Evidence map›Paper›PMID 38165458›Full record

SynthesisEuropean archives of psychiatry and clinical neuroscience2025

Vaccination and clozapine use: a systematic review and an analysis of the VAERS database.

Aslihan Aksar, Justina Lutz, Elias Wagner, Wolfgang Strube, Jurjen J Luykx, Alkomiet Hasan

Open access · greenAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European archives of psychiatry and clinical neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Aslihan AksarDepartment of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, Bezirkskrankenhaus Augsburg, University of Augsburg, Geschwister-Schoenert-Str. 1, 86156, Augsburg, Germany. Aslihan.Aksar@bkh-augsburg.de.ORCID http://orcid.org/0000-0003-4199-5422
Justina LutzDepartment of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, Bezirkskrankenhaus Augsburg, University of Augsburg, Geschwister-Schoenert-Str. 1, 86156, Augsburg, Germany.
Elias WagnerDepartment of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, Bezirkskrankenhaus Augsburg, University of Augsburg, Geschwister-Schoenert-Str. 1, 86156, Augsburg, Germany.
Wolfgang StrubeDepartment of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, Bezirkskrankenhaus Augsburg, University of Augsburg, Geschwister-Schoenert-Str. 1, 86156, Augsburg, Germany.
Jurjen J LuykxDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
Alkomiet HasanDepartment of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, Bezirkskrankenhaus Augsburg, University of Augsburg, Geschwister-Schoenert-Str. 1, 86156, Augsburg, Germany.
University of Augsburg · DEBezirkskrankenhaus Augsburg · DEUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In the context of COVID-19 concerns related to the potential interactions between clozapine and vaccination arose. With the ultimate goal of deriving recommendations for clinical practice, we systematically reviewed the current evidence regarding altered vaccine effectiveness in clozapine-treated patients and safety aspects of vaccination, such as haematological changes and the impact of vaccines on clozapine blood levels, in clozapine-treated patients. A systematic PRISMA-conform literature search of four databases (PubMed, PsycINFO, EMBASE and Cochrane Library) complemented by a case-by-case analysis of the Vaccine Adverse Event Reporting System (VAERS) database was performed. We then systematically appraised the joint evidence and tried to derive recommendations for clinical practice. 14 records were included in this analysis. These records consisted of 5 original articles and 9 case reports. Among the original articles, two studies provided data on the association between clozapine use and antibody responses to vaccination, both indicating that clozapine use in schizophrenia may be associated with reduced levels of immunoglobulins. Additionally, three studies examined vaccine safety in clozapine-treated patients, with no clinically significant adverse effects directly attributable to the interplay between vaccinations and clozapine. VAERS Analysis encompassed 137 reports and showed no consistent evidence of an increased risk for clozapine blood level increases or adverse events. We found no evidence indicating that clozapine impairs the effectiveness of vaccines. Moreover, no serious safety concerns seem to apply when patients on clozapine are receiving vaccines. However, it is crucial to acknowledge that data on the interaction between clozapine and vaccines remain limited.

Indexed as

Adverse Drug Reaction Reporting SystemsAntipsychotic AgentsClozapineCOVID-19COVID-19 VaccinesSchizophreniaVaccinationDatabases, FactualHumansAntipsychotic AgentsClozapineCOVID-19 VaccinesBlood levelsClozapineImmunizationSafetyTherapeutic drug monitoring (TDM)Vaccination

Identifiers

PMID38165458
OpenAlexW4390498846

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.