This review/analysis gives a first impression of numerous adverse events related to Covid-19 vaccination, which
have received little attention to date, are often unexplained, but are nevertheless very distressing. Frequently
observed organ-related ADRs after Covid-19 vaccination were such of the nervous system, musculoskeletal system,
gastrointestinal tract, and skin.
The involvement of almost all organs in the side effect spectrum of Covid-19 vaccines demonstrates their systemic
efficacy. As shown by the ADRs occurrence even after numerous days to weeks, the duration of spike production
obviously lasts longer than claimed.
The key role is played by the interaction between the spike subunit S1 and the membrane-bound enzyme ACE2, the
receptor for SARS-CoV. Downregulation of ACE2 by spikes and following activation of RAAS can lead to numerous
clinically relevant disorders, such as vasoconstriction, tissue ischemia, induction of proliferative processes,
increased oxidative stress, inflammation, or coagulation disorders, as previously shown for cardiovascular
reactions. It is proposed to use the collective term “SPAS” (in German: Spike ausgelöste Störungen) – spike
induced disturbances for side effects based on this mode of action.
The common mode of action and only slightly different frequencies of adverse events and fatal outcomes do not
indicate any principal differences in adverse event profiles of the individual spike-based Covid-19 vaccines. A
class-specific side effect profile can be assumed.
Knowledge and awareness of the comprehensive adverse event profile of the novel Covid-19 vaccines and their
potential dangerousness may improve vaccine safety.

Spike-produzierende Impfstoffe verfügen impfstoffuntypisch über einen Doppelcharakter. Die Spikes lösen einerseits über ihre Antigen-Eigenschaft die Bildung von Antikörpern aus und können somit zur gewünschten Immunität gegen SARS-Cov-2 führen. Weil die Antigeneigenschaft jedoch an die sogenannte Rezeptorbindungsdomäne (RBD) S1 der Spikes gekoppelt ist und diese andererseits auch für die Anhaftung an das membranständige Enzym ACE2 verantwortlich ist, kommt es zusätzlich zur Funktionsstörung bzw. zum Funktionsausfall von ACE2 mit nicht zu vernachlässigenden Konsequenzen, wie eine aktuelle Analyse der Nebenwirkungen zeigt.