Recent major media coverage useful for educating others: https://www.science.org/content/article/rare-cases-coronavirus-vaccines-may-cause-long-covid-symptoms
The current theories for why people experience an adverse reaction to the COVID-19 vaccination vary. This page is updated regularly as new information becomes available. Most theories are based on speculation founded in existing research on post-COVID-19 long-term effects, as there is little current ongoing research regarding these rare vaccine reactions. The following theories fit many of the symptom profiles found in those with adverse vaccine side effects and incidentally also those suffering from long COVID (post-acute sequelae of COVID-19). These theories can be categorized into the following models:
What are monocytes? Monocytes are a type of white blood cell (leukocyte) that heavily reside in blood or around blood vessels. They have three main functions:
- Phagocytosis - “eating” bacteria, dead tissue cells, or small mineral particles, in this case, this may be the spike proteins or dying cells that contained spike proteins
- Antigen presentation - showing/presenting foreign matter to other parts of the immune system to teach it, in this case the presented foreign matter refers to small fragments or “peptides” of the spike protein
- Cytokine release (proteins in blood that function as immune system signaling, often for inflammation)
- Persistence of the S1/S2/mutant S1 subunit peptides in non-classical and intermediate monocytes leading to blood vessel inflammation/damage, vasodilation, and other issues. The peptides detected in post vaccination patients were shown in this presentation.
- Inflammation can lead to clotting, endothelial damage which can then lead to the “loss of physiologic anticoagulant, antiaggregant and vasodilatory properties of endothelium.”
- Is thought to cause an extremely wide variation of symptoms, from cardiac, pains, tinnitus, brain fog, and all sorts of other symptoms seen in long covid.
- A paper explaining this phenomenon can be found here, and a paper they published discussing cytokine differences in long haulers also found to be relevant to post vaccination long haulers can be accessed here
- Noted to occur post vaccination without prior covid infection
- An interview Dr. Patterson did with Dr. Been explaining this issue
- A more recent interview with Dr. Patterson on Dr. Been’s channel that includes more information on post vaccination long haulers - This one is more grounded in reality with more data to back up claims.
- Signup for their testing at https://covidlonghaulers.com/ (360$ for their custom cytokine panel) - codes for reimbursement with insurance are provided
- Followup with a telehealth appointment to discuss treatment (200$, codes for insurance available)
- Prior to beginning, liver enzymes are tested to ensure they are in range. After 4 weeks, generally additional blood tests for liver enzymes and potentially another round of cytokine testing will occur before the next telehealth consult. This method can be costly, so waiting longer than 4 weeks for repeating cytokine testing may be more economical.
- The core of their treatment is Maraviroc 300mg twice a day and a statin, generally pravastatin 10mg is used currently. A trial using this combination for the treatment of long covid will occur in 2022. Additional medications are prescribed based on inflammatory markers, symptoms, and tolerability of medicines (Individual doctors may have differences in treatments as well). Some examples include: Ivermectin (controversial, 0.2mcg/kg every 3 days), Fluvoxamine (tends to be a lower dose, such as 25mg), Fenofibrate (used in case patients do not tolerate statins), Low dose Aspirin (81mg, once or twice daily), Antihistamines, Low dose naltrexone, and prednisone (Tapered from 20mg,10mg,5mg for a short period or low dose prednisone ~5mg).
- A preprint describes the usage of pravastatin and maraviroc in the treatment of endothelial dysfunction/inflammation and platelet hyperactivity. Targeting the Monocytic-Endothelial-Platelet Axis with Maraviroc and Pravastatin as a Therapeutic Option to Treat Long COVID/ Post-Acute Sequelae of COVID (PASC)
- Various forms of autoimmunity can occur. It is unknown whether the viral persistence in monocytes contributes to this problem persisting or not. One example from a reddit user can be found here, who got tested for POTS related autoantibodies at celltrend.
