COVID-19 vaccination-associated myelitis

Abstract

Learning Point for Clinicians Of all COVID-19 vaccination-associated adverse events, 2.69% may be neurological in nature. We report the first case of myelitis from India with ChAdOX1 nCoV-19 vaccine; the patient had excellent recovery. Having occurred after an administration of > 50 million doses, benefits of vaccination seem to outweigh the risk of adverse events.

A case of longitudinally extensive transverse myelitis following vaccination against Covid-19

“…In contrast, for two other cases of transverse myelitis that also occurred during clinical trials a relation to AZD1222 was denied (one pre-existing multiple sclerosis, one in the control-group receiving meningococcal vaccine) (Medicines and Healthcare products Regulatory Agency (MHRA), 2021a; Voysey et al, 2021). Recently a single case of focal myelitis following Covid-19 vaccination with AstraZeneca-vaccine in India has been described (Singh Malhotra et al, 2021). Moreover, national vigilance boards already received several spontaneous reports on myelitis following covid-19 vaccines, for instance in the UK 17 cases for BioNTech vaccine and 45 cases for AstraZeneca vaccine (as at 28-Apr-2021), in Germany one case for BioNTech vaccine and 2 cases for AstraZecena vaccine (as at 30-Apr-2021) and in the US 9 cases without mentioning specific vaccine (as at 02-Mar-2021) (Goss et al, 2021; Medicines and Healthcare products Regulatory Agency (MHRA), 2021b, 2021c; Paul-Ehrlich-Institut (PEI), 2021).…”

Acute myelitis and ChAdOx1 nCoV-19 vaccine: Casual or causal association?

“…To date, SARS-CoV-2 infection has been associated with several PINSs, including ADEM, transverse myelitis and inflammatory neuropathy, even though the underlying mechanisms are still unclear. On the other hand, to the best of our knowledge only rare post-vaccination syndromes have been reported to date during this vaccination campaign, including a single case of myelitis occurred 8 days after the first dose of AZD1222 vaccine (April 22, 2021) ( Cao and Ren, 2021 ; Malhotra et al, 2021 ; Waheed et al, 2021 ). During the AZD1222 trial transverse myelitis had been described in two patients, 10 days after ChAdOx1 nCoV-19 first dose and 14 days after booster vaccination, respectively.…”

Early approval of COVID-19 vaccines: Pros and cons

“…59 During the phase III trials of the AstraZeneca and JNJ vaccines, there were early warning signals whereby serious adverse events following immunization (AEFI), such as multiple sclerosis and transverse myelitis, were reported in like Germany, Austria, USA, and India. [60][61][62][63] As of March 2, 2021, more than 51 million dosages of the COVID-19 vaccines from different platforms were administered in the United States and 9,442 adverse reactions had been reported. 64 Common side effects were dizziness, headache, pain, muscle spasms, myalgia, and paresthesia, while in rare cases, tremors, diplopia, tinnitus, dysphonia, seizures, and reactivation of herpes zoster have been detected.…”