Autoimmune diseases related to post-SARS-CoV-2 vaccination: A rheumatology perspective

Dadgar, Farhad; Casseb, Jorge; Keikha, Masoud

doi:10.1016/j.vacune.2023.10.013

array:23 ["pii" => "S2445146023000699" "issn" => "24451460" "doi" => "10.1016/j.vacune.2023.10.013" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "299" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Vacunas. 2023;24:400-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S2445146023000705" "issn" => "24451460" "doi" => "10.1016/j.vacune.2023.10.014" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "301" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Vacunas. 2023;24:402-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "Letter to the editor" "titulo" => "The impact of vaccination against monkeypox on risk of mpox reinfection" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "402" "paginaFinal" => "403" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Farhad Dadgar, Jalil Rouhani, Fatemeh Dehghani, Masoud Keikha" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Farhad" "apellidos" => "Dadgar" ] 1 => array:2 [ "nombre" => "Jalil" "apellidos" => "Rouhani" ] 2 => array:2 [ "nombre" => "Fatemeh" "apellidos" => "Dehghani" ] 3 => array:2 [ "nombre" => "Masoud" "apellidos" => "Keikha" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2445146023000705?idApp=UINPBA00004N" "url" => "/24451460/0000002400000004/v2_202401230726/S2445146023000705/v2_202401230726/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2445146023000523" "issn" => "24451460" "doi" => "10.1016/j.vacune.2023.10.001" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "294" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Vacunas. 2023;24:394-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Vaccine strategies" "titulo" => "Fifteen years of vaccination against the human papilloma virus in Spain. An update" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "394" "paginaFinal" => "399" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Quince años de vacunación frente al virus del papiloma humano en España. Actualización" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Moraga-Llop" "autores" => array:1 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Moraga-Llop" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1576988723000341" "doi" => "10.1016/j.vacun.2023.05.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1576988723000341?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2445146023000523?idApp=UINPBA00004N" "url" => "/24451460/0000002400000004/v2_202401230726/S2445146023000523/v2_202401230726/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Letter to the editor" "titulo" => "Autoimmune diseases related to post-SARS-CoV-2 vaccination: A rheumatology perspective" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "400" "paginaFinal" => "401" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Farhad Dadgar, Jorge Casseb, Masoud Keikha" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Farhad" "apellidos" => "Dadgar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "af0005" ] ] ] 1 => array:3 [ "nombre" => "Jorge" "apellidos" => "Casseb" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "af0010" ] ] ] 2 => array:4 [ "nombre" => "Masoud" "apellidos" => "Keikha" "email" => array:1 [ 0 => "masoud.keykha90@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "af0015" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Internal Medicine, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran" "etiqueta" => "a" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Laboratory of Medical Investigation (LIM56) of the Faculty of Medicine, Department of Dermatology, São Paulo University, São Paulo, Brazil" "etiqueta" => "b" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Department of Medical Microbiology, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran" "etiqueta" => "c" "identificador" => "af0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "The new coronavirus 2019 (COVID-19) disease emerged as a form of atypical pneumonia in Wuhan, China late in 2019. As of May 2023, WHO accounted over 750 million laboratory-confirmed cases as well as almost seven million deaths caused by the SARS-CoV-2 infection. Angiotensin converting enzyme 2 (ACE2) plays a critical role in the SARS-CoV-2 virus cleavage to respiratory tract cells. The widespread expression, as well as tissue distribution of ACE2 is responsible for extra-pulmonary COVID-19 related symptoms e.g., gastrointestinal, blood vessels, muscles, and synovial membrane [<a class="elsevierStyleCrossRef" href="#bb0010">1</a>]. There are several evidences related to clinical relevance of SARS-CoV-2 infection in autoimmune diseases i.e., thrombosis, reactive arthritis, vasculitis, systemic sclerosis, systemic lupus erythematosus, myositis, Sjögren syndrome, and even Multi-system inflammatory syndrome [<a class="elsevierStyleCrossRef" href="#bb0010">1</a>,<a class="elsevierStyleCrossRef" href="#bb0015">2</a>]. In this scenario, SARS-CoV-2 is primarily associated to induction of hyperinflammatory responses; Furthermore, SARS-CoV-2 infected-individuals may shed virions for longer time, than previously expected [<a class="elsevierStyleCrossRef" href="#bb0010">1</a>]. Thus, long persistence of COVID-19 symptoms, particularly in individuals affected by immune disorders, may predispose these patients to develop autoimmune disease by reactivation of the virus in periods of immune