MNKYPOX Monkeypox - Consolidated Thread.

helen

Panic Sex Lady
Minnesota Smith, I owe you an apology for calling your post shit. We're trying to keep this thread useful. Your cartoon reminded me of graffiti. I used to work in juvenile court, and unwanted behavior had to be extinguished immediately.

Your little girls can get monkeypox, with concurrent risk of encephalitis, blindness, and sepsis. You may need a quick source of information too.
 

helen

Panic Sex Lady
Article has not been peer reviewed.

This is why mass monkeypox outbreak will slaughter all services. Look how long the incubation periods are for the breakthrough cases.


Among the 276 vaccinated individuals, 12 (4%) had a confirmed Monkeypox breakthrough infection with no severe infection. Ten out of 12 patients developed a Monkeypox infection in the five days following vaccination and two had a breakthrough infection at 22 and 25 days. Conclusion EPRV with a third-generation smallpox vaccine was well tolerated and effective against Monkeypox but did not completely prevent breakthrough infections.

 

helen

Panic Sex Lady
All in all, it's clear that everyone not vaccinated within the past 3 years (and that's almost everyone!) ultimately will require vaccination. That 85% efficacy does not apply to those vaccinated over FIFTY yrs ago. It only confuses people & gives them a false sense of security.
Bottom line:

No one knows how effective the current vaccines will be against monkeypox or how much protection remains from vaccines 50-plus yrs ago. There's not even any real-world data on the efficacy of Jynneos in humans, only in primates.



File version: Thread by @organichemusic on Thread Reader App

Old smallpox vaccination may NOT help with current monkeypox infection.

View: https://twitter.com/organichemusic/status/1555473430606118912?s=20
 

SageRock

Veteran Member

helen

Panic Sex Lady
Actually, there is evidence that prior smallpox vaccinations do provide good protection. Check out this article:

Monkeypox shows longevity of smallpox shots

I discussed this earlier in this thread in the following posts:



I wonder which strain of monkeypox they studied, the old stable version or one of many mutating strains?
 

Babs

Veteran Member
As I scrolled past this thread tonight, I could have sworn it was titled "Monkeycox". Oiy, I must be really tired.
And then I remembered that it's mostly homos who are getting/giving it away, and I giggled to myself at the misread.
 
Last edited:

SageRock

Veteran Member
I wonder which strain of monkeypox they studied, the old stable version or one of many mutating strains?

There are so many MSM articles lately about these supposed mutating strains -- seems like a coordinated PR campaign and the sort of gaslighting that we saw so frequently with the plandemic. All part of a larger agenda, no doubt.

Don't trust'em. Just more fake "science." Not buying it, not one bit!!
 

SouthernBreeze

Has No Life - Lives on TB
There are so many MSM articles lately about these supposed mutating strains -- seems like a coordinated PR campaign and the sort of gaslighting that we saw so frequently with the plandemic. All part of a larger agenda, no doubt.

Don't trust'em. Just more fake "science." Not buying it, not one bit!!

I'm half way inclined to agree with you. Regardless of mutations or not, I am NOT getting another vaccine. I do NOT trust the government with this disease or any other. COVID proved they can't be trusted.
 

phloydius

Veteran Member
That’s a LOT of people who were exposed!

A few thoughts on the

"Authorities said no one else has tested positive." My thought on that is the sky is blue. Of course no one else has tested positive, not enough time has passed. Disease takes time to incubate and build up, and the infected will test negative until enough virus has taken hold to be detected. Also, right now the CDC/FDA only allow the Monkeypox test that tests lesions. So until the children have lesions, they can not be tested. If they could be tested, it take a week to get the results, so none of the results would be back yet, anyways. (That is, unless the Illinois.gov is using tests they won't let the rest of the people use...) This is a case where the Fed.gov's focus is on calming language.


A calming note: This is a good example of the way the Fed.gov could have stop Monkeypox in it's track if it had been competent two months ago. Someone tests positive, go in and give everyone the vaccine (that is willing to take it) that they have contact with & tell everyone to isolate for about 21 days. They would probably miss a contact or two in some cases, but when that person tests positive, repeat the process. With reasonably competent contact tracing & quick deployment of a glut of vaccinations Monkeypox could be stopped very quickly -- assuming the number of infected inbound travelers could be mitigated.