- G-Protein Coupled Receptor Autoantibodies may turn out to be a common finding in those who have persistent symptoms. A case report containing examples of “MIS-V” shows elevations in these autoantibodies However, the paper states “elevated G-Protein-coupled autoantibodies as in our cases are not clearly related to clinical symptoms” so additional research is necessary to evaluate what symptoms these autoantibodies cause. Drug BC007 is being trialed for treating G-Protein Coupled Receptor Autoantibodies in covid long haulers soon.
- Molecular mimicry is one mechanism that can contribute to the development of autoimmunity. This refers to the phenomenon where proteins encoded by the vaccine match proteins found in the human body, so when immune cells are trained against these proteins, they end up attacking your own body. For example: In response to spike proteins or the RBD, cross-reactive autoantibodies against angiotensin II can be produced.
- There are many more unique, less documented autoimmune reactions that require specific testing and diagnosis from highly skilled doctors.
- Some additional examples are vasculitis, optic neuritis and small fiber neuropathy have also been reported. A more comprehensive review of documented autoimmune reactions will be added in the future.
- Some discussion on why autoantibody tests may be misleading or less helpful can be found in this video, with commentary from Dr. Yogendra from the Incelldx team (Be aware of potential bias)
Found in individuals who are suffering from long-COVID and relevant cytokine elevations are also found in vaccination sequelae. This was finally acknowledged in the science.org publication on long-covid like vaccine side effects where Dr. Pretorius commented the following: “Pretorius suspects all COVID-19 vaccines might also sometimes trigger subtler clotting issues. She says she has preliminary evidence that vaccination can lead to microclots, although in most cases they go unnoticed and quickly disappear—an effect she and a colleague saw in their own blood and that of eight other healthy volunteers, which they sampled after their vaccinations.”
A good interview summarizing the problem can be found here. A research paper describing this issue can be found here. This paper discusses the spike protein’s role in this process
This also occurs during active infection, but resolves for most people afterward. It has been suggested that preventing the persistence of these microclots during infection may reduce the symptoms or chance of long covid.
- Examination under a microscope with proper preparation of blood
- sCD40L on the Incelldx cytokine panel is used as a marker of this problem
- Mast Cell Activation Syndrome triggered by an adverse immune response to the vaccine in the same way it is triggered by covid.
- There are reports of people recovering from this entirely, so it may be slightly different from other cases of MCAS, though similar treatment may still be effective.
- A preprint on an antihistamine trial in long covid patients
- Some cytokines relevant to allergic inflammation and mast cells are commonly elevated in long haulers.
- IL-4: The interleukin 4 is a cytokine that induces differentiation of naive helper T cells to Th2 cells. Upon activation by IL-4, Th2 cells subsequently produce additional IL-4 in a positive feedback loop. IL-4 is produced primarily by mast cells, Th2 cells, eosinophils, and basophils.
- IL-13 is a cytokine produced by Th2 cells, NK cells, mast cells, basophils and is a mediator of allergic inflammation and a key regulator of IgE synthesis, mucus hypersecretion, and airway hyperresponsiveness. [Rael et al., Gulati, et al.,]
- IGE, Eosinophils, tryptase, or most simply, trialing antihistamines. It is unclear how useful these tests are and trialing antihistamines or a low histamine diet may be the best option.
- H1/H2 antihistamine blockers in combination (Example: cetrizine, famotidine)
- Low histamine diet
- Additional treatment can be found on the FLCCC’s I-Recover protocol, in the bottom right
Viruses such as EBV have been found to reactivate after immune stress caused by COVID or vaccination and could possibly play a role in post vaccine symptoms.
The phase-I/II trial with BNT162b1 (now called tozinameran) showed a dose-dependent decrease in lymphocytes in the first days following injection. With the dosage now used worldwide, which is 30 micrograms, 45.5% of the recipients had lymphocyte counts below 1 × 109, with one subject (9.1%) having grade-3 lymphopenia (0.2–0.5 × 109). These decreases were transient, with lymphocyte levels returning to normal 6–8 days after vaccination. It is conceivable that this short period of lymphopenia — after COVID-19 infection or vaccination — can trigger a Varicella zoster virus reactivation.