suppression [<a class="elsevierStyleCrossRef" href="#bb0010">1</a>]. Fortunately, since early 2020, vaccination against SARS-CoV-2 was available and highly effective worldwide [<a class="elsevierStyleCrossRef" href="#bb0020">3</a>]. Thus, vaccination is one of the most critical strategies in establishing a strong barrier in general population to attenuate the speed of spread of SARS-CoV-2 infection, reducing the virus transmission from symptomatic and asymptomatic carriers, as well as hindering poor clinical outcomes in the current global crisis [<a class="elsevierStyleCrossRef" href="#bb0025">4</a>]. WHO accounted about 72.3% of the world population received at least one dose of a SARS-CoV-2 vaccine [<a class="elsevierStyleCrossRef" href="#bb0030">5</a>]. There are two main SARS-CoV-2 vaccine platforms including mRNA (i.e. Pfizer-BioNTech and Moderna) and vector virus vaccine (i.e. Johnson & Johnson and AstraZeneca) that, when administrated, elicit robust immune response against SARS-COV-2 at a global scale. Unfortunately, randomized human trials postulated various SARS-CoV-2 vaccine related-adverse events ranging from local symptoms to systemic symptoms such as de-novo autoimmune manifestations i.e. thrombotic thrombocytopenia, autoimmuneliverdiseases, Guillain–Barré syndrome, IgAnephropathy, Inflammatoryarthritis, Systemic lupus erythematosus, Graves' disease, Autoimmune polyarthritis, Type 1 diabetes mellitus, etc., [<a class="elsevierStyleCrossRef" href="#bb0035">5</a>,<a class="elsevierStyleCrossRef" href="#bb0040">6</a>]. However, the accurate impact of SARS-CoV-2 vaccines in triggering autoimmune diseases remains nebulous.In mRNA based-vaccines, the SARS-CoV-2 spike protein was translated from the mRNA enters via ribosomes. Subsequently, the spike translated protein was recognized and binds to the ACE2. Through the following antigen translation process, the robust CD8+ and CD4 + T-cell-mediated response i.e., memory lymphoid cells as well as neutralizing antibodies were generated. Whereas in adenoviral vector based-vaccines, SARS-CoV-2 antigens are delivered to the host cells by their vectors. The spike protein is expressed on the cell surface and triggers T-cell-mediated immune response [<a class="elsevierStyleCrossRef" href="#bb0045">8</a>]. According to available literature, the main explanations for the impact of SARS-CoV-2 vaccines in initiation of de-novo autoimmune disease consists in 1) molecular mimicry, 2) trigger of auto-antibodies, 3) adjuvants, and 4) bystander activation [<a class="elsevierStyleCrossRef" href="#bb0045">8</a>,<a class="elsevierStyleCrossRef" href="#bb0050">9</a>].In relation to this, the SARS-CoV-2 spike glycoprotein are partially homologous to lung surfactant proteins, by sharing 13 of 24 pentapeptides [<a class="elsevierStyleCrossRef" href="#bb0050">9</a>]; Furthermore, cross-reaction between SARS-CoV-2 antigens with various human-tissue antigens can render immune system to trigger autoimmunity against the cardiovascular, gastrointestinal and nervous system tissues [<a class="elsevierStyleCrossRef" href="#bb0055">10</a>]. Production of autoantibodies by B cells was also an unfavorable outcome reported in the context of autoimmune hepatitis following hyper-inflammatory responses to SARS-CoV-2 vaccines [<a class="elsevierStyleCrossRef" href="#bb0050">9</a>]. Adjuvants are essential components of both mRNA and adenovirus-based SARS-CoV-2 vaccines that include a mixture of different lipid substances. Adjuvants can be responsible for development of hypersensitivity reactions after vaccination which have been confirmed through animal investigations [<a class="elsevierStyleCrossRef" href="#bb0060">11</a>]. Bystander activation is another mechanism for development of autoimmune disease related to post-SARS-CoV-2 vaccination. Bystander activation is defined as a situation that both of B and T lymphocytes subset are activated in an antigen-independent manner. Therefore, this phenomenon could be occurring as a result of SARS-CoV-2 vaccine administration as a possible result non-specific immune-stimulation [<a class="elsevierStyleCrossRef" href="#bb0040">7</a>].To sum, there are several reviews regarding de-novo autoimmune symptoms post-SARS-CoV-2 vaccination. However, this evidence should not encourage vaccine discontinuation in general population. There are still major gaps and limitations regarding main mechanisms involved in pathogenesis of autoimmune disease as an adverse effect of SARS-CoV-2 vaccines that should be elucidated. There are no standard guidelines regarding continuation of further SARS-CoV-2 vaccine doses in population with autoimmune manifestations after the first dose. In addition, there is no guide for diagnosis or treatment of SARS-CoV-2 vaccine-induced autoimmune manifestations. Clinicians should be aware as to the potential autoimmune manifestations of COVID-19 vaccines. In the light of existing evidence, there is need for broad surveillance regarding countermeasures for autoimmune diseases developed after SARS-CoV-2 vaccination in general population. There is also need for further investigation to establishing suitable criteria for diagnosis as well as management of de-novo autoimmune manifestations post-COVID-19 vaccination." "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-05-26" "fechaAceptado" => "2023-06-07" "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bb0010" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "COVID-19 and the clinical course of rheumatic manifestations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Ahmed" 1 => "O. Zimba" 2 => "A.Y. Gasparyan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-021-05691-x" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2021" "volumen" => "40" "paginaInicial" => "2611" "paginaFinal" => "2619" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33733315" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bb0015" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The autonomic aspects of the post-COVID19 syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Dotan" 1 => "P. David" 2 => "D. Arnheim" 3 => "Y. Shoenfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.autrev.2022.103071" "Revista" => array:6 [ "tituloSerie" => "Autoimmun Rev" "fecha" => "2022" "volumen" => "21" "numero" => "5" "paginaInicial" => "103071" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35182777" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bb0020" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Third booster vaccination and stopping the Omicron, a new variant of concern" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Ghazvini" 1 => "M. Karbalaei" 2 => "M. Keikha" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.vacun.2022.05.005" "Revista" => array:6 [ "tituloSerie" => "Vacunas." "fecha" => "2022" "volumen" => "23" "paginaInicial" => "S103" "paginaFinal" => "S110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35818430" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bb0025" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Landscape and progress of global COVID-19 vaccine development" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:9 [ 0 => "H.Y. Huang" 1 => "S.H. Wang" 2 => "Y. Tang" 3 => "W. Sheng" 4 => "C.J. Zuo" 5 => "D.W. Wu" 6 => "H. Fang" 7 => "Q. Du" 8 => "N. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/21645515.2021.1945901" "Revista" => array:7 [ "tituloSerie" => "Hum Vaccin Immunother" "fecha" => "2021" "volumen" => "17" "numero" => "10" "paginaInicial" => "3276" "paginaFinal" => "3280" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34254894" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bb0030" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "https://covid19.trackvaccines.org/agency/who/" "fecha" => "2023" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bb0035" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New-onset autoimmune phenomena post-COVID-19 vaccination" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Chen" 1 => "Z. Xu" 2 => "P. Wang" 3 => "X.M. Li" 4 => "Z.W. Shuai" 5 => "D.Q. Ye" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/imm.13443" "Revista" => array:7 [ "tituloSerie" => "Immunology." "fecha" => "2022" "volumen" => "165" "numero" => "4" "paginaInicial" => "386" "paginaFinal" => "401" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34957554" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bb0040" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoimmune inflammatory rheumatic diseases post-COVID-19 vaccination" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Safary" 1 => "K. Esalatmanesh" 2 => "A.T. Eftekharsadat" 3 => "M.-R.J. Nakjavani" 4 => "A. Khabbazi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Int Immunopharmacol" "fecha" => "2022" "volumen" => "110" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bb0045" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoimmune hepatitis after COVID-19 vaccination" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H. Zheng" 1 => "T. Zhang" 2 => "Y. Xu" 3 => "X. Lu" 4 => "X. Sang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Front Immunol" "fecha" => "2022" "paginaInicial" => "13" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bb0050" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "On the molecular determinants of the SARS-CoV-2 attack" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Kanduc" 1 => "Y. Shoenfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clim.2020.108426" "Revista" => array:5 [ "tituloSerie" => "Clinical Immunology (Orlando, Fla)" "fecha" => "2020" "volumen" => "215" "paginaInicial" => "108426" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32311462" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bb0055" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Vojdani" 1 => "D. Kharrazian" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Clinical Immunology (Orlando, Fla)" "fecha" => "2020" "volumen" => "217" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bb0060" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Other excipients than PEG might cause serious hypersensitivity reactions in COVID-19 vaccines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.D. Borgsteede" 1 => "T.H. Geersing" 2 => "Ž. Tempels-Pavlica" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/all.14774" "Revista" => array:6 [ "tituloSerie" => "Allergy." "fecha" => "2021" "volumen" => "76" "numero" => "6" "paginaInicial" => "1941" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34128559" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24451460/0000002400000004/v2_202401230726/S2445146023000699/v2_202401230726/en/main.assets" "Apartado" => array:4 [ "identificador" => "91117" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24451460/0000002400000004/v2_202401230726/S2445146023000699/v2_202401230726/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2445146023000699?idApp=UINPBA00004N"]