A freaking out note: The number of vaccines that the Fed.gov has (or more accurately "is willing to use") and is providing to the states is insufficient to stop the Monkeypox outbreak in the manner described in a calming note above. There are many news headlines of all the vaccines that the Government bought, but those have not been made yet, and it will be quite a while before those are in-hand. Oh what action could the Fed.gov take to slow down the spread? Or to flatten the curve, just until we get enough vaccines? I bet they could come up with some action to take.

The FDA is "allowing" a vaccine that is not allowed to be used on children, to be used on children. The FDA is a bureaucracy, not an autocracy . Someone isn't going to simply call up the head of the FDA and ask if they will allow them to break the "law" and the FDA would answer "normally no, but this time it is okay". That mean the FDA has already had the meetings, reviewed science material, and otherwise laid the paperwork / groundwork to make the exception. That takes time. For the head of the FDA to say "yes", means that they bureaucracy has authorized them (via CYA paperwork) to make that determination.

That is the second daycare that has been reported in this thread. The first was one in Delaware, but was only a tweet - and the veracity of the claim has not been backed up yet by other reports.

I watched the press conference. One of the things I noted was the big bold "Monkeypox is NOT airborne!" statement said in a forceful tone, followed a couple of sentences later by stating it can be transmitted by breathing the same air as someone infected (in a very subdued tone). Obviously both can be true, but this will be, yet again, something they use to confuse the public for a while in an attempt to clam them. The term 'airborne' has very different definitions from a scientific technical viewpoint vs. a layman's viewpoint. Again this is an example of calming language instead of focusing on stopping the spread.
 

bw

Fringe Ranger
Get gloves asap if you’re thinking about buying them!

I had 1 mil exam gloves tear repeatedly when grocery shopping and handling multiple items. You might want to consider heavier ones, 4 mil or 6 mil. Just got a case of 6 mil and those puppies are nice. Most of the time I'll use the thin ones, but when needed the 6 mil should stand up fine.
 

psychgirl

Has No Life - Lives on TB
A few thoughts on the

"Authorities said no one else has tested positive." My thought on that is the sky is blue. Of course no one else has tested positive, not enough time has passed. Disease takes time to incubate and build up, and the infected will test negative until enough virus has taken hold to be detected. Also, right now the CDC/FDA only allow the Monkeypox test that tests lesions. So until the children have lesions, they can not be tested. If they could be tested, it take a week to get the results, so none of the results would be back yet, anyways. (That is, unless the Illinois.gov is using tests they won't let the rest of the people use...) This is a case where the Fed.gov's focus is on calming language.


A calming note: This is a good example of the way the Fed.gov could have stop Monkeypox in it's track if it had been competent two months ago. Someone tests positive, go in and give everyone the vaccine (that is willing to take it) that they have contact with & tell everyone to isolate for about 21 days. They would probably miss a contact or two in some cases, but when that person tests positive, repeat the process. With reasonably competent contact tracing & quick deployment of a glut of vaccinations Monkeypox could be stopped very quickly -- assuming the number of infected inbound travelers could be mitigated.

A freaking out note: The number of vaccines that the Fed.gov has (or more accurately "is willing to use") and is providing to the states is insufficient to stop the Monkeypox outbreak in the manner described in a calming note above. There are many news headlines of all the vaccines that the Government bought, but those have not been made yet, and it will be quite a while before those are in-hand. Oh what action could the Fed.gov take to slow down the spread? Or to flatten the curve, just until we get enough vaccines? I bet they could come up with some action to take.

The FDA is "allowing" a vaccine that is not allowed to be used on children, to be used on children. The FDA is a bureaucracy, not an autocracy . Someone isn't going to simply call up the head of the FDA and ask if they will allow them to break the "law" and the FDA would answer "normally no, but this time it is okay". That mean the FDA has already had the meetings, reviewed science material, and otherwise laid the paperwork / groundwork to make the exception. That takes time. For the head of the FDA to say "yes", means that they bureaucracy has authorized them (via CYA paperwork) to make that determination.

That is the second daycare that has been reported in this thread. The first was one in Delaware, but was only a tweet - and the veracity of the claim has not been backed up yet by other reports.

I watched the press conference. One of the things I noted was the big bold "Monkeypox is NOT airborne!" statement said in a forceful tone, followed a couple of sentences later by stating it can be transmitted by breathing the same air as someone infected (in a very subdued tone). Obviously both can be true, but this will be, yet again, something they use to confuse the public for a while in an attempt to clam them. The term 'airborne' has very different definitions from a scientific technical viewpoint vs. a layman's viewpoint. Again this is an example of calming language instead of focusing on stopping the spread.
They’re straight out lying.

