Bell's palsy as a possible complication of mRNA-1273 (Moderna) vaccine against COVID-19

Poudel, Sujan; Nepali, Prakash; Baniya, Santosh; Shah, Sangam; Bogati, Sunil; Nepal, Gaurav; Ojha, Rajeev; Edaki, Omoyeme; Lazovic, Gavrilo; Kara, Sam

doi:10.1016/j.amsu.2022.103897

Cited by 16 publications

(8 citation statements)

References 17 publications

(14 reference statements)

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“…Thus, 34 records were excluded, and the remaining 50 records entered our study. Of the 50 studies, 17 articles comparing BP incidence in SARS-CoV-2–vaccinated and control groups that could be pooled were included in the meta-analysis, and the remaining 33 articles were included only in the qualitative synthesis (ie, the characteristics of which were extracted and formatted into eTable 2 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…The 50 included studies comprised 22 case reports and case series, 2 SCCSs, 2 case-control studies, 3 cross-sectional studies, 16 cohort studies, and 5 RCTs . A summary of the characteristics of the included studies is represented in the Table (case reports and case series are summarized in eTable 3 in Supplement 1) and detailed in eTable 2 in Supplement 1.…”

Section: Resultsmentioning

confidence: 99%

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Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy

Rafati

Pasebani

Jameie

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceBell palsy (BP) has been reported as an adverse event following the SARS-CoV-2 vaccination, but neither a causative relationship nor a higher prevalence than in the general population has been established.ObjectiveTo compare the incidence of BP in SARS-CoV-2 vaccine recipients vs unvaccinated individuals or placebo recipients.Data SourcesA systematic search of MEDLINE (via PubMed), Web of Science, Scopus, Cochrane Library, and Google Scholar from the inception of the COVID-19 report (December 2019) to August 15, 2022.Study SelectionArticles reporting BP incidence with SARS-CoV-2 vaccination were included.Data Extraction and SynthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was conducted with the random- and fixed-effect models using the Mantel-Haenszel method. The quality of the studies was evaluated by the Newcastle-Ottawa Scale.Main Outcomes and MeasuresThe outcomes of interest were to compare BP incidence among (1) SARS-CoV-2 vaccine recipients, (2) nonrecipients in the placebo or unvaccinated cohorts, (3) different types of SARS-CoV-2 vaccines, and (4) SARS-CoV-2–infected vs SARS-CoV-2–vaccinated individuals.ResultsFifty studies were included, of which 17 entered the quantitative synthesis. Pooling 4 phase 3 randomized clinical trials showed significantly higher BP in recipients of SARS-CoV-2 vaccines (77 525 vaccine recipients vs 66 682 placebo recipients; odds ratio [OR], 3.00; 95% CI, 1.10-8.18; I2 = 0%). There was, however, no significant increase in BP after administration of the messenger RNA SARS-CoV-2 vaccine in pooling 8 observational studies (13 518 026 doses vs 13 510 701 unvaccinated; OR, 0.70; 95% CI, 0.42-1.16; I2 = 94%). No significant difference was found in BP among 22 978 880 first-dose recipients of the Pfizer/BioNTech vaccine compared with 22 978 880 first-dose recipients of the Oxford/AstraZeneca vaccine (OR, 0.97; 95% CI, 0.82-1.15; I2 = 0%). Bell palsy was significantly more common after SARS-CoV-2 infection (n = 2 822 072) than after SARS-CoV-2 vaccinations (n = 37 912 410) (relative risk, 3.23; 95% CI, 1.57-6.62; I2 = 95%).Conclusions and RelevanceThis systematic review and meta-analysis suggests a higher incidence of BP among SARS-CoV-2–vaccinated vs placebo groups. The occurrence of BP did not differ significantly between recipients of the Pfizer/BioNTech vs Oxford/AstraZeneca vaccines. SARS-CoV-2 infection posed a significantly greater risk for BP than SARS-CoV-2 vaccination.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy

Rafati

Pasebani

Jameie

et al. 2023

JAMA Otolaryngol Head Neck Surg

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“…When type I IFN signaling is flawed, as it is done after vaccination with SARS-CoV-2, the capability of CD8+ T cells to retain herpes under control would also be damaged. The reactivation of HSV-1 is probably the most accepted theory [ 33 ]. A study involving 14 patients with Bell’s palsy, nine with Ramsy–Hunt syndrome, and 14 control patients, managed to show a link between the presence of the HSV-1 genome in patients and the development of Bell’s palsy [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Bell’s Palsy and COVID-19 Vaccines: A Systematic Review and Meta-Analysis

et al. 2023

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Introduction: Once the COVID-19 pandemic was declared, the world was waiting for the clue that would be able to cut down the progression of the disease. Vaccines play a crucial role in reducing the disease and saving many people worldwide. However, there are several side effects of these vaccines, like pain, fatigue, fever, and neurological defects like Bell’s palsy. In this systematic review, we presented evidence about the occurrence of Bell’s palsy followed by COVID-19 vaccination. Methods: We searched PubMed, SCOPUS, EBSCO, and Web of Science (WOS) from inception till October 2022. The quality assessment was conducted using the Joanna Briggs Institute, National Institute of Health, and Newcastle-Ottawa. The analysis was conducted on SPSS. Results: Thirty-five records were involved in our study. The results of our cases revealed that most of the patients (62.8%) experienced unilateral facial paralysis. Also, the majority of the cases were reported after the first dose, and most cases were after Pfizer, AstraZeneca, and Sputnik V vaccines, respectively. The patients who were treated with corticosteroids, IVIG, and anti-viral drugs, showed marked recovery afterward. Conclusion: The rate ratio of Bell’s palsy after COVID-19 vaccination was 25.3 per 1,000,000. The ratio was higher after the first dose compared to the second dose and was higher among those who took Oxford/AstraZeneca vaccine compared to other vaccines. However, this condition was reported in a small number of cases among a large number of vaccinated people worldwide. It is important to note that the benefits of getting vaccinated far outweigh any potential risks.

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“…Nineteen FNP cases were reported following COVID-19 vaccination [110][111][112][113][114][115][116][117][118][119][120][121][122][123][124][125][126] across the world. The patients' age ranged from 17 to 62 years (median (IQR): 38 (34, 57) years), 11 out of 19 patients were female (58%), and 4 patients had a prior history of FNP.…”

Section: Facial Nerve Palsymentioning

confidence: 99%

Neuromuscular diseases associated with COVID-19 vaccines: A systematic review and pooled analysis of 258 patients

Tayebi,

Samimisedeh,

Afshar

et al. 2023

Preprint

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Background: Neuromuscular diseases (NMD) emerged as one of the main side effects of the COVID-19 vaccination. We pooled and summarized the evidence on the clinical features and outcomes of NMD associated with COVID-19 vaccination. Methods: We comprehensively searched three databases, Medline, Embase, and Scopus, using the key terms covering “Neuromuscular disease” AND “COVID-19 vaccine”, and pooled the individual patient data extracted from the included studies. Results: A total of 258 NMD cases following COVID-19 have been reported globally; of which 171 cases were Guillain barre syndrome (GBS), 40 Parsonage-Turner syndrome (PTS), 22 Myasthenia Gravis (MG), 19 facial nerve palsy (FNP), 5 single fiber neuropathy, and 1 Tolosa-Hunt syndrome. All (100%) SFN patients and 58% of FNP patients were female; in remained NMDs, patients predominantly were male, including MG (82%), GBS (63%), and PTS (62.5%). The median time from vaccine to symptom was less than 2 weeks in all groups. Symptoms mainly appeared following the first dose of vector vaccine, but there was no certain pattern for mRNA-based. Conclusion: COVID-19 vaccines might induce some NMDs, mainly in adults. The age distribution and gender characteristics of affected patients may differ based on the NMD type. About two-thirds of the cases probably occur in less than two weeks from the vaccination.

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Bell's palsy as a possible complication of mRNA-1273 (Moderna) vaccine against COVID-19

Cited by 16 publications

References 17 publications

Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy

Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy

Bell’s Palsy and COVID-19 Vaccines: A Systematic Review and Meta-Analysis

Neuromuscular diseases associated with COVID-19 vaccines: A systematic review and pooled analysis of 258 patients

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