Evaluation of the effectiveness and adverse effects of COVID-19 vaccines administered at Kashan University of Medical Sciences

Document Type : Original Article


1 Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran

2 Internal Medicine Department, Kashan University of Medical Sciences, Kashan, Iran

3 Infectious Disease Resident, Kashan University of Medical Sciences, Kashan, Iran

4 Radiology Resident, Kashan University of Medical Sciences, Kashan, Iran


Objectives: The development of protective immunity through COVID-19 vaccines is influenced by both host factors and the composition of the vaccine. Therefore, it is essential to assess the efficacy and side effects of different vaccines among individuals with diverse socioeconomic and genetic backgrounds.
Methods: In this cross-sectional descriptive study, we examined 192 vaccinated individuals (126 recipients of Sinopharm and 66 recipients of AstraZeneca) for neutralizing antibodies two to four weeks after receiving their second vaccine dose. Additionally, we monitored these individuals for the presence or absence of COVID-19 symptoms and adverse effects over a one-month period following vaccination.
Results: There was no significant difference in mean antibody titers between the Sinopharm and AstraZeneca vaccine groups (p=0.452). The percentage of positive antibody results in the Sinopharm and AstraZeneca groups was 69.8% and 84.8%, respectively, with no statistically significant variance (p=0.437). The most common side effect reported in the Sinopharm group was malaise (87.3%), while in the AstraZeneca group, malaise was also prevalent (95.5%). Compared to Sinopharm, the AstraZeneca group experienced a higher incidence of side effects (p<0.05). However, the Sinopharm group had a higher percentage of injection site pain as a complication (p<0.001).
Conclusion: Our study revealed that there is no significant difference in efficacy between Sinopharm and AstraZeneca vaccines in individuals without a history of COVID-19. Common side effects following COVID-19 vaccination were observed in both Sinopharm and AstraZeneca recipients, with higher frequencies noted in the AstraZeneca group in most cases. This information may aid individuals who are concerned about potential vaccine side effects in making informed decisions.


Roozbeh Esalatmanesh [Pubmed] [Google Scholar]