I’m following/reading, a high level dermatologist this very minute.
It IS transmissible by air.
People who make studying this disease their life work….are the ones telling the truth!
 

phloydius

Veteran Member
Get gloves asap if you’re thinking about buying them!
This is a long thread full of comments regarding people using them, advice on how to sanitize etc
But mostly it’s about using gloves!

I had 1 mil exam gloves tear repeatedly when grocery shopping and handling multiple items. You might want to consider heavier ones, 4 mil or 6 mil. Just got a case of 6 mil and those puppies are nice. Most of the time I'll use the thin ones, but when needed the 6 mil should stand up fine.

Right now gloves are the cheapest I've seen them since the start of the pandemic. Before the pandemic (in 2014) I was buying my preferred gloves for $12.99 for a box of 100. During the pandemic they were going for over $100 per box, when they were in stock (which was almost never). I could find much lower quality gloves for $25 per box, if I would have needed any. Those same gloves are now $14.99 but on sale for $12.99.

Gloves were not in huge demand during the Covid pandemic. They will be in insane demand during the Monkeypox pandemic, in my opinion.

FYI, most latex/nitrile/vinyl gloves are made in China and (sometimes) repackaged in the USA.

My preferred gloves are nitrile black over 6 mil.

What I have been telling my friends & family (including nurses), is get a 2 year supply RTFN. Not that anyone listens.
 
Last edited:

psychgirl

Has No Life - Lives on TB
Right now gloves are the cheapest I've seen them since the start of the pandemic. Before the pandemic I was buying my preferred gloves for $12.99 for a box of 100. During the pandemic they were going for over $100 per box, when they were in stock (which was almost never). I could find much lower quality gloves for $25 per box, if I would have needed any. Those same gloves are now $14.99 but on sale for $12.99.

Gloves were not in huge demand during the Covid pandemic. They will be in insane demand during the Monkeypox pandemic, in my opinion.

FYI, most latex/nitrile/vinyl gloves are made in China and (sometimes) repackaged in the USA.

My preferred gloves are nitrile black over 6 mil.

What I have been telling my friends & family (including nurses), is get a 2 year supply RTFN. Not that anyone listens.
Smart move.
I need more myself.
 

psychgirl

Has No Life - Lives on TB
In some of the YouTube "on the ground reports" (not just from southernprepper1) there has been some notes over the last coupe of weeks that hospitals & home health procurement are having a harder time sourcing (buying) gloves.
Crap.
I’ve been sneaking them home from work to use at the gas station or to handle grocery carts for some time, now.
But I’d rather just buy my own.
 

phloydius

Veteran Member
Remember that some people have latex allergies (that can be very serious) and may not even know it or that develop over time after repeated exposure to latex.

1659795736948.png
 

phloydius

Veteran Member
Crap.
I’ve been sneaking them home from work to use at the gas station or to handle grocery carts for some time, now.
But I’d rather just buy my own.

Would love to get your opinion on a strategy that I use when doing things like working with raw chicken. I am wondering if it might be useful for dealing with objects during the Monkeypox pandemic. I call it the "dirty hand, clean hand" strategy. There are many things you can do with one hand (although some are more difficult). Although, obviously not everything can be. But basically, the dirty hand touches the chicken and anything that is "dirty", and the clean hand touches everything else like the fridge door as an example. This limits the number of times I need to wash hands while preparing food and makes clean up easier.

[I know you know this, but stating the obvious for anyone that may not]: Because with Monkeypox at the gas station (as a simple example), once the gloves touch the pump handle the gloves are "dirty" and will transmit the disease to anything the gloves touch, such as a credit card, cell phone, the car door handle, etc.

I have yet to practice it, and I can tell you it takes practice to get it right without making errors.

Since you use the gloves at work pretty regularly, do you think the "dirty hand, clean hand" strategy might be effective while out in public doing basic every day tasks?
 

phloydius

Veteran Member
If you are looking for disposable tough exam gloves try a search for Thicksters

They are available on Scamazon Crime.

We use them handling oil field tools that come out of the well. They are tough and hold up pretty well to rough use.

Wow. Those are nice & thick, 14 mil thick latex!
 

helen

Panic Sex Lady
Would love to get your opinion on a strategy that I use when doing things like working with raw chicken. I am wondering if it might be useful for dealing with objects during the Monkeypox pandemic. I call it the "dirty hand, clean hand" strategy. There are many things you can do with one hand (although some are more difficult). Although, obviously not everything can be. But basically, the dirty hand touches the chicken and anything that is "dirty", and the clean hand touches everything else like the fridge door as an example. This limits the number of times I need to wash hands while preparing food and makes clean up easier.

[I know you know this, but stating the obvious for anyone that may not]: Because with Monkeypox at the gas station (as a simple example), once the gloves touch the pump handle the gloves are "dirty" and will transmit the disease to anything the gloves touch, such as a credit card, cell phone, the car door handle, etc.

I have yet to practice it, and I can tell you it takes practice to get it right without making errors.

Since you use the gloves at work pretty regularly, do you think the "dirty hand, clean hand" strategy might be effective while out in public doing basic every day tasks?
I do that too.
 

somewherepress

Has No Life - Lives on TB
Page 1 of 2
Is it just me or does the presentation of varicella-zoster virus closely resemble MPX

View: https://twitter.com/Is2021OverYet/status/1555929181690728450

Real-world evidence from over one million COVID-19 vaccinations is consistent with reactivation of the varicella-zoster virus

M. Hertel,M. Heiland,S. Nahles,M. von Laffert,C. Mura,P.E. Bourne,R. Preissner,S. Preissner
First published: 26 April 2022

https://doi.org/10.1111/jdv.18184
Citations: 1
Funding sources
This work was supported by the Deutsche Forschungsgemeinschaft (TRR295 and KFO339).
Conflicts of interest
The authors declare that they have no conflicts of interest.

SECTIONS
PDF PDF
TOOLS

SHARE


Abstract
Background
Reactivation of the varicella-zoster virus (VZV), which causes herpes zoster (HZ, synonym: shingles) in humans, can be a rare adverse reaction to vaccines. Recently, reports of cases after COVID-19 vaccination have arisen.
Objectives
The aim of this study was to assess whether the frequency of HZ is found to increase after COVID-19 vaccination in a large cohort, based on real-world data. As a hypothesis, the incidence of HZ was assumed to be significantly higher in subjects who received a COVID-19 vaccine (Cohort I) vs. unvaccinated individuals (Cohort II).
Methods
The initial cohorts of 1 095 086 vaccinated and 16 966 018 unvaccinated patients were retrieved from the TriNetX database and were matched on age and gender in order to mitigate confounder bias.
Results
After matching, each cohort accounted for 1 095 086 patients. For the vaccinated group (Cohort I), 2204 subjects developed HZ within 60 days of COVID-19 vaccination, while among Cohort II, 1223 patients were diagnosed with HZ within 60 days after having visited the clinic for any other reason (i.e. not vaccination). The risk of developing shingles was calculated as 0.20% and 0.11% for cohort I and cohort II, respectively. The difference was statistically highly significant (P < 0.0001; log-rank test). The risk ratio and odds ratio were 1.802 (95% confidence interval [CI] = 1.680; 1.932) and 1.804 (95% CI = 1.682; 1.934).
Conclusions
Consistent with the hypothesis, a higher incidence of HZ was statistically detectable post-COVID-19 vaccine. Accordingly, the eruption of HZ may be a rare adverse drug reaction to COVID-19 vaccines. Even though the molecular basis of VZV reactivation remains murky, temporary compromising of VZV-specific T-cell-mediated immunity may play a mechanistic role in post-vaccination pathogenesis of HZ. Note that VZV reactivation is a well-established phenomenon both with infections and with other vaccines (i.e. this adverse event is not COVID-19-specific).

Introduction
Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly became a pandemic, starting from the identification of the first cases. Globally, immense hope rests upon vaccination against COVID-19. Most available vaccines act by presenting the viral spike (S) protein to the host immune system, yielding an active immunization by the induction of a specific humoral response, followed by the formation of neutralizing anti-viral antibodies. The sera contain either (i) S protein-encoding mRNA embedded in lipid nanoparticles (LNPs), for example BioNTech/Pfizer's BNT162b2 or Moderna's mRNA-1273; (ii) adenovirus vectors, such as Astra-Zeneca's ChAdOx1 nCoV-19, Johnson & Johnson's Ad26.COV2.S or Gam-COVID-19-Vac (Gamaleya National Centre of Epidemiology and Microbiology); or (iii) inactivated SARS-CoV-2 virions, as in Sinovac's CoronaVac. A broad spectrum of clinical studies conducted in different countries has shown high protection levels against COVID-19, especially as regards severe courses of the disease. Safety profiles were found to be acceptable despite the occurrence of minor adverse effects such as muscle aches (myalgia), fatigue and other flu-like symptoms.1-10 Nevertheless, reports have recently emerged of very rare but severe adverse drug reactions (ADR) and adverse drug events (ADE). Specifically, eosinophilic lung disease, cerebral venous sinus thrombosis (CVST), pulmonary embolism, vaccine-induced immune thrombocytopenia (VITT) and myocarditis were found to be associated with COVID-19 vaccination.11-18
Because of the rapidity with which the first generation of COVID-19 vaccines had to be developed, tested, produced, delivered and finally utilized, there is an acute need to screen vaccinated cohorts for as yet unknown adverse reactions and undesirable effects; such data are also indispensable in continually refining next-generation vaccines. Although any scientific report of risks or complications can be misconstrued (the present work included), for example as part of anti-vaccine agendas, we believe that it is of fundamental ethical relevance that potential ADRs/ADEs are meticulously investigated and disclosed to the public. Note that many adverse events are known to occur both with infections (e.g. COVID-19 itself) and, in some cases, even with other (non-COVID) vaccines: that is, these adverse events are not necessarily specific side-effects of the various COVID vaccines. Any decision-making process—be it a population-wide policy recommendation or an individual/personal choice—is healthiest if it is balanced and data-informed, weighing the potential complications reported herein against the significant and well-established benefits of COVID-19 vaccination.19
Herpes zoster (HZ, synonym: shingles) is an infectious mucocutaneous disease caused by reactivation of the varicella-zoster virus (VZV). The initial infection, often contracted in childhood, emerges as a maculopapular rash (varicella, synonym: chickenpox). Despite clinical recovery, VZV persists in the bodies of neural cells located in the spinal dorsal root ganglia and the trigeminal ganglia.20 Typically, shingles presents as a painful unilateral cutaneous or mucous rash consisting of confluent erosions following the formation of vesicles. The exanthema/enanthema typically corresponds to a dermatome or the innervation area of a sensory nerve. HZ is primarily diagnosed clinically and can be confirmed via polymerase chain reaction (PCR) and enzyme-linked immunosorbent assays (ELISA).21 Herpes zoster can be treated with a family of nucleoside analogue compounds (aciclovir, valaciclovir and famciclovir) that inhibit the viral DNA polymerase. These virostatic agents require prompt administration, ideally within 72 h of onset of the rash. Furthermore, a VZV vaccine is available.20
Reactivation of herpesviridae, including VZV, has been reported to be potentially triggered by vaccines against, inter alia, yellow fever, hepatitis A, rabies and influenza.22 An association of HZ with COVID-19 vaccination has been reported worldwide in case reports and case series,23-35 as well as in a retrospective study focusing on the safety of BNT162b2. The latter found a risk ratio (RR) of 1.43 based on 15.8 events of HZ per 100.000 patients.36 Iwanaga et al. published a narrative review on 399 patients who developed shingles after COVID-19 vaccination including two cases of oral HZ. Among those, 24 individuals reported a history of varicella/HZ. Twenty subjects had been vaccinated against VZV. BNT162b2 was most often associated with HZ.37 Fathy et al. reviewed 35 cases of HZ after COVID-19 vaccination reported in the International Dermatology Registry. Shingles occurred in similar proportions after the use of BNT162b2 and mRNA-1273.38
Even though HZ can be sufficiently treated by prompt administration of nucleoside analogues, severe complications can occur. Of those, the most frequent ones are secondary infections, the development of subacute herpetic neuralgia and post-herpetic neuralgia, as well as zoster ophthalmicus including acute retinal necrosis, which can cause loss of vision.20 Rather rare potential neurological complications are Hunt syndrome, Guillain–Barré syndrome, Bell's palsy, aseptic meningitis, peripheral motor neuropathy and myelitis.45 Furthermore, VZV is known to increase maternal morbidity in pregnant individuals.21
The present work seeks to determine whether an association between COVID-19 vaccination and the eruption of herpes zoster can be found in a large international cohort, based on statistical analysis of real-world data. As a working hypothesis, we assumed that the incidence of HZ would be significantly (detectably) higher in individuals who were vaccinated against COVID-19, vs. those who remained unvaccinated. To gather subject data, the TriNetX Global Health Research Network was used. This database offers high volumes of real-world data aggregated from multiple centres; as of November 2021, TriNetX includes medical records of over 250 million individuals. The clinical data in the TriNetX biomedical research network are drawn from over 120 healthcare organizations (HCO) across 19 countries; it brings together HCOs, contract research sites and biopharmaceutical companies in order to exchange longitudinal clinical data and provide state-of-the-art analytics. The TriNetX resource was used recently for retrospective, real-world evidence (RWE) studies of other COVID-19-related topics.39, 40 Herein, we describe our findings for shingle-associated reactivation of VZV, based on a statistical survey of over 1 M COVID-19 vaccinations.
Materials and methods
Inclusion and exclusion criteria
The TriNetX database was accessed on 25 November 2021, and the eligibility period was limited to 2y backwards from the access date. Thus, all patients who visited the respective HCO for evaluation and management services in this timeframe were eligible for inclusion. Subsequently, to construct the initial cohorts, the database was searched for (i) individuals who had received at least one intramuscular injection of mRNA LNP or adenovirus vector-based COVID-19 vaccine (giving Cohort I), and (ii) those who were not vaccinated against COVID-19 (giving Cohort II).
Matching process
In order to mitigate confounder bias via the method of propensity score matching, stratified and balanced sub-cohorts across current age and gender distributions were constructed from the initial cohorts, as shown in Fig. 1. One-to-one matching was conducted to replicate randomized conditions as closely as possible.
Details are in the caption following the image
 
