Neurologic Safety Monitoring of COVID-19 Vaccines

Thakur, Kiran T.; Epstein, Susan L.; Bilski, Amanda; Balbi, Alanna; Boehme, Amelia K; Brannagan, Thomas H.; Wesley, Sarah; Riley, Claire

doi:10.1212/wnl.0000000000012703

Cited by 11 publications

(8 citation statements)

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“…For example, acute disseminated encephalomyelitis has been reported post-rabies vaccine, Guillain-Barre neuritis has been reported following swine influenza vaccine and autoimmune thrombocytopenia has been reported post-measles vaccine. 4 Mechanisms postulated in the development of autoimmunity to vaccines include the following: ► Molecular mimicry means similarity between vaccine molecules and the patient's self-antigen. ► Bystander activation.…”

Section: Discussionmentioning

confidence: 99%

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Reactivation of adult-onset Still’s disease after use of the COVID-19 ChAdOx1-S vaccine

et al. 2022

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A woman in her 60s with a history of adult-onset Still’s disease (AOSD) in remission for 14 years received the ChAdOx1-S vaccine as a booster to her initial vaccination schedule (two doses of CoronaVac vaccine 6 months apart). Two weeks later, she consulted for symptoms suggestive of AOSD reactivation. This was confirmed during hospitalisation, where renal and cardiac involvement were also observed. Despite using high-dose corticosteroids, troponin T and N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) were persistently elevated. Tocilizumab was used, with which the patient achieved complete remission of her symptoms and normalised her laboratory tests.

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Section: Discussionmentioning

confidence: 99%

“…The risk of post-vaccination autoimmune diseases has been discussed in the literature. For example, acute disseminated encephalomyelitis has been reported post-rabies vaccine, Guillain-Barre neuritis has been reported following swine influenza vaccine and autoimmune thrombocytopenia has been reported post-measles vaccine 4…”

Section: Discussionmentioning

confidence: 99%

Reactivation of adult-onset Still’s disease after use of the COVID-19 ChAdOx1-S vaccine

et al. 2022

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“…Thus far, several neurological AEFIs related to the BNT162b2 vaccine have been reported, some examples of which are Bell's palsy, Guillain Barre syndrome, multiple sclerosis-like central nervous system demyelination syndrome and rhombencephalitis, as well as functional neurological disorders. The pathophysiological mechanisms for these phenomena in potential relation to the vaccine are still mostly unknown [4][5][6][7][8][9][10][11]. Luckily, preliminary data indicate that neurological complications from SARS-CoV-2 vaccines are rare in incidence [12].…”

Section: Introductionmentioning

confidence: 99%

Benign Fasciculation Syndrome and Migraine Aura without Headache: Possible Rare Side Effects of the BNT162b2 mRNA Vaccine? A Case Report and a Potential Hypothesis

et al. 2022

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The BNT162b2 (Pfizer BioNTech) mRNA vaccine is an effective vaccine against COVID-19 infection. Here, we report an adverse event following immunization (AEFI) in a 48-year-old female patient who presented with fasciculations, migraine auras without headaches and in an increased discomfort of previously present palpitations, as well as excitation and insomnia. Her fasciculations were intermittently present until the time this paper was written, starting from the 6th day post-vaccination; they changed localization and frequency, but most commonly they were generalized, affecting almost all muscle groups. The patient also suffered from two incidents of migraine auras with visual kaleidoscope-like phenomena without headaches a few months after the vaccination. These symptoms were considered to be AEFI and no causal relation with the vaccine could be proven.

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“…Serious AEs that have been linked to other immunizations include Guillain-Barré syndrome (GBS), paralytic poliomyelitis, acute disseminated encephalomyelitis (ADEM), and meningoencephalitis. 5 Here, we summarize reports to date and the extent and quality of evidence regarding possible serious adverse neurological events following COVID-19 vaccination, focusing on FDA-approved vaccines in the United States (BNT162b2, mRNA-1273, and Ad26.COV2.S).…”

mentioning

confidence: 99%

“…Serious AEs that have been linked to other immunizations include Guillain – Barré syndrome (GBS), paralytic poliomyelitis, acute disseminated encephalomyelitis (ADEM), and meningoencephalitis. 5…”

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confidence: 99%

Neurological Considerations with COVID-19 Vaccinations

et al. 2023

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The benefits of coronavirus disease 2019 (COVID-19) vaccination significantly outweigh its risks on a public health scale, and vaccination has been crucial in controlling the spread of SARS-CoV-2. Nonetheless, several reports of adverse events following vaccination have been published.To summarize reports to date and assess the extent and quality of evidence regarding possible serious adverse neurological events following COVID-19 vaccination, focusing on Food and Drug Administration (FDA)-approved vaccines in the United States (BNT162b2, mRNA-1273, and Ad26.COV2.S).A review of literature from five major electronic databases (PubMed, Medline, Embase, Cochrane Library, and Google Scholar) was conducted between December 1, 2020 and June 5, 2022. Articles included in the review were systematic reviews and meta-analysis, cohort studies, retrospective studies, case–control studies, case series, and reports. Editorials, letters, and animal studies were excluded, since these studies did not include quantitative data regarding adverse side effects of vaccination in human subjects.Of 149 total articles and 97 (65%) were case reports or case series. Three phase 3 trials initially conducted for BNT162b2, MRNA-1273, and Ad26.COV2.S were included in the analysis.The amount and quality of evidence for possible neurological adverse events in the context of FDA-approved COVID-19 vaccinations is overall low tier. The current body of evidence continues to suggest that COVID-19 vaccinations have a high neurological safety profile; however, the risks and benefits of vaccination must continue to be closely monitored.

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Neurologic Safety Monitoring of COVID-19 Vaccines

Cited by 11 publications

References 50 publications

Reactivation of adult-onset Still’s disease after use of the COVID-19 ChAdOx1-S vaccine

Reactivation of adult-onset Still’s disease after use of the COVID-19 ChAdOx1-S vaccine

Benign Fasciculation Syndrome and Migraine Aura without Headache: Possible Rare Side Effects of the BNT162b2 mRNA Vaccine? A Case Report and a Potential Hypothesis

Neurological Considerations with COVID-19 Vaccinations

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