ISSN: 2445-1460

Official journal of the Asociación Española de Vacunología (AEV) Vacunas is a peer-reviewed journal supported by an advisory board of experts in the field of vaccinology. The aim of the journal is to contribute to the dissemination of the scientific advances made in the area of basic and applied research in the field of vaccine-preventable diseases in humans. It places special emphasis on aspects associated with planning and evaluation (epidemiology of vaccine-preventable diseases, development of vaccination programs, evaluation of the efficacy, effectiveness and efficiency of vaccinations). Vacunas publishes, in Spanish and in English, Editorials, Original Articles, Special Articles, Reviews, Strategies and Vaccination Programs. There are also sections on Literature Reviews, News and on Congresses associated with vaccinations. The peer review process is done anonymously by reviewers with expertise in the area of knowledge of each manuscript as well as experts in methodology or statistics, as determined by the Editorial board, which works towards maintaining an efficient editorial process in order for the manuscripts to be published as soon as possible.

See more Open Access Option

Indexed in:

Scopus, EMBASE/Excerpta Médica e IBECS

Subscribe:

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

3.9

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.423

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

0.421

View more metrics

Journal Information

Previous article | Next article

Vol. 24. Issue 4.

Pages 400-401 (October - December 2023)

Export reference

Download PDF

Article

These are the options to access the full texts of the publication Vacunas (English Edition)

Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”

Subscribe to

Vacunas (English Edition)

More information

Purchase

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now

Contact

Phone for subscriptions and reporting of errors

From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.

Calls from Spain

932 415 960

Calls from outside Spain

+34 932 415 960

E-mail

atencionalcliente@elsevier.com

Indexed in:

Follow us:

Subscribe:

Article

Subscribe to our newsletter