Herpes simplex encephalitis following ChAdOx1 nCoV-19 vaccination: a case report and review of the literature

Abstract

Background Ever since the administration of early doses of COVID-19 vaccines, instances of adverse effects have been reported. Viral infections, specifically herpes simplex reinfection and coinfections, have been reported following administration of different types of vaccines. To our knowledge, there have not been any reports of herpes simplex encephalitis following administration of any type of COVID-19 vaccine to date. Case presentation In this article intends to report a case of herpes simplex encephalitis in a 27-year-old male patient who was vaccinated with the ChAdOx1 nCoV-19 vaccine. Conclusions Our study suggests a possible but very rare side effect of ChAdOx1 nCoV-19 vaccine, which requires immediate medical attention and can lead to devastating consequences if left undiagnosed and untreated.

COVID-19 Vaccination and the Rate of Immune and Autoimmune Adverse Events Following Immunization: Insights From a Narrative Literature Review

“…Due to its rarity, the authors highlighted that the benefits of the vaccine outweigh the risks. It is noteworthy to mention hereby, that herpes simplex encephalitis was reported following ChAdOx1 vaccine ( 108 ) however, this can be regarded as an infection-related AEFI rather than autoimmune induced.…”

Case report: Varicella zoster virus encephalitis following COVID-19 vaccination in an immunocompetent individual

“…Various reports of VZV infection [ [12] , [13] , [14] ] or VZV encephalitis [ [15] , [16] , [17] ] have been reported after COVID-19 infection [ 2 ]. As such, cases of HSV encephalitis [ 18 ] and VZV meningitis [ 19 ] have also been reported after COVID-19 vaccination. The downregulation of natural killer (NK cells) group 2D (NKG2D) ligands (which help prevent autoreactivity of NK cells against host tissues) occurs during HSV and VZV infections, which can contribute to viral latency and evasion from NK cells reactions [ 18 ].…”

“…As such, cases of HSV encephalitis [ 18 ] and VZV meningitis [ 19 ] have also been reported after COVID-19 vaccination. The downregulation of natural killer (NK cells) group 2D (NKG2D) ligands (which help prevent autoreactivity of NK cells against host tissues) occurs during HSV and VZV infections, which can contribute to viral latency and evasion from NK cells reactions [ 18 ]. However, disruption of this balance can occur during stress-inducing conditions, such as hypoxia and viral infections such as SARS-COV-2 infection, which consequently lead to viral reactivation [ 18 ].…”

Investigation of Neurological Complications after COVID-19 Vaccination: Report of the Clinical Scenarios and Review of the Literature

“…Several case reports have revealed the effects of SARS-CoV-2 vaccinations on herpes simplex virus and varicella-zoster virus reactivation [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. Cases of herpetic meningoencephalitis following COVID-19 vaccines of ChAdOx1 nCoV-19 [ 70 ] and Covaxin [ 71 ] were reported. However, the actual incidence of vaccine-associated herpes simplex encephalitis was not well established.…”