Last edited:

psychgirl

Has No Life - Lives on TB
Would love to get your opinion on a strategy that I use when doing things like working with raw chicken. I am wondering if it might be useful for dealing with objects during the Monkeypox pandemic. I call it the "dirty hand, clean hand" strategy. There are many things you can do with one hand (although some are more difficult). Although, obviously not everything can be. But basically, the dirty hand touches the chicken and anything that is "dirty", and the clean hand touches everything else like the fridge door as an example. This limits the number of times I need to wash hands while preparing food and makes clean up easier.

[I know you know this, but stating the obvious for anyone that may not]: Because with Monkeypox at the gas station (as a simple example), once the gloves touch the pump handle the gloves are "dirty" and will transmit the disease to anything the gloves touch, such as a credit card, cell phone, the car door handle, etc.

I have yet to practice it, and I can tell you it takes practice to get it right without making errors.

Since you use the gloves at work pretty regularly, do you think the "dirty hand, clean hand" strategy might be effective while out in public doing basic every day tasks?
Well, yes.
But “de gloving properly”…takes practice.
I’ll try to explain it
But yes, I keep one, clean hand free while out, and my other hand gloved…it’s hard, at first, but you get used to it.

You absolutely need to be sure when you are all done doing the things, that it’s ok to take off the dirty glove hand using one finger of your clean hand….to slip under the dirty glove on the back of your hand… consider the palm side, of the dirty glove, as contaminated…making absolutely sure your clean finger slips entirely under BEFORE you flip the glove off your hand….it should come off inside out…so that you’ll never touch any contaminated surface.

It’ll be performed as one, rapid movement.
Practice at home :)

There might be videos out there to show you how.
I don’t do it “exactly” like my doctor does for surgery, so I’ve improvised my own method for daily uses.
 
Last edited:

somewherepress

Has No Life - Lives on TB
Page 2

Figure 1
Open in figure viewerPowerPoint
CONSORT flow chart.
Statistical analysis
We defined the primary outcome as clinically diagnosed ‘herpes zoster’ (International Classification of Diseases [ICD] 10 code B.02) that condition being met either (i) within 1–60 days post-COVID-19 vaccination (for Cohort I) or (ii) within 1–60 days of a patient's visit to the HCO for any other reason (for Cohort II). Next, this framework was used to conduct a Kaplan–Meier analysis, and risk ratios (RRs) and odds ratios (ORs) were calculated. In addition, both cohorts were tested for distribution differences regarding the history of radiotherapy and/or chemotherapy, iatrogenic immunosuppression, as well as asymptomatic and symptomatic infection with human immunodeficiency virus (HIV; ICD-10 codes Z21 and B20). Statistical analyses were performed using the log-rank test, whereby the significance threshold was defined as P ≤ 0.05.