Main Subjects

  1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Medicine. 2020. doi:10.1056/NEJMoa2001017 PMid:31978945 PMCid:PMC7092803
  2. Miri M, Nordvall M, Wong A, Zarei S. Comparing road traffic accident and COVID-19 casualties in Iran: A call to action. Arch Trauma Res. 2023; 12(3): 169-170. doi: 10.48307/atr.2023.419936.1037
  3. Johnson KD, Harris C, Cain JK, Hummer C, Goyal H, Perisetti A. Pulmonary and extra-pulmonary clinical manifestations of COVID-19. Front Med. 2020;7:526. doi:10.3389/fmed.2020.00526 PMid:32903492 PMCid:PMC7438449
  4. Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017-32. doi:10.1038/s41591-020-0968-3 PMid:32651579
  5. Esposito S, Noviello S, Pagliano P. Update on treatment of COVID-19: ongoing studies between promising and disappointing results. Infez Med. 2020;28(2):198-211.
  6. Chen Y, Liu Q, Guo D. Emerging coronaviruses: genome structure, replication, and pathogenesis. J Med Virol. 2020;92(4): 418-23. doi:10.1002/jmv.25681 PMid:31967327 PMCid:PMC7167049
  7. Goyal P, Sikary AK, Sachdeva RA, Parashar L, Tarique A. Mortality analysis of COVID-19 cases during the second wave and its comparison with the first wave: A hospital-based study. J Fam Med Prim Care. 2022;11(10):6091-5. doi:10.4103/jfmpc.jfmpc_341_22 PMid:36618203 PMCid:PMC9810977
  8. Alijotas-Reig J, Esteve-Valverde E, Belizna C, Selva-O'Callaghan A, Pardos-Gea J, Quintana A, et al. Immunomodulatory therapy for the management of severe COVID-19. Beyond the anti-viral therapy: A comprehensive review. Autoimmun Rev. 2020; 19 (7): 102569. doi:10.1016/j.autrev.2020.102569 PMid:32376394 PMCid:PMC7252146
  9. Group RC. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021;384(8):693-704. doi:10.1056/NEJMoa2021436 PMid:32678530 PMCid:PMC7383595
  10. Sterne JA, Murthy S, Diaz JV, Slutsky AS, Villar J, Angus DC, et al. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA. 2020;324(13):1330-41. doi:10.1001/jama.2020.17023 PMid:32876694 PMCid:PMC7489434
  11. Abdoli A, Falahi S, Kenarkoohi A. COVID-19-associated opportunistic infections: a snapshot on the current reports. Clin Exp Med. 2022;22(3):327-46. doi:10.1007/s10238-021-00751-7 PMid:34424451 PMCid:PMC8381864
  12. Koksoy Vayisoglu S, Aydin Besen M, Oncu E. Perspectives of midwifery and nursing students on recommending the COVID-19 vaccine to women of reproductive age and factors influencing counseling competency: a cross-sectional study. J Prev Complement Med. 2024; 3(1): 1-11. doi: 10.22034/ncm.2023.418212.1133
  13. Wu J, Liang B, Chen C, Wang H, Fang Y, Shen S, et al. SARS-CoV-2 infection induces sustained humoral immune responses in convalescent patients following symptomatic COVID-19. Nat Commun. 2021; 12 (1): 1813. doi:10.1038/s41467-021-22034-1 PMid:33753738 PMCid:PMC7985370
  14. Ma H, Zeng W, He H, Zhao D, Jiang D, Zhou P, et al. Serum iga, igm, and igg responses in covid-19. Cell Mol Immunol. 2020; 17 (7):773-5. doi:10.1038/s41423-020-0474-z PMid:32467617 PMCid:PMC7331804
  15. Harvala H, Robb ML, Watkins N, Ijaz S, Dicks S, Patel M, et al. Convalescent plasma therapy for the treatment of patients with COVID‐19: assessment of methods available for antibody detection and their correlation with neutralising antibody levels. Transfus Med. 2021;31(3): 167-75. doi:10.1111/tme.12746 PMid:33333627 PMCid:PMC8246874
  16. Li Lq, Huang T, Wang Yq, Wang Zp, Liang Y, Huang Tb, et al. COVID‐19 patients' clinical characteristics, discharge rate, and fatality rate of meta‐analysis. J Med Virol. 2020;92(6):577-83. doi:10.1002/jmv.25757 PMid:32162702 PMCid:PMC7228329
  17. Huang Z, Xu S, Liu J, Wu L, Qiu J, Wang N, et al. Effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines against SARS-CoV-2 Omicron BA. 2 variant infection, severe illness, and death. BMC Med. 2022;20(1):400. doi:10.1186/s12916-022-02606-8 PMid:36266697 PMCid:PMC9583051
  18. Letafati A, Eyvazzadeh N, Gharehkhani A, Khorshidian A, Chalabiani S, Soufiani EK, et al. Comparison of AstraZeneca and sinopharm vaccines as boosters in protection against COVID-19 infection. Biologicals. 2023;82:101668. doi:10.1016/j.biologicals.2023.101668 PMid:37004277 PMCid:PMC10008804
  19. Jahan N, Rahman FI, Saha P, Ether SA, Roknuzzaman A, Sarker R, et al. Side Effects Following Administration of the First Dose of Oxford-AstraZeneca's Covishield Vaccine in Bangladesh: A Cross-Sectional Study. Infect Dis Rep. 2021;13(4):888-901. doi:10.3390/idr13040080 PMid:34698203 PMCid:PMC8544399
