SARS-CoV-2 the ASIA virus (Autoimmune/autoinflammatory Syndrome Induced by Adjuvants), the risk of infertility and vaccine hesitancy

ABSTRACT

Introduction

COVID-19 has had a catastrophic impact on the world. The current death toll far exceeds 6 million and large numbers of patients are experiencing long-term medical and psychiatric morbidity from the infection. The immunopathology of severe COVID-19 is now better understood. In severely affected patients, there is a chaotic, destructive immune response triggered by SARS-CoV-2, where autoimmunity features prominently.

Areas covered

COVID-19 vaccines ensure a coordinated, balanced immune response to future SARS-CoV-2 infection. The rapid global deployment of effective COVID-19 vaccines has been hindered by financial, logistical and political barriers. Of concern is increasing vaccine hesitancy caused by unfounded conspiracy theories of vaccine adverse effects, often fueled by misinformation and disinformation on social media.

Expert opinion

This perspective discusses the potential impact of the so-called Autoimmune/autoinflammatory Syndrome Induced by Adjuvants (ASIA) on COVID-19 vaccine uptake. Proponents of the ASIA syndrome have inappropriately linked infertility to HPV vaccines and have recently suggested antigenic cross-reactivity between SARS-CoV-2 and ovarian follicles. COVID-19 vaccines have also been linked to ASIA and unfounded fear of infertility is a leading cause of vaccine hesitancy. Vaccine hesitancy caused by spurious disorders such as ASIA are likely to harm individuals and delay global vaccination efforts leading to emergence of vaccine and monoclonal antibody-resistant SARS-CoV-2 variants, thereby prolonging the COVID-19 pandemic.

KEYWORDS:

• COVID-19
• SARS-CoV-2
• ASIA syndrome
• vaccination

Article highlights

• COVID-19 has had a devastating impact on the world

• Several effective vaccines and new antiviral drugs are now available for COVID-19

• Vaccines and new antiviral therapeutics represent the most effective way to end the pandemic

• Vaccine inequity and vaccine hesitancy are major barriers to immunizing the entire world

• Vaccine hesitancy is fueled by conspiracy theories spread through social media

• The Autoimmune/ autoinflammatory Syndrome Induced by Adjuvants (ASIA) Is an example of vaccine misinformation and disinformation leading to conspiracy theories

• The diagnostic criteria for ASIA do not define a clinically recognizable disorder

• The proponents of ASIA have linked the HPV vaccine to infertility

• The advocates of ASIA have also suggested antigenic cross-reactivity between SARS-CoV-2 and ovarian follicles, implying molecular mimicry could cause autoimmune infertility

• COVID-19 vaccines have been linked to ASIA by the proponents of this spurious condition

• Fear of infertility is an important factor in COVID-19 vaccine hesitancy in many individuals

• Large epidemiological studies do not support a link between vaccines and infertility

• It is important to counter spurious, pseudoscientific concepts such as ASIA, which represent a serious threat to global immunization efforts to end the pandemic

Declaration of interest

The author was commissioned by the New Zealand government (NZG) to review the basis for ASIA. The author received payment from the NZG for this work. The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.