longcovid like presentations?

A thread 🧵 (focused on human evidence rather than theoretical or mechanistic)

#PostVac #teamclots #vaccineinjuries

I will start by saying the *published* evidence is limited. Therefore going off published evidence alone is (by definition) incomplete (same for any research: the active researchers have a knowledge advantage)

1. This was first reported in the mainstream in Jan 2022 by Science mag:
science.org/content/articl…
Importantly, there are a handful of such cases in the trials that were excluded from final analysis, one is described in the Science article

2. Case studies showing long covid pathologies post-vaccination have been reported, including one case series from a NIH researcher:
medrxiv.org/content/10.110…

https://twitter.com/angryhacademic/status/1495875024426831877

3. Clinicians in Germany (@SchiefferDr @ProfSchieffer) opened a clinic in response to patient need: frontiersin.org/articles/10.33…
Ive heard the waiting list for this clinic is long

4. Jacob Laubscher (South Africa) & @BeateJaegerMD (Germany) have seen the same hypercoagulation in patients with post covid vac syndrome as #longcovid patients (currently unpublished but discussed briefly here & here )

5. Patients in countries/areas that were covid zero, like New Zealand, have reported having long covid like presentations post vaccination. Research is ongoing, but the observation is mentioned in this paper: frontiersin.org/articles/10.33…

6. Surveying #pwME suggested around 20 % worsen post vaccination; this is important due to the overlaps in symptoms and pathophysiology of #MECFS and #longcovid
anzmes.org.nz/anzmes-prelimi…
Some stories here: meassociation.org.uk/2021/05/covid-…

7. Indeed, a similar proportion of long covid patients get worse post vaccination
ncbi.nlm.nih.gov/pmc/articles/P…

With one study showing a higher antibody response to vaccination correlated with symptom worsening: pubmed.ncbi.nlm.nih.gov/35238053/

If we can believe patients can get worse from vaccination, is it not reasonable to think some people get ill from vaccination? It is an immune stimulus after all

https://twitter.com/angryhacademic/status/1593383914051174401

8. @brucep13's group showed lingering spike protein in immune cells in long covid patients but not recovered controls. He then found similar in post covid vaccine syndrome patients
researchsquare.com/article/rs-184…

9. Such presentations dont appear to be new to covid vaccines, for example there are reported cases of POTS post-HPV vaccination, eg link.springer.com/article/10.100…

Such cases often get ignored due to intuitive bias that precludes critical thought ("antivax" "correlation ≠ causation"), and because we dont see population risk increases (a lack of which does not preclude causality) bmj.com/content/376/bm…

Indeed, for illnesses with sometimes relatively low population prevalence that are often misdiagnosed, or missed completely, biomedical research is a much stronger method to infer causality. Which leads me to...

10. Upcoming biomedical research:
• @resiapretorius has a SA MRC grant to look at #microclots, discussed briefly here:
• Researchers in the UK won a grant to also look at microclotting

https://twitter.com/patientled/status/1595123788265717760

• @VirusesImmunity is investigating, also working with Prof Pretorius

https://twitter.com/VirusesImmunity/status/1573659800717742081

watch Prof Iwasaki talk about her hypothesis here:
• Researchers in NZ are looking at immune profiling

https://twitter.com/DrAnnaNZ/status/1586809815783047169

Based on the current *published* evidence we cannot infer strongly that post covid vaccine syndrome is "real" (i.e. causally from the vaccine). However, those who are actively treating patients (i.e. those who have seen most data) and doing the research seem to have little doubt

As it stands, many cases do adequately meet "standards" to infer causality. Those who doubt this seem to be those who are not actively involved in the research or clinical care of patients; ime they are often unaware of the ongoing research too

https://twitter.com/angryhacademic/status/1586828219432505345

Will some cases be a coincidence or caused by something else? Most likely YES. But that is true for anything. Long covid, lung cancer in a smoker, back ache in someone with bad posture etc. We shouldnt use that line of reasoning to dismiss the possibility.

Dismissing possibilities stagnates progress.

Until the biomed work has been published we cannot make absolute statements that these patients are not suffering from vaccine harms. Especially if an alternative explanation is given that is based on no evidence like "must have been infection" (dontbelievehype.co.uk/covid-%26-vacc…).

Patients are telling THEIR truth. And believe me, they wish it wasnt their truth. Those who know they had infection are often the first to say. We think about this 24/7, we're open to explanations. We'd rather it wasnt the vax, esp as vaccines are the only COVID mitigation atm

If you are in doubt, what evidence would change your mind? Let us know, and hopefully we can consider this in research. We want to know the truth, we might be wrong. But so might you.

https://twitter.com/doctorasadkhan/status/1594389918163378176

for clarity: we are building a clinical picture here, not giving absolutes

Post script: if you can believe some ME / long covid patients get better post vaccine (which surveys suggest does happen, more often than getting worse), but you cannot believe others get worse, then i think you need to consider why that is & whether youre being consistent

More research / stuff i forgot:

Patteron's group found distinct immune profiles in #postvacsyndrome vs #LongCovid and #lyme patients
researchsquare.com/article/rs-159…

Resrarchers in Germany suspect autoimmunity, though i cant find a research publication on this so take with a pinch of salt (or link me if ive missed it!)
deutschlandfunk.de/post-vac-neu-e…

Starting to see population signals for #POTS which is a common problem with post vaccine #LongCovid like reactions
nature.com/articles/s4416…

Editorial here: nature.com/articles/s4416…