  20. Feng Y, Chen J, Yao T, Chang Y, Li X, Xing R, et al. Safety and immunogenicity of inactivated SARS-CoV-2 vaccine in high-risk occupational population: a randomized, parallel, controlled clinical trial. Infect Dis Poverty. 2021;10(1):138. doi:10.1186/s40249-021-00924-2 PMid:34933684 PMCid:PMC8692079
  21. Omran EA, Habashy RE, Ezz Elarab LA, Hashish MH, El-Barrawy MA, Abdelwahab IA, et al. Anti-Spike and Neutralizing Antibodies after Two Doses of COVID-19 Sinopharm/BIBP Vaccine. Vaccines (Basel). 2022; 10(8). doi:10.3390/vaccines10081340 PMid:36016228 PMCid:PMC9415602
  22. Chau NVV, Nguyet LA, Truong NT, Toan LM, Dung NT, Hung LM, et al. Immunogenicity of Oxford-AstraZeneca COVID-19 Vaccine in Vietnamese Health-Care Workers. Am J Trop Med Hyg. 2022;106(2): 556-61. doi:10.4269/ajtmh.21-0849 PMid:34996048 PMCid:PMC8832887
  23. Pourakbari B, Mirbeyk M, Mahmoudi S, Hosseinpour Sadeghi RH, Rezaei N, Ghasemi R, et al. Evaluation of response to different COVID-19 vaccines in vaccinated healthcare workers in a single center in Iran. J Med Virol. 2022;94(12):5669-77. doi:10.1002/jmv.28029 PMid:35883215 PMCid:PMC9353408
  24. Anvari E, Talepoor AG, Eshkevar Vakili M, Karimi N, Ataollahi M, Najafi G, et al. Comparison of the Antibody Responses Following Vaccination with AstraZeneca and Sinopharm. Iranian J Immunol. 2022;19(3):321-9.
  25. Fedele F, Aria M, Esposito V, Micillo M, Cecere G, Spano M, et al. COVID-19 vaccine hesitancy: a survey in a population highly compliant to common vaccinations. Hum Vaccin Immunother. 2021;17(10):3348-54. doi:10.1080/21645515.2021.1928460 PMid:34096836 PMCid:PMC8437535
  26. Meo AS, Masood A, Shabbir U, Ali H, Nadeem Z, Meo SA, et al. Adverse Effects of Sinopharm COVID-19 Vaccine among Vaccinated Medical Students and Health Care Workers. Vaccines (Basel). 2023;11(1). doi:10.3390/vaccines11010105 PMid:36679950 PMCid:PMC9863525
  27. Babaee E, Amirkafi A, Tehrani-Banihashemi A, SoleimanvandiAzar N, Eshrati B, Rampisheh Z, et al. Adverse effects following COVID-19 vaccination in Iran. BMC Infect Dis. 2022;22(1):476. doi:10.1186/s12879-022-07411-5 PMid:35585518 PMCid:PMC9116064
  28. Ganesan S, Al Ketbi LMB, Al Kaabi N, Al Mansoori M, Al Maskari NN, Al Shamsi MS, et al. Vaccine Side Effects Following COVID-19 Vaccination Among the Residents of the UAE-An Observational Study. Front Public Health. 2022;10. doi:10.3389/fpubh.2022.876336 PMid:35602146 PMCid:PMC9120526
  29. Razazian N, Sahraian MA, Rezaei M, Eskandarieh S, Khamoushian K, Mousavi SE, et al. Comparison of side effects of the dose-1 of AstraZeneca and Sinopharm vaccines in patients with multiple sclerosis in Kermanshah, Iran (2021). Curr J Neurol. 2023:8-15. doi:10.18502/cjn.v22i1.12611 PMid:38011394 PMCid:PMC10444592
  30. Zare H, Rezapour H, Mahmoodzadeh S, Fereidouni M. Prevalence of COVID-19 vaccines (Sputnik V, AZD-1222, and Covaxin) side effects among healthcare workers in Birjand city, Iran. Int Immunopharmacol. 2021;101(Pt B):108351. doi:10.1016/j.intimp.2021.108351 PMid:34801416 PMCid:PMC8577998
  31. Desalegn M, Garoma G, Tamrat H, Desta A, Prakash A. The prevalence of AstraZeneca COVID-19 vaccine side effects among Nigist Eleni Mohammed memorial comprehensive specialized hospital health workers. Cross sectional survey. PLOS One. 2022; 17(6):e0265140. doi:10.1371/journal.pone.0265140 PMid:35749520 PMCid:PMC9232121
  32. Yesuf EA, Riad A, Sofi-Mahmudi A, Sudhakar M, Mekonnen A, Endalkachew S, et al. Self-reported side effects of the Oxford AstraZeneca COVID-19 vaccine among healthcare workers in Ethiopia, Africa: A cross-sectional study. Front Public Health. 2022;10. doi:10.3389/fpubh.2022.937794 PMid:35928493 PMCid:PMC9343757
  33. Omeish H, Najadat A, Al-Azzam S, Tarabin N, Abu Hameed A, Al-Gallab N, et al. Reported COVID-19 vaccines side effects among Jordanian population: a cross sectional study. Hum Vaccin Immunother. 2022; 18(1):1981086. doi:10.1080/21645515.2021.1981086 PMid:34614383 PMCid:PMC8920252
  34. Hatmal MM, Al-Hatamleh MAI, Olaimat AN, Hatmal M, Alhaj-Qasem DM, Olaimat TM, 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 (Basel). 2021;9(6). doi:10.3390/vaccines9060556 PMid:34073382 PMCid:PMC8229440
  35. Almufty HB, Mohammed SA, Abdullah AM, Merza MA. Potential adverse effects of COVID19 vaccines among Iraqi population; a comparison between the three available vaccines in Iraq; a retrospective cross-sectional study. Diabet Metab Syndr. 2021;15(5):102207. doi:10.1016/j.dsx.2021.102207 PMid:34280733 PMCid:PMC8274281