The Impact of COVID-19 Vaccination on Thyroid Disease in 7 Million Adult and 0.2 Million Adolescent Vaccine Recipients. The Journal of clinical endocrinology and metabolism CONTEXT:Emerging reports have raised concerns regarding the potential link between COVID-19 vaccination and thyroid dysfunction, specifically thyroiditis. OBJECTIVE:This study aimed to investigate the potential association between COVID-19 vaccination and the prevalence of thyroid diseases using data from a Korean national cohort. METHODS:This study included 7,579,210 adult and 241,063 adolescent vaccine recipients. A self-controlled case series design was applied to estimate the incidence rate ratio (IRR) of thyroid disease during the 55-day post-vaccination period (first and second dose) compared to the baseline period (non-exposure period) using conditional Poisson regression. RESULTS:In the adult population, IRRs for hyperthyroidism, hypothyroidism, subacute thyroiditis, and thyroid eye disease were 0.98 (95% CI 0.89-1.09), 0.91 (95% CI 0.84-0.98), 1.27 (95% CI 0.94-1.72), and 0.68 (95% CI 0.50-0.93) after the first vaccine dose and 0.96 (95% CI 0.87-1.06), 0.93 (95% CI 0.87-0.99), 1.32 (95% CI 0.96-1.80), and 1.06 (95% CI 0.81-1.38) after the second vaccine dose. While the risk of hyperthyroidism recurrence did not increase after vaccination, we observed an increased risk of hypothyroidism exacerbation. Subgroup analyses based on age, sex, and vaccine type revealed no significant differences in the incidence of thyroid diseases. In adolescents aged 12-17 years, no increase in the risk of thyroid disease was observed after vaccination. CONCLUSIONS:This extensive national self-controlled case series analysis found an increased risk of exacerbation of hypothyroidism following COVID-19 vaccination. However, no significant association was observed between COVID-19 vaccination and an increased risk of most other thyroid diseases. These findings contribute to increasing evidence supporting the safety of COVID-19 vaccination in relation to thyroid health. 10.1210/clinem/dgae858

Durability of Responses after SARS-CoV-2 mRNA-1273 Vaccination. Widge Alicia T,Rouphael Nadine G,Jackson Lisa A,Anderson Evan J,Roberts Paul C,Makhene Mamodikoe,Chappell James D,Denison Mark R,Stevens Laura J,Pruijssers Andrea J,McDermott Adrian B,Flach Britta,Lin Bob C,Doria-Rose Nicole A,O'Dell Sijy,Schmidt Stephen D,Neuzil Kathleen M,Bennett Hamilton,Leav Brett,Makowski Mat,Albert Jim,Cross Kaitlyn,Edara Venkata-Viswanadh,Floyd Katharine,Suthar Mehul S,Buchanan Wendy,Luke Catherine J,Ledgerwood Julie E,Mascola John R,Graham Barney S,Beigel John H, The New England journal of medicine 10.1056/NEJMc2032195

Sensitivity of SARS-CoV-2 B.1.1.7 to mRNA vaccine-elicited antibodies. Nature Transmission of SARS-CoV-2 is uncontrolled in many parts of the world; control is compounded in some areas by the higher transmission potential of the B.1.1.7 variant, which has now been reported in 94 countries. It is unclear whether the response of the virus to vaccines against SARS-CoV-2 on the basis of the prototypic strain will be affected by the mutations found in B.1.1.7. Here we assess the immune responses of individuals after vaccination with the mRNA-based vaccine BNT162b2. We measured neutralizing antibody responses after the first and second immunizations using pseudoviruses that expressed the wild-type spike protein or a mutated spike protein that contained the eight amino acid changes found in the B.1.1.7 variant. The sera from individuals who received the vaccine exhibited a broad range of neutralizing titres against the wild-type pseudoviruses that were modestly reduced against the B.1.1.7 variant. This reduction was also evident in sera from some patients who had recovered from COVID-19. Decreased neutralization of the B.1.1.7 variant was also observed for monoclonal antibodies that target the N-terminal domain (9 out of 10) and the receptor-binding motif (5 out of 31), but not for monoclonal antibodies that recognize the receptor-binding domain that bind outside the receptor-binding motif. Introduction of the mutation that encodes the E484K substitution in the B.1.1.7 background to reflect a newly emerged variant of concern (VOC 202102/02) led to a more-substantial loss of neutralizing activity by vaccine-elicited antibodies and monoclonal antibodies (19 out of 31) compared with the loss of neutralizing activity conferred by the mutations in B.1.1.7 alone. The emergence of the E484K substitution in a B.1.1.7 background represents a threat to the efficacy of the BNT162b2 vaccine. 10.1038/s41586-021-03412-7

Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2. Nature Although two-dose mRNA vaccination provides excellent protection against SARS-CoV-2, there is little information about vaccine efficacy against variants of concern (VOC) in individuals above eighty years of age. Here we analysed immune responses following vaccination with the BNT162b2 mRNA vaccine in elderly participants and younger healthcare workers. Serum neutralization and levels of binding IgG or IgA after the first vaccine dose were lower in older individuals, with a marked drop in participants over eighty years old. Sera from participants above eighty showed lower neutralization potency against the B.1.1.7 (Alpha), B.1.351 (Beta) and P.1. (Gamma) VOC than against the wild-type virus and were more likely to lack any neutralization against VOC following the first dose. However, following the second dose, neutralization against VOC was detectable regardless of age. The frequency of SARS-CoV-2 spike-specific memory B cells was higher in elderly responders (whose serum showed neutralization activity) than in non-responders after the first dose. Elderly participants showed a clear reduction in somatic hypermutation of class-switched cells. The production of interferon-γ and interleukin-2 by SARS-CoV-2 spike-specific T cells was lower in older participants, and both cytokines were secreted primarily by CD4 T cells. We conclude that the elderly are a high-risk population and that specific measures to boost vaccine responses in this population are warranted, particularly where variants of concern are circulating. 10.1038/s41586-021-03739-1