A large study based on Hong Kong data of 3,227,186 vaccinated individuals found the following: "It was deduced that an additional 5 and 7 cases of herpes zoster related hospitalization may occur for every 1,000,000 doses of CoronaVac and BNT162b2, respectively, compared with no vaccination. "
- HHV6, cytomegalovirus, and EBV antibodies
- VZV has documented reactivation as well. This is not an exhaustive list, and more examples may exist.
- Antiviral medications. (ex. valacyclovir/acyclovir)
- If a significant amount of the vaccine reaches the bloodstream, it can cause myocarditis and/or pericarditis in animal models. Other factors likely contribute, and it is unknown whether this is a prerequisite to developing myo/pericarditis. Molecular mimicry could also potentially be a cause.
It is best to visit the ER to get an EKG/ECG (electrocardiogram, it shows the electrical activity of your heart in detail, and commonly has abnormalities in the case of pericarditis. Often ST segment changes) and troponin tested as soon as possible. A troponin test measures the level of troponin in your blood. Troponin is a type of protein found in the muscles of your heart. Troponin isn’t normally found in the blood. When heart muscles become damaged, troponin is sent into the bloodstream. As heart damage increases, greater amounts of troponin are released in the blood. Optimally, troponin should be tested soon after the onset of chest pain. It can stay elevated for around 4-12 days.
The CDC guidelines suggest C reactive protein, erythrocyte sedimentation rate, troponin, and other inflammatory markers also be tested.
An echocardiogram can detect more severe cases of myocarditis or pericarditis, however a cardiac mri may be necessary for proper diagnosis. In a case series of 7 patients with myo or pericarditis, 5/7 had normal echocardiograms with abnormal findings upon getting a cardiac mri.
- Your doctor may prescribe any combination of the following depending on your condition, prednisone, colchicine, or NSAIDS. In case of recurrence or these do not work, IL-1b blockers such as anakinra may be used.
- Discuss necessary lifestyle changes with your doctor. These may include a low salt diet, reduced exercise or avoidance of exercise, or other interventions.
- Ensuring proper electrolyte intake is necessary to avoid cardiac electrical abnormalities (Examples: Magnesium, potassium).
- If after follow up examination, other symptoms persist despite resolution of cardiac inflammation, see the other sections of the wiki for additional testing. It’s likely in the case of myo/pericarditis that inflammatory monocytes or autoantibodies can contribute to persistent inflammation.
¶ Depletion of nutrients, NAD+ deficiency, and the Microbiome
Addressing these issues may accelerate or enable recovery, but it’s difficult to determine whether they can be a main cause of symptoms.
NAD+ is a core component to cellular metabolism and the creation of energy within our cells. It is theorized in long covid that people become deficient in this nutrient, and it could also play a role to some degree in vaccine long haul as well. Even if it doesn’t play a significant role, providing extra NAD+ precursors may be a valid way to assist in recovery.
Chronic inflammation may also lead to anemia or iron deficiency. Functional iron deficiency of chronic inflammation and management is discussed in this paper: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8002799/ PPIs, H2 blockers, digestion issues may also contribute to developing anemia, or making it more difficult to recover from.
¶ Pituitary Gland Inflammation or Hormonal dysregulation
- Theoretical explanation that was created because of covid long haulers having low or high cortisol if they have been long hauling for a long period of time. It is difficult to assess the validity of this theory but may be helpful nonetheless.
- Inflammation of the pituitary gland resulting in hormonal imbalance.
- Dysregulation of hormone levels including aldosterone, cortisol, sex hormones and more.
- Resultant hormonal imbalance could lead to heart palpitations, tachycardia, brain fog, fluid dysregulation, and other hormonal issues.
- This may be caused by some of the theories listed above, such as viral persistence in monocytes, or autoantibodies.
- Hormone testing, Cortisol, Aldosterone, sex hormones, etc.
- Extended low dose prednisone
- Vitamin C
- Extra hydration
- Hormone replacement