Ethics approval
All methods were performed in compliance with relevant guidelines and regulations. All HCOs from which data were transferred to TriNetX obtained (written) informed consent from all patients and/or their legal guardians. TriNetX is compliant with the Health Insurance Portability and Accountability Act (HIPAA), which is the US federal law that protects the privacy and security of healthcare data. TriNetX is certified to the ISO 27001:2013 standard and maintains an Information Security Management System (ISMS) to ensure the protection of the healthcare data it has access to and to meet the requirements of the HIPAA Security Rule. Any data displayed on the TriNetX platform in aggregate form or any patient-level data provided in a data set generated by the TriNetX platform only contains de-identified data, per the de-identification standard defined in Section §164.514(a) of the HIPAA Privacy Rule. The process by which the data are de-identified is attested to through a formal determination by a qualified expert as defined in Section §164.514(b) (1) of the HIPAA Privacy Rule. This formal determination by a qualified expert, refreshed in December 2020, supersedes the need for TriNetX's previous waiver from the Western Institutional Review Board (IRB). The TriNetX network contains data provided by participating healthcare organizations (HCOs), each of which represents and warrants that it has all necessary rights, consents, approvals and authority to provide the data to TriNetX under a business associate agreement (BAA), so long as their name remains anonymous as a data source and their data are utilized for research purposes. The data shared through the TriNetX platform are masked to ensure that they do not include sufficient information to facilitate the determination of which HCO contributed which specific information about a patient.41

Results
Based on the inclusion and exclusion criteria, 1 095 086 and 16 966 018 patients were eligible to comprise Cohorts I and II, respectively. After the matching process, each Cohort accounted for 1 095 086 individuals. The demographic characteristics of the included subjects are shown in Table 1, and the frequencies of the vaccines applied within Cohort I are presented in Table 2.

Table 1. Patient characteristics before and after matching of cohorts I (ICD-10 code B.02 after COVID-19 vaccination) and II (ICD-10 code B.02 without COVID-19 vaccination)

Before matching After matching
Patients (n) Cohort I Cohort II P-value Standardized mean difference Cohort I Cohort II P-value Standardized mean difference
Total 1 095 086 16 966 018

1 095 086 1 095 086

Female 638 242 (58.28%) 9 278 596 (54.69%) <0.0001 0.0725 638 242 (58.28%) 638 242 (52.28%) 1.0 0
Male 456 687 (41.72%) 7 682 275 (45.31%) <0.0001 0.0722 456 687 (41.72%) 456 687 (41.72%) 1.0 0
Mean current age (years) 54.74 40.31 <0.0001 0.6420 54.74 54.74 1.0 0
Standard deviation 20.20 24.53

20.20 20.20
0
Minimum 12 0

12 12

Maximum 90 90

90 90

Mean age at diagnosis (years) 54.10 40.00 <0.0001 0.6736 54.10 54.10 1.0 0
Standard deviation 20.16 24.49

20.16 20.16

Minimum 7 0

7 7

Maximum 90 90

90 90

Abbreviation: ICD, International Classification of Diseases.
Percentage refers to gender distribution within the respective cohorts. P-value refers to comparison between both cohorts (log-rank test).

Table 2. Types of COVID-19 vaccines applied in Cohort I
Vaccine type Patients (n)
BNT162b2 (30 μg/0.3 mL) 970 465 (88.62%)
First dose 511 186 (46.68%)
Second dose 459 279 (41.49%)
mRNA-1273 (100 μg/0.5 mL) 108 085 (9.87%)
First dose 56 397 (5.15%)
Second dose 51 688 (4.72%)
Ad26.COV2.S [5 x 1010 viral particles/0.5 mL; single-dose] 16 536 (1.51%)
Percentage are of the total number from among the 1 095 086 patients within the cohort. Bold values are absolute numbers.

Among the individuals in Cohort I, 2204 subjects developed HZ within 60 days of COVID-19 vaccination (Fig. 2). Meanwhile, in Cohort II we found 1223 patients were diagnosed with HZ within 60 days of having visited an HCO for any other reason. The risk of developing shingles was calculated as 0.20% vs. 0.11% for Cohorts I and II, respectively. The underlying risk difference of 0.09% was statistically highly significant (P < 0.0001; 95% confidence interval [CI] = 0.079%; 0.100%). Computed RR and OR values (Fig. 2) were 1.802 (95% CI = 1.680; 1.932) and 1.804 (95% CI = 1.682; 1.934), respectively.

