Open Access Journal Article

Local and Systemic side effects of COVID-19 Vaccines

by Ahmed D. Alatawi 1 Marwa O. Elgendy 2,3,* Ahmed M. Sayed 4 Shafiq Naguib Shafiq 5 Ali H. El-Bahrawy 6 Tauqeer Hussain Mallhi 1 Yusra Habib Khan 1 Abdulaziz Ibrahim Alzarea 1 Nasser Hadal Alotaibi 1  and  Abdullah Salah Alanazi 1
1
Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
2
Department of Clinical Pharmacy, Beni-Suef University Hospitals, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
3
Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University, Egypt
4
Department of Pharmacognosy, Faculty of Pharmacy, Nahda University, Beni-Suef 62513, Egypt
5
Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt
6
Department of Clinical Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut, Egypt
*
Author to whom correspondence should be addressed.
IJCMR  2023 2(1):17; https://doi.org/10.61466/ijcmr2010002
Received: 8 November 2023 / Accepted: 13 December 2023 / Published Online: 14 December 2023

Abstract

Background:

To increase the public's acceptance of the vaccine, knowledge of its side effects is crucial. Thus, the purpose of this study was to identify side effects in the Saudi population following vaccinations with Pfizer BioNTech and AstraZeneca.

Method:

In Saudi Arabia, an online survey was conducted between March and October of 2021. Participants from Saudi Arabia who received two doses of the Pfizer BioNTech or AstraZeneca vaccine took part. The survey identified side effects following vaccinations.

Results:

AstraZeneca and Pfizer BioNTech administered vaccines to 174 and 224 of the 398 subjects, respectively. Fatigue (83.9%), local pain (78.2%), bone or joint pain (74.1%), fever (67.8%), vomiting or loss of appetite (24.1%), swelling (24.1%), and redness (21.8%) were the most commonly reported side effects for participants who took AstraZeneca. 

For the participants who received Pfizer BioNTech, the most common adverse effects that were reported were fatigue (43.8%), bone or joint pain (38.4%), swelling (28.6%), fever (22.8%), redness (15.1%), and nausea or vomiting (11.2%). Local pain accounted for 90.6% of the adverse effects that participants reported.

Conclusions:

After receiving the COVID-19 vaccine, the majority of participants reported experiencing at least one side effect. Whereas the AstraZeneca vaccination was linked to a higher prevalence of systemic side effects, the Pfizer BioNTech vaccination was linked to a higher prevalence of local adverse effects. Most adverse events following vaccination are not fatal. After receiving an AstraZeneca or Pfizer BioNTech vaccination, side effects were more common in women and younger age groups. Vaccinations against coronavirus have a good safety record.


Copyright: © 2023 by Alatawi, Elgendy, Sayed, Shafiq, El-Bahrawy, Mallhi, Khan, Alzarea, Alotaibi and Alanazi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (Creative Commons Attribution 4.0 International License). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Share and Cite

ACS Style
Alatawi, A. D.; Elgendy, M. O.; Sayed, A. M.; Shafiq, S. N.; El-Bahrawy, A. H.; Mallhi, T. H.; Khan, Y. H.; Alzarea, A. I.; Alotaibi, N. H.; Alanazi, A. S. Local and Systemic side effects of COVID-19 Vaccines. International Journal of Clinical Medical Research, 2024, 2, 17. https://doi.org/10.61466/ijcmr2010002
AMA Style
Alatawi A D, Elgendy M O, Sayed A M, Shafiq S N, El-Bahrawy A H, Mallhi T H, Khan Y H, Alzarea A I, Alotaibi N H, Alanazi A S. Local and Systemic side effects of COVID-19 Vaccines. International Journal of Clinical Medical Research; 2024, 2(1):17. https://doi.org/10.61466/ijcmr2010002
Chicago/Turabian Style
Alatawi, Ahmed D.; Elgendy, Marwa O.; Sayed, Ahmed M.; Shafiq, Shafiq N.; El-Bahrawy, Ali H.; Mallhi, Tauqeer H.; Khan, Yusra H.; Alzarea, Abdulaziz I.; Alotaibi, Nasser H.; Alanazi, Abdullah S. 2024. "Local and Systemic side effects of COVID-19 Vaccines" International Journal of Clinical Medical Research 2, no.1:17. https://doi.org/10.61466/ijcmr2010002
APA style
Alatawi, A. D., Elgendy, M. O., Sayed, A. M., Shafiq, S. N., El-Bahrawy, A. H., Mallhi, T. H., Khan, Y. H., Alzarea, A. I., Alotaibi, N. H., & Alanazi, A. S. (2024). Local and Systemic side effects of COVID-19 Vaccines. International Journal of Clinical Medical Research, 2(1), 17. https://doi.org/10.61466/ijcmr2010002

Article Metrics

Article Access Statistics

References

  1. Gralinski, L.E., A. Bankhead III, S. Jeng, V.D. Menachery, S. Proll, S.E. Belisle, M. Matzke, B.-J.M. Webb-Robertson, M.L. Luna, and A.K. Shukla, Mechanisms of severe acute respiratory syndrome coronavirus-induced acute lung injury. MBio, 2013. 4(4): p. e00271-13.
  2. Elgendy, M.O. and M.E. Abdelrahim, Public awareness about coronavirus vaccine, vaccine acceptance, and hesitancy. Journal of Medical Virology, 2021.
  3. Eid, R.A., M.O. Elgendy, A.O. El-Gendy, S.O. Elgendy, L. Belbahri, A.M. Sayed, and M.E. Rateb, Efficacy of ceftazidime and cefepime in the management of COVID-19 patients: single center report from Egypt. Antibiotics, 2021. 10(11): p. 1278.
  4. Andrzejczak-Grządko, S., Z. Czudy, and M. Donderska, Side effects after COVID-19 vaccinations among residents of Poland. Eur Rev Med Pharmacol Sci, 2021. 25(12): p. 4418-4421.
  5. Mehboob, R., F. Ahmad, A. Qayyum, M.A. Rana, S.A. Gilani, M.A. Tariq, G. Ali, S.J. Akram, and J. Akram, Aprepitant as a combinant with Dexamethasone reduces the inflammation via Neurokinin 1 Receptor Antagonism in severe to critical Covid-19 patients and potentiates respiratory recovery: A novel therapeutic approach. medRxiv, 2020.
  6. Elgendy, M.O., A.O. El-Gendy, S. Mahmoud, T.Y. Mohammed, M.E. Abdelrahim, and A.M. Sayed, Side effects and efficacy of COVID-19 vaccines among the Egyptian population. Vaccines, 2022. 10(1): p. 109.
  7. Noda, K., K. Matsuda, S. Yagishita, K. Maeda, Y. Akiyama, J. Terada-Hirashima, H. Matsushita, S. Iwata, K. Yamashita, and Y. Atarashi, A novel highly quantitative and reproducible assay for the detection of anti-SARS-CoV-2 IgG and IgM antibodies. Scientific reports, 2021. 11(1): p. 1-10.
  8. Elgendy, M.O., A.O. El-Gendy, A.I. Alzarea, S. Mahmoud, S.S. Alqahtani, A.M. Fahmy, H.R. El-Seedi, A.M. Sayed, A.D. Alatawi, and M.E. Abdelrahim, SARS-CoV-2 post vaccinated adverse effects and efficacy in the Egyptian Population. Vaccines, 2021. 10(1): p. 18.
  9. Elgendy, M.O., A.O. El-Gendy, and M.E. Abdelrahim, Public awareness in Egypt about COVID-19 spread in the early phase of the pandemic. Patient education and counseling, 2020. 103(12): p. 2598-2601.
  10. Riad, A., D. Sağıroğlu, B. Üstün, A. Pokorná, J. Klugarová, S. Attia, and M. Klugar, Prevalence and risk factors of CoronaVac side effects: an independent cross-sectional study among healthcare workers in Turkey. Journal of Clinical Medicine, 2021. 10(12): p. 2629.
  11. Battistoni, I., M. Francioni, N. Morici, A. Rubboli, G.M. Podda, A. Pappalardo, M.E. Abdelrahim, M.O. Elgendy, S.O. Elgendy, and A.M. Khalaf, Pre-and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes. Journal of Cardiovascular Medicine, 2022. 23(4): p. 264-271.
  12. Alhazmi, A., E. Alamer, D. Daws, M. Hakami, M. Darraj, S. Abdelwahab, A. Maghfuri, and A. Algaissi, Evaluation of Side Effects Associated with COVID-19 Vaccines in Saudi Arabia. Vaccines, 2021. 9(6): p. 674.
  13. Elgendy, M.O., A.M. Khalaf, A.O. El-Gendy, M.A. Abdelrahman, S.O. El Gendy, A.M.A. Hamied, O. Essam, K. Al Amir, E.M. Yousry, and M.E. Abdelrahim, An Observational Study on the Management of COVID-19 Patients in Limited-Resource Hospitals. Journal of Clinical and Nursing Research, 2022. 6(3): p. 43-53.
  14. Hatmal, M.m.M., M.A. Al-Hatamleh, A.N. Olaimat, M. Hatmal, D.M. Alhaj-Qasem, T.M. Olaimat, and R. Mohamud, Side Effects and Perceptions Following COVID-19 Vaccination in Jordan: A Randomized, Cross-Sectional Study Implementing Machine Learning for Predicting Severity of Side Effects. Vaccines, 2021. 9(6): p. 556.
  15. Klugar, M., A. Riad, M. Mekhemar, J. Conrad, M. Buchbender, H.-P. Howaldt, and S. Attia, Side effects of mRNA-based and viral vector-based COVID-19 vaccines among German healthcare workers. Biology, 2021. 10(8): p. 752.
  16. STANKEVIČ, O.K., COMMENTARY: THE NEW CORONAVIRUS COVID-19. PACIFIC JOURNAL OF MEDICAL SCIENCES: p. 22.
  17. Elgendy, M.O., M.A. Abdelrahman, H. Osama, A. O. El‐Gendy, and M.E. Abdelrahim, Role of repeating quarantine instructions and healthy practices on COVID‐19 patients and contacted persons to raise their awareness and adherence to quarantine instructions. International Journal of Clinical Practice, 2021: p. e14694.
  18. Dando, T.M. and C.M. Perry, Aprepitant. Drugs, 2004. 64(7): p. 777-794.
  19. Solomon, Y., T. Eshete, B. Mekasha, and W. Assefa, COVID-19 Vaccine: Side Effects After the First Dose of the Oxford AstraZeneca Vaccine Among Health Professionals in Low-Income Country: Ethiopia. Journal of Multidisciplinary Healthcare, 2021. 14: p. 2577.
  20. Riad, A., A. Pokorná, S. Attia, J. Klugarová, M. Koščík, and M. Klugar, Prevalence of COVID-19 Vaccine Side Effects among Healthcare Workers in the Czech Republic. Journal of Clinical Medicine, 2021. 10(7): p. 1428.
  21. Khadka, S., A. Yuchi, D.B. Shrestha, P. Budhathoki, S.M.M. Al-Subari, T.Z. Alhouzani, and A. Butt, Repurposing Drugs for COVID-19: an Approach for Treatment in the Pandemic. Altern Ther Health Med, 2020. 26: p. 100-7.
  22. Klein, S.L., A. Jedlicka, and A. Pekosz, The Xs and Y of immune responses to viral vaccines. The Lancet Infectious Diseases, 2010. 10(5): p. 338-349.
  23. Menni, C., K. Klaser, A. May, L. Polidori, J. Capdevila, P. Louca, C.H. Sudre, L.H. Nguyen, D.A. Drew, and J. Merino, Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. The Lancet Infectious Diseases, 2021.
  24. Elgendy, M.O., A.O. El-Gendy, S.O. Elgendy, L.N. Abdelaty, M.E. Abdelrahim, and M.A. Abdelrahman. Perceptions, Knowledge, and Experiences of Using Face Masks among Egyptian Healthcare Workers during the COVID-19 Pandemic: A Cross-Sectional Study. in Healthcare. 2023. MDPI.
  25. Elgendy, S.O., M.O. Elgendy, A.O. El-Gendy, A.M.A. Hamied, K. Al Amir, R.A. Gad, and A.M. Fahmy, Health Care Workers’ Awareness about the Post-COVID Syndrome and Different Types of COVID-19 Vaccines in Egypt. NeuroQuantology, 2022. 20(11): p. 3830-3839.
  26. Elgendy, M.O., M.N. Abd Elmawla, A.M. Abdel Hamied, S.O. El Gendy, and M.E. Abdelrahim, COVID‐19 patients and contacted person awareness about home quarantine instructions. International Journal of Clinical Practice, 2021. 75(4): p. e13810.
  27. Fahmy, A.M., M.O. Elgendy, A.M. Khalaf, M.A. Abdelrahman, M.E. Abdelrahim, and A.O. El-Gendy, COVID-19 Patients with Hepatic Complications During the Third Wave of Pandemic in Egypt. Journal of Clinical and Nursing Research, 2022. 6(3): p. 108-121.
  28. Abdou, L.M., A.O. El-Gendy, M.O. Elgendy, R.A. Gad, S.O. Elgendy, R.A. Eid, A.M. Sayed, and T.M. Mahmoud, The Impact of Combining Cefepime or Ceftazidime with Steroidal and Anticoagulant Therapy in the Treatment of COVID-19 Patients. NeuroQuantology, 2022. 20: p. 3696-3701.
  29. El-Shitany, N.A., S. Harakeh, S.M. Badr-Eldin, A.M. Bagher, B. Eid, H. Almukadi, B.S. Alghamdi, A.A. Alahmadi, N.A. Hassan, and N. Sindi, Minor to moderate side effects of Pfizer-BioNTech COVID-19 vaccine among Saudi residents: A retrospective cross-sectional study. International journal of general medicine, 2021. 14: p. 1389.
  30. Elgendy, M.O., H. Saeed, and H.A. Abou-Taleb, Assessment of educated people awareness level and sources about COVID-19. International Journal of Clinical Medical Research, 2023. 1(1): p. 19-27.
  31. Zawbaa, H.M., H. Osama, A. El‐Gendy, H. Saeed, H.S. Harb, Y.M. Madney, M. Abdelrahman, M. Mohsen, A.M. Ali, and M. Nicola, Effect of mutation and vaccination on spread, severity, and mortality of COVID‐19 disease. Journal of Medical Virology, 2021.
  32. El-Hosari, D.G., W.M. Hussein, M.O. Elgendy, S.O. Elgendy, A.R. Ibrahim, A.M. Fahmy, A. Hassan, F.A. Mokhtar, M.F. Hussein, and M.E. Abdelrahim, Galangal–cinnamon spice mixture blocks the coronavirus infection pathway through inhibition of SARS-CoV-2 MPro, three HCoV-229E targets; quantum-chemical calculations support in vitro evaluation. Pharmaceuticals, 2023. 16(10): p. 1378.
  33. Sayed, A.M., A.M. Khalaf, M.E. Abdelrahim, and M.O. Elgendy, Repurposing of some anti‐infective drugs for COVID‐19 treatment: A surveillance study supported by an in silico investigation. International Journal of Clinical Practice, 2021. 75(4): p. e13877.
  34. Zaki, A., M.O. Elgendy, M.A. Abdelrahman, H. Ali, E.M. Khalil, M. Hassan, A.M. Fahmy, R.A. Gad, and H.F. Salem, The Efficacy of Using Different Antibiotics to Prevent Maternal Surgical Site Infections in COVID-19-Infected Cases. Eur. Chem. Bull, 2023. 6: p. 1342-1348.
  35. Elgendy, M.O., M.A. Abdelrahman, and M.E. Abdelrahim, What should be learned from the COVID-19 pandemic for the next coronavirus pandemics? International Journal of Clinical Medical Research, 2023. 1(1): p. 9-11.
  36. Alghamdi, A., A. Ibrahim, R. Almutairi, M. Joseph, G. Alghamdi, and A. Alhamza, A cross-sectional survey of side effects after COVID-19 vaccination in Saudi Arabia: male versus female outcomes. Journal of Advanced Pharmacy Education & Research| Apr-Jun, 2021. 11(2).
  37. Abu-Hammad, O., H. Alduraidi, S. Abu-Hammad, A. Alnazzawi, H. Babkair, A. Abu-Hammad, I. Nourwali, F. Qasem, and N. Dar-Odeh, Side Effects Reported by Jordanian Healthcare Workers Who Received COVID-19 Vaccines. Vaccines, 2021. 9(6): p. 577.
  38. Gralinski, L.E., et al., Mechanisms of severe acute respiratory syndrome coronavirus-induced acute lung injury. MBio, 2013. 4(4): p. e00271-13.
  39. Elgendy, M.O. and M.E. Abdelrahim, Public awareness about coronavirus vaccine, vaccine acceptance, and hesitancy. Journal of Medical Virology, 2021.
  40. Eid, R.A., et al., Efficacy of ceftazidime and cefepime in the management of COVID-19 patients: single center report from Egypt. Antibiotics, 2021. 10(11): p. 1278.
  41. Andrzejczak-Grządko, S., Z. Czudy, and M. Donderska, Side effects after COVID-19 vaccinations among residents of Poland. Eur Rev Med Pharmacol Sci, 2021. 25(12): p. 4418-4421.
  42. Mehboob, R., et al., Aprepitant as a combinant with Dexamethasone reduces the inflammation via Neurokinin 1 Receptor Antagonism in severe to critical Covid-19 patients and potentiates respiratory recovery: A novel therapeutic approach. medRxiv, 2020.
  43. Elgendy, M.O., et al., Side effects and efficacy of COVID-19 vaccines among the Egyptian population. Vaccines, 2022. 10(1): p. 109.
  44. Noda, K., et al., A novel highly quantitative and reproducible assay for the detection of anti-SARS-CoV-2 IgG and IgM antibodies. Scientific reports, 2021. 11(1): p. 1-10.
  45. Elgendy, M.O., et al., SARS-CoV-2 post vaccinated adverse effects and efficacy in the Egyptian Population. Vaccines, 2021. 10(1): p. 18.
  46. Elgendy, M.O., A.O. El-Gendy, and M.E. Abdelrahim, Public awareness in Egypt about COVID-19 spread in the early phase of the pandemic. Patient education and counseling, 2020. 103(12): p. 2598-2601.
  47. Riad, A., et al., Prevalence and risk factors of CoronaVac side effects: an independent cross-sectional study among healthcare workers in Turkey. Journal of Clinical Medicine, 2021. 10(12): p. 2629.
  48. Battistoni, I., et al., Pre-and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes. Journal of Cardiovascular Medicine, 2022. 23(4): p. 264-271.
  49. Alhazmi, A., et al., Evaluation of Side Effects Associated with COVID-19 Vaccines in Saudi Arabia. Vaccines, 2021. 9(6): p. 674.
  50. Elgendy, M.O., et al., An Observational Study on the Management of COVID-19 Patients in Limited-Resource Hospitals. Journal of Clinical and Nursing Research, 2022. 6(3): p. 43-53.
  51. Hatmal, M.m.M., et al., Side Effects and Perceptions Following COVID-19 Vaccination in Jordan: A Randomized, Cross-Sectional Study Implementing Machine Learning for Predicting Severity of Side Effects. Vaccines, 2021. 9(6): p. 556.
  52. Klugar, M., et al., Side effects of mRNA-based and viral vector-based COVID-19 vaccines among German healthcare workers. Biology, 2021. 10(8): p. 752.
  53. STANKEVIČ, O.K., COMMENTARY: THE NEW CORONAVIRUS COVID-19. PACIFIC JOURNAL OF MEDICAL SCIENCES: p. 22.
  54. Elgendy, M.O., et al., Role of repeating quarantine instructions and healthy practices on COVID‐19 patients and contacted persons to raise their awareness and adherence to quarantine instructions. International Journal of Clinical Practice, 2021: p. e14694.
  55. Dando, T.M. and C.M. Perry, Aprepitant. Drugs, 2004. 64(7): p. 777-794.
  56. Solomon, Y., et al., COVID-19 Vaccine: Side Effects After the First Dose of the Oxford AstraZeneca Vaccine Among Health Professionals in Low-Income Country: Ethiopia. Journal of Multidisciplinary Healthcare, 2021. 14: p. 2577.
  57. Riad, A., et al., Prevalence of COVID-19 Vaccine Side Effects among Healthcare Workers in the Czech Republic. Journal of Clinical Medicine, 2021. 10(7): p. 1428.
  58. Khadka, S., et al., Repurposing Drugs for COVID-19: an Approach for Treatment in the Pandemic. Altern Ther Health Med, 2020. 26: p. 100-7.
  59. Klein, S.L., A. Jedlicka, and A. Pekosz, The Xs and Y of immune responses to viral vaccines. The Lancet Infectious Diseases, 2010. 10(5): p. 338-349.
  60. Menni, C., et al., Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. The Lancet Infectious Diseases, 2021.
  61. Elgendy, M.O., et al. Perceptions, Knowledge, and Experiences of Using Face Masks among Egyptian Healthcare Workers during the COVID-19 Pandemic: A Cross-Sectional Study. in Healthcare. 2023: MDPI.
  62. Elgendy, S.O., et al., Health Care Workers’ Awareness about the Post-COVID Syndrome and Different Types of COVID-19 Vaccines in Egypt. NeuroQuantology, 2022. 20(11): p. 3830-3839.
  63. Elgendy, M.O., et al., COVID‐19 patients and contacted person awareness about home quarantine instructions. International Journal of Clinical Practice, 2021. 75(4): p. e13810.
  64. Fahmy, A.M., et al., COVID-19 Patients with Hepatic Complications During the Third Wave of Pandemic in Egypt. Journal of Clinical and Nursing Research, 2022. 6(3): p. 108-121.
  65. Abdou, L.M., et al., The Impact of Combining Cefepime or Ceftazidime with Steroidal and Anticoagulant Therapy in the Treatment of COVID-19 Patients. NeuroQuantology, 2022. 20: p. 3696-3701.
  66. El-Shitany, N.A., et al., Minor to moderate side effects of Pfizer-BioNTech COVID-19 vaccine among Saudi residents: A retrospective cross-sectional study. International journal of general medicine, 2021. 14: p. 1389.
  67. Elgendy, M.O., H. Saeed, and H.A. Abou-Taleb, Assessment of educated people awareness level and sources about COVID-19. International Journal of Clinical Medical Research, 2023. 1(1): p. 19-27.
  68. Zawbaa, H.M., et al., Effect of mutation and vaccination on spread, severity, and mortality of COVID‐19 disease. Journal of Medical Virology, 2021.
  69. El-Hosari, D.G., et al., Galangal–cinnamon spice mixture blocks the coronavirus infection pathway through inhibition of SARS-CoV-2 MPro, three HCoV-229E targets; quantum-chemical calculations support in vitro evaluation. Pharmaceuticals, 2023. 16(10): p. 1378.
  70. Sayed, A.M., et al., Repurposing of some anti‐infective drugs for COVID‐19 treatment: A surveillance study supported by an in silico investigation. International Journal of Clinical Practice, 2021. 75(4): p. e13877.
  71. Zaki, A., et al., The Efficacy of Using Different Antibiotics to Prevent Maternal Surgical Site Infections in COVID-19-Infected Cases. Eur. Chem. Bull, 2023. 6: p. 1342-1348.
  72. Elgendy, M.O., M.A. Abdelrahman, and M.E. Abdelrahim, What should be learned from the COVID-19 pandemic for the next coronavirus pandemics? International Journal of Clinical Medical Research, 2023. 1(1): p. 9-11.
  73. Alghamdi, A., et al., A cross-sectional survey of side effects after COVID-19 vaccination in Saudi Arabia: male versus female outcomes. Journal of Advanced Pharmacy Education & Research| Apr-Jun, 2021. 11(2).
  74. Abu-Hammad, O., et al., Side Effects Reported by Jordanian Healthcare Workers Who Received COVID-19 Vaccines. Vaccines, 2021. 9(6): p. 577.