Psikiyatrik Bozukluğu Olan Çocuk ve Ergenlerde COVID-19 Aşısı Sonrası Erken Yan Etkiler

Year 2024, , 114 - 125, 27.11.2024

Seda Kafalı , Selma Tural Hesapçıoğlu , Dilan Aydın Ayva , Duygu Aslantaş , Mehmet Ceylan

https://doi.org/10.70852/tmj.1585694

Abstract

Amaç: COVID-19 aşıları enfeksiyonun şiddetini azaltmada ve ölümleri önlemede büyük bir gelişme olmuştur. Psikiyatrik bozukluklar nedeniyle psikofarmakolojik ilaç kullanan çocukların ebeveynleri de bu öncelikten yararlanmak amacıyla hastaneye başvurmuş ve ilk olarak aşının çocukları için güvenli olup olmadığını merak etmişlerdir. Kronik psikofarmakolojik ilaç kullanımının aşı ile nasıl etkileşeceği bu döneme kadar bilinmemektedir. Bu araştırmada COVID-19 aşılarının 12-18 yaş arası kronik psikiyatrik bozukluğu olup psikofarmakolojik ilaç kullanan çocuk ve ergenlerde erken dönem yan etkilerinin incelenmesi amaçlanmıştır.

Yöntem: Çocuk ve ergen psikiyatri kliniğinde kronik psikiyatrik bozukluk nedeniyle takip edilen ve psikofarmakolojik ilaç kullanan 12-18 yaş arası 88 hastanın aşı sonrası kısa dönem yan etkileri takip edilmiş ve aşı olan 88 sağlıklı kontrolle karşılaştırılmıştır.

Bulgular: Çalışmaya alınan hastaların 80’i (%90,9) BNT162b2 (BioNTech) aşısı; 8’i (%9,1) Sinovac aşısı olmuştu. Tüm hastaların 76’sı (%86,3) ikinci doz, 21’i (%24) ise üçüncü dozla aşılanmıştı. Kontrol grubu için 83 kişi ikinci dozu ve 26 kişi ise üçüncü dozu olmuştu. Antipsikotik kullanımı hastaların %45,4’ünde mevcuttu. Aşılar sonrası dördüncü ve yedinci günde olguların muayeneleri yapıldı. Aşı sonrası dördüncü günde hasta grubunda birinci BNT162b2 dozundan sonra en sık bildirilen yan etkiler lokal ağrı (%58,8), yorgunluk (%16,3), kızarıklık (%12,5) ve baş ağrısı (%11,3) iken, birinci Sinovac dozundan sonra ise lokal ağrı (%75,0), kızarıklık (%25,0), yorgunluktu (%25,0). Dördüncü gündeki yan etkiler açısından BNT162b2 ya da Sinovac aşısı yapılan hasta ve kontrol grupları arasında anlamlı bir fark yoktu. Aynı zamanda psikiyatrik bozukluk tanısı konulan hastalar arasındaki karşılaştırmalarda erken dönem yan etkiler açısından antipsikotik kullanan ve kullanmayanlarda istatistiksel farklılık bulunmadı.

Tartışma: Bu çalışmada incelenen COVID-19 aşılarının, psikofarmakolojik ilaç kullanan psikiyatrik bozukluğu olan ergenler için kısa vadede güvenli olduğu bulunmuştur. Bu bilgiler, kanıta dayalı klinik karar alma süreçlerine rehberlik etmede ve psikiyatrik bozukluğu olan çocuk ve ergenlerin güvenliğini ve refahını sağlamada kritik öneme sahip olacaktır.

Keywords

Antipsikotik, Aşı, Çocuk, COVID-19, Ergen, Psikiyatrik bozukluk

Thanks

We thank the participants, their parents/caregivers, and Mehmet Emin Seker, MSc, for his technical support.

Early Adverse Effects after COVID-19 Vaccine in Children and Adolescents with Psychiatric Disorders

Abstract

Objective: Vaccines for COVID-19 have reduced the severity of the infection and prevented deaths. Parents of children on psychopharmacological medications for psychiatric disorders were also referred to the hospital to learn whether the vaccine was safe for their children. It is not known until this period how chronic psychopharmacological drug use will interact with the vaccine. This study aimed to examine the early adverse effects of COVID-19 vaccines in children and adolescents aged 12-18 who have chronic psychiatric disorders and use psychopharmacological medications.

Method: Post-vaccine short-term effects of 88 patients aged 12-18, who were followed up in the child and adolescent psychiatry clinic due to chronic psychiatric disorders and were using psychopharmacological medications, were monitored and compared with 88 vaccinated healthy controls.

Results: Of the 88 patients, 80 (90.9%) were vaccinated with BNT162b2 (BioNTech) as the healthy control group; 8 (9.1%) were with Sinovac. Seventy-six (86.3%) of all patients were vaccinated with the second, and 21 (24%) were with the third dose. These were 83-second and 26-third doses for the control group. From all 45.4% of the patients were using antipsychotics. The cases were examined on the fourth and seventh days after vaccination. While the most frequently reported adverse effects after the first BNT162b2 dose in the patient group on the fourth day after vaccination were local pain (58.8%), fatigue (16.3%), redness (12.5%), and headache (11.3%), side affects first Sinovac dose in the patient group were local pain (75.0%), redness (25.0%), fatigue (25.0%). There was no significant difference between the patient and control groups receiving the BNT162b2 or Sinovac vaccine regarding adverse ffects on the fourth day. At the same time, in comparisons between patients diagnosed with psychiatric disorders, no statistical difference was found in terms of early adverse effects between the patients with and without antipsychotic use.

Discussion: Our study shows that the vaccines mentioned in children and adolescents with psychiatric disorders are as safe and tolerable in terms of short-term side effects as in healthy individuals. This knowledge will be crucial in guiding evidence-based clinical decision-making and ensuring the safety of children and adolescents with psychiatric disorders.

Keywords

Adolescent, Antipsychotic, Child, COVID-19, Psychiatric disorder

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