Doctor—Should I get the <scp>COVID</scp>‐19 vaccine? Infection and immunization in individuals with neuromuscular disorders

Živković, Sasha; Gruener, Gregory; Narayanaswami, Pushpa

doi:10.1002/mus.27179

Cited by 26 publications

(31 citation statements)

References 84 publications

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“…Based on COVID-19 vaccine data from the general population and extrapolations from other vaccines studied in patients with neurological disease, statements from the American Academy of Neuromuscular and Electrodiagnostic Medicine and the National Multiple Sclerosis Society support vaccination. 47,48 As discussed further below, a single study has now reported no increased risk of complications in multiple sclerosis patients receiving the Pfizer COVID-19 vaccine. 49…”

Section: Safety and Efficacymentioning

confidence: 98%

COVID-19 and Vaccination in the Setting of Neurologic Disease

et al. 2021

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The COVID-19 pandemic caused by the SARS-CoV-2 virus has left many unanswered questions for patients with neurological disorders and the providers caring for them. Elderly and immunocompromised patients are at increased risk for severe symptoms due to COVID-19, and the virus may increase symptoms of underlying neurological illness, particularly for those with significant bulbar and respiratory weakness or other neurologic disability. Emerging SARS-CoV-2 vaccines offer substantial protection from symptomatic infection, but both patients and providers may have concerns regarding theoretical risks of vaccination, including vaccine safety and efficacy in the context of immunotherapy and the potential for precipitating or exacerbating neurological symptoms. In this statement on behalf of the Quality Committee of the AAN we review the current literature, focusing on COVID-19 infection in adults with neurological disease, in order to elucidate risks and benefits of vaccination in these individuals. Based on existing evidence, neurologists should recommend COVID-19 vaccination to their patients. For those patients being treated with immunotherapies, attention should be paid to timing of vaccination with respect to treatment and the potential for an attenuated immune response.

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Section: Safety and Efficacymentioning

confidence: 98%

COVID-19 and Vaccination in the Setting of Neurologic Disease

et al. 2021

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“…The major concerns regarding vaccination in this patient group included vaccine-related worsening of the underlying disorder, triggering of new autoimmune NMD, or suboptimal vaccine efficacy. Available evidence of COVID-19 vaccine safety is scarce, but it seems that benefits of vaccination outweigh the possible risks [ 8 ].…”

Section: The Vaccine Campaigns and Neurological Complicationsmentioning

confidence: 99%

“…Several neurological side effects have also been reported, such as headache, dizziness, paresthesia. Some more serious adverse effects include transverse myelitis, Guillain–Barré syndrome, Bell’s palsy, cerebral venous sinus thrombosis, and ischemic stroke [ 6 , 8 ].…”

Section: The Vaccine Campaigns and Neurological Complicationsmentioning

confidence: 99%

“…Because of these changes, social media has become a driving way of sharing, producing, and disseminating information related to health and medicine [ 8 ]. However, precisely because of its structure, which allows for the rapid dissemination of information, social media began to spread myths and misinformation about the coronavirus.…”

Section: The Pandemic and Social Mediamentioning

confidence: 99%

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What the Aftermath of the Global Pandemic Will Mean for Neurologists

Rutović

Volevach

Maršálková

et al. 2021

Neurology International

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“…In fact, the clinical consensus is that the COVID-19 vaccine is safe for patients with myasthenia gravis, and indeed recommended as myasthenia gravis might correlate to a worse clinical outcome with COVID-19. [17,18] The slightly elevated ROR must be understood in the context of the COVID-19 vaccination programme. First, the incidence of myasthenia gravis increases with age.…”

Section: Myasthenia Gravismentioning

confidence: 99%

A case-control study of autoimmune AEFIs following COVID-19 vaccination reported to VAERS

Csefalvay¹

2021

Preprint

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Autoimmune adverse effects following immunisation (AEFIs) are widely regarded as a chief concern driving vaccine hesitancy. This case-control study seeks to shed light on the true risk of autoimmune AEFIs associated with the COVID-19 vaccine through a case-control analysis of VAERS reports. Reports of autoimmune aetiology were matched with reports of non-autoimmune controls. Statistical analysis reveals that the safety profile of COVID-19 vaccines with regard to autoimmune AEFIs is highly favourable. In particular, neuroautoimmune AEFIs have statistically significant reporting odds ratios below unity (Guillain-Barre syndrome: 0.35, multiple sclerosis: 0.70, transverse myelitis: 0.79), indicating a reduced association of reports of these conditions with the COVID-19 vaccine versus other vaccines. Only three autoimmune aetiologies exceed a ROR of 2.0 and thus present a potential signal. Of these, myasthenia gravis (ROR = 3.90, p < 0.001, 95% CI: 2.63-5.80) may be the result of epidemiological confounding factors not sufficiently controlled by matching, as the population most likely to develop myasthenia gravis was strongly prioritised in the COVID-19 vaccine's initial rollout. Immune thrombocytopaenia (ROR = 26.83, p < 0.001, 95% CI: 16.93-42.54) is a clear safety signal, confirming a large number of case reports and studies that indicate a risk of immune thrombocytopaenic events following the COVID- 19 vaccine. The lone strong safety signal of immune thrombocytopaenia notwithstanding, this study attests to the safety of the COVID-19 vaccine where autoimmune conditions are concerned. Through quantifying the risk of autoimmune disorders associated with COVID-19 vaccination, this study contributes to a growing body of evidence supporting the safety of such vaccines.

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Doctor—Should I get the COVID‐19 vaccine? Infection and immunization in individuals with neuromuscular disorders

Cited by 26 publications

References 84 publications

COVID-19 and Vaccination in the Setting of Neurologic Disease

COVID-19 and Vaccination in the Setting of Neurologic Disease

What the Aftermath of the Global Pandemic Will Mean for Neurologists

A case-control study of autoimmune AEFIs following COVID-19 vaccination reported to VAERS

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