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 ADRs of the nervous system, the musculoskeletal system, the gastrointestinal tract and the skin.

The involvement of almost all organs in the side effect spectrum of Covid-19 vaccines demonstrates their systemic efficacy. As shown by the ADR 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 responses. 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.