SARS-CoV-2 Vaccination-Induced Transverse Myelitis

Tahir, Nayha; Koorapati, Gowthami; Prasad, Sonika; Jeelani, Hafiz Muhammad; Sherchan, Robin; Shrestha, Jishna; Shayuk, Maryna

doi:10.7759/cureus.16624

Cited by 43 publications

(52 citation statements)

References 17 publications

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“…In the patient having received the Johnson & Johnson vaccine, transverse myelitis was associated with facial palsy. 12 The patient who developed transverse myelitis after vaccination with the Moderna vaccine, additionally had vitamin-B12 deficiency, which may have contributed to the development of the neurological compromise. 13 Several other neurological abnormalities occurred after SARS-CoV-2 vaccinations, but the number of reported cases was below 5 (Table 1).…”

Section: Re Sultsmentioning

confidence: 99%

Neurological side effects of SARS‐CoV‐2 vaccinations

Finsterer

2021

Acta Neuro Scandinavica

140

117

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Though SARS-CoV-2 vaccinations are usually sold as well tolerated, they can cause mild-to-severe side effects in some patients. 1 Since the benefit for the global population outweighs these adverse reactions, and since political and pecuniary interests create the image of a "safe and indispensable" tool against the currently dominant global burden, there is only moderate reporting and discussion about them. 2There is also an anti-vaccine movement in the world nowadays that also contributes to the biased assessment of these adverse effects.Usually, single case reports, case series, or registration studies report these side effects but systematic, transnational, multicenter, postmarketing investigations on this matter are infrequently done. This shortage of published information about type, frequency, severity, and therapeutic management of vaccination-related side effects is in contradiction to the daily experience of healthcare workers and affected probands, and may contribute to the individual or organized resistance and reservations against the vaccination from parts of the populations, the only moderate effect of vaccination campaigns, and the tendency to introduce compulsory vaccination. 3 Neurological side effects to SARS-CoV-2 vaccinations are usually mild, of short duration, self-limiting, and ambulatorily manageable.However, in some cases, these side effects are severe and require hospitalization or even admission to an intensive care unit (ICU). 4 Only, rarely these side effects can be fatal. 5 Since the virus and the adverse reactions to vaccinations show a tropism for neuronal structures and tissues this narrative review about the neurological side effects was conducted to collect and discuss published data in order to discover type, frequency, treatment, and outcome of these side effects and to eventually discover if certain patients are prone to

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Section: Re Sultsmentioning

confidence: 99%

Neurological side effects of SARS‐CoV‐2 vaccinations

Finsterer

2021

Acta Neuro Scandinavica

140

117

View full text Add to dashboard Cite

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“…For COVID-19 vaccine-related events, a total of 51,755,447 doses of COVID-19 vaccines were administered until March 2021 and nine cases of related ATM were reported among 9442 adverse events; the incidence is approximately 1.739/per million people [ 2 ]. After the literature review, we summarized the published case reports of SARS-CoV-2 vaccination-related transverse myelitis with detailed clinical information in Table 1 [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…The cross-reaction between the epitope and self-antigen activates B lymphocyte and the bystander activation of T cells, which induces the immune response. These mechanism appears to be the explanation for the vaccine with viral antigen adjuvants, which might mediate immune responses targeting the spinal cords [ 1 , 6 , 7 , 15 ]. This could be somehow explained by the pleocytosis found in patients’ CSF considering that the blood–brain barrier might have been broken down within a focal area of the spinal cord [ 6 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…This could be somehow explained by the pleocytosis found in patients’ CSF considering that the blood–brain barrier might have been broken down within a focal area of the spinal cord [ 6 , 15 ]. It is noticeable that both the AZD1222 and Johnson & Johnson COVID-19 vaccines contain adenovirus antigens, and they might induce ATM by the same pathogenesis [ 1 , 7 ]. As other vaccines are without a viral vector, a similar hypothesis was proposed that immune dysregulation secondary to vaccination might trigger ATM [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Acute Transverse Myelitis after COVID-19 Vaccination

et al. 2021

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The adverse effects of the COVID-19 vaccine have been discovered as the rapid application of the vaccines continues. Neurological complications such as transverse myelitis raise concerns as cases were observed in clinical trials. Transverse myelitis is a rare immune-mediated disease with spinal cord neural injury, resulting in neurological deficits in the motor, sensory, and autonomic system. Vaccine-related transverse myelitis is even rarer. We present a case of acute transverse myelitis after vaccination against COVID-19 with the ChAdOx1 nCOV-19 vaccine (AZD1222), which was the first case reported in Taiwan. Although it rarely occurs, post-vaccination neurological complications should not be ignored. As the pandemic of SARS-COV-2 continues to spread and concern about vaccination efficacy and safety rises, heterologous vaccination were implemented in health public policy in several countries. A literature review of several clinical trials shows promising effects of mix-and-match vaccination. Further study on different combinations of vaccines can be expected.

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“…Other rare causes of transverse myelitis are systemic autoimmune diseases; for instance, systemic lupus erythematosus Sjögren's syndrome that injures the spinal cord. Although many cases of transverse myelitis are correctly diagnosed, the actual causes for 30% of the cases are not known [18].…”

Section: Discussionmentioning

confidence: 99%

Acute inflammatory Transverse Myelitis post Pfizer-BioNTech-COVID-19 vaccine in 16-year-old

Albokhari

Alsawas

Adnan

et al. 2021

Preprint

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Coronavirus disease 2019 (COVID-19) originated in China in early March 2019. Saudi Food and Drug Authorityapproved the registration of the Pfizer-BioNTech COVID-19 vaccine in Saudi Arabia on December 10, 2020 and on May 10, 2021, Pfizer-BioNTech was given an authorized emergency use in 12 to 15 years old children. Saudi Arabia’s Ministry of Health started Pfizer-BioNTech COVID-19 vaccination for 12 to 18 years old on June 27, 2021. Here we have a case of 16-year-old female admitted to the medical ward diagnosed with acