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Endothelial dysfunction after BNT162b2 mRNA vaccination

Flow-mediated dilation (FMD) is a high-resolution ultrasound assessment of endothelial function, whereas nitroglycerin-induced vasodilation (NID) assessment reflects the vascular smooth muscle function. In this study, the Japanese authors investigated the effects of the BNT162b2 (BioNTech and Pfizer) mRNA vaccine on endothelial and vascular smooth muscle function using brachial arterial FMD and NID, as markers for cardiovascular events. In relatively healthy participants, the FMD and NID showed endothelial dysfunction after the second BNT162b2 mRNA vaccination, which was restored within six months.

According to previous data, the FMD measurements are useful for predicting short-term cardiovascular events in a high-risk population and long-term cardiovascular risk in a lower-risk population. Prior studies have demonstrated diminished FMD values in patients with atherosclerosis and coronary risk factors. It was reported that every 1% decrease in FMD was associated with a 10% increase in the risk of cardiovascular events. 

 

 

About the study

This single-center prospective study was conducted at Hiroshima University and involved 23 participants (16 men and 7 women). The mean age of the subjects was 36 years, ranging from 25 to 59 years. One subject had hypertension and two participants had dyslipidemia.

All subjects received two BNT162b2 mRNA vaccines (BioNTech and Pfizer). The FMD and NID were measured before vaccination and two weeks and six months after the second vaccination. The subjects fasted overnight and abstained from smoking, drinking alcohol, and taking antioxidants, vitamins, and caffeine for at least 12 hours before the study. The participants were kept in a supine position, in a quiet, dark, and air-conditioned room throughout the study. The FMD and NID were measured after 30 minutes in the supine position.

 

Results

Two weeks after the second vaccination, the FMD values were reduced significantly compared to the pre-vaccination value, but this difference did not exist six months after the second vaccination. Since the FMD values have returned to their pre-vaccination baseline level, the authors concluded that impaired endothelial function after BNT162b2 mRNA vaccination was temporary.

NID values were similar before and after the vaccination, suggesting that the BNT162b2 vaccination did not impair the function of vascular smooth muscles.

 

 

 

Conclusion

In relatively healthy participants, the FMD and NID showed endothelial dysfunction after the second BNT162b2 mRNA vaccination, which was restored within six months. The BNT162b2 vaccination did not impair the function of vascular smooth muscles.

The authors suggested that endothelial dysfunction observed after the second dose of the BNT162b2 vaccine may be related, at least in part, to thrombotic events that develop early after vaccination. Additionally, there is the possibility that the deleterious effect of the BNT162b2 vaccine on vascular function is more severe and prolonged in individuals with advanced atherosclerosis compared to healthy people.

This article was published in the Plos ONE.

 

 

Journal Reference

Yamaji T, Harada T, Hashimoto Y, Nakano Y, Kajikawa M, Yoshimura K, et al. Effects of BNT162b2 mRNA Covid-19 vaccine on vascular function. PLoS ONE 2024; 19(4): e0302512. https://doi.org/10.1371/journal.pone.0302512

 

 

 

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