Details are in the caption following the image
Figure 2
Open in figure viewerPowerPoint
Cohort statistics after 1:1 matching.
Patient data on a history of radiotherapy and chemotherapy, iatrogenic immunosuppression, as well as asymptomatic and symptomatic infection with HIV (ICD-10 codes Z21 and B20), were available for 641 277 subjects from both cohorts. The frequencies of histories of radiotherapy or chemotherapy were significantly higher among Cohort II, with the differences being (for Cohort I vs. II): radiotherapy = 10 vs. 41; chemotherapy = 1020 vs. 2219 subjects (P ≤ 0.05). As regards the use of immunosuppressants and the prevalence of the HIV-related ICD-10 codes (Z21 and B20), no significant differences were detected (P > 0.05).

Discussion
The present study sought to determine whether the frequency of herpes-zoster diagnoses was higher among patients who received COVID-19 vaccines (Cohort I) vs. those who were not vaccinated (Cohort II). We anticipated that the incidence of HZ might be detectably higher in Cohort I vs. Cohort II, based on prior reports by others and what is generally known about herpesviridae reactivation phenomena. The hypothesis was confirmed, based on comparative analysis of a 60-day period after vaccination (for Cohort I) vs. the same time period after a visit to the HCO for any other reason (Cohort II). Accordingly, reactivation of the varicella-zoster virus appears to be a potential ADR to COVID-19 vaccines, at least for mRNA LNP-based formulations. This finding concurs with recent reports (cited in the Introduction), a significant difference being that the present work is on a broader scale (volume of cases and distributed internationally) vs. what was sampled in other recent reports. However, we cannot draw conclusions from our analysis of the vector-based (vs mRNA-based) vaccines, as only 1.51% of the subjects in Cohort I received Ad26.COV2.S.

Intriguingly, a generally increased incidence of herpes virus infections has been reported since the COVID-19 pandemic began.42, 43 The possibility has been raised that herpesviridae reactivation may be triggered by suppressive effects of SARS-CoV-2 on a host immune system; furthermore, pandemic-related psychological stress has been noted to potentially play a causal role, too.31 On the other hand, vaccination against COVID-19 seems to potentially raise the risk of precipitating HZ. While the specific molecular mechanisms that cause VZV to reactivate remain unknown, certain risk factors have been identified—including stress, elevated age, usage of immunosuppressants, chemotherapy and radiotherapy. A unifying thread among these conditions is that they correspond to a decreased immune competence, in terms of immunoglobulins, CD4+ and CD8+ T lymphocytes and memory T cells.44 In the context of the present study, we note that innate- or cell-mediated immune failures, caused by a host's response to COVID-19 vaccination, have been raised as potentially causative factors for VZV reactivation.38 Psichogiou et al. postulated a temporary incapacity of VZV-specific CD8+ T cells, allowing VZV to reactivate and thereby cause HZ.25

Both the probability of severe courses of disease, as well as the risks of the listed complications, are heightened with increasing age because of adaptive immunosenescence45; concerningly, immunosenescence has been found to be associated not only with an increased susceptibility to viral infections but also with a decreased response to vaccination46. This raises an issue that is a potentially beneficial source of information (on a patient-by-patient basis): those who show reactivation of VZV following COVID-19 immunization might have a lower protection rate against COVID-19. Furthermore, it may be worth considering whether vaccination for VZV, or even prophylactic use of nucleoside analogue drugs, could be applied in patients at high risk of VZV reactivation, especially for patients above the age of 60 years. Given all of the above, we reiterate that, on the balance, the general benefits of COVID-19 vaccination far outweigh potential risks for a vast preponderance of the population.

Beyond the constraints that are inherent to its retrospective nature (e.g. unavailability of a placebo arm/control cohorts), the study reported here is not without certain limitations; future work can seek to address these issues. For example, data on psycho-emotional stress levels, history of VZV vaccination and history of chickenpox could be highly valuable to include in this type of analysis. Similarly, data on the use of immunosuppressants or the presence of general diseases which cause immunodeficiency (especially HIV infection), and histories of chemotherapy and/or radiotherapy were provided for a limited number of patients, but detailed background information was unavailable for inclusion in the present analysis. To overcome these limitations, future studies might consider using a standard prospective design (placebo-controlled, randomized, double-blinded) in order to both assess and extend the results reported here.
 
Top