Spectrum of Adverse Event Following COVID-19 Immunization in High Altitude, Nepal

IntroductionNepal started vaccinating frontline workers against COVID-19, in January 2021.Side effects of the vaccine are still unknown in high altitude regions. Poor surveillance and the lack of health workers in remote places to take care of people in case of vaccination side-effects could prove to be a challenge in the drive, especially in high altitudes like Humla district, Nepal. High altitude regions are harder to access and also mobilization of vaccines and manpower is strenuous due to harsh weather conditions and complex geography. We aimed to study the spectrum of Adverse Event Following COVID-19 Immunization among the front liners of Humla district. MethodsThis is a cross-sectional study conducted in Humla district, Nepal. COVID-19 Immunization vaccine recipients were contacted through a phone call within 5 days of vaccination to record the adverse effects. Patterns and distribution of adverse effects were analyzed in high altitude settings. Ethical approval was taken from Nepal Health Research Council. ResultsOf total respondents, 84.1% (95% C.I: 80.9 to 86.9) had shown symptoms after vaccination. The average time for the appearance of symptoms was 1.27 +_ 0.60 days. For systemic effects, tenderness was the side effect seen after vaccination (63.8%) followed by other side effects like pain (58.5%), Pyrexia (37.4%), Chills (29.8%), Myalgia (28.9%) and Malaise (15.2%) while for localized effects, the symptoms such as Arthralgia (16.6%) and Bruising (16.1%) were the most common effects. ConclusionsSerious and life threatening adverse effects following immunization were not seen in our study site which was of altitude 2500 meter and above. Our study shows a similar type of side effect pattern as that of the lower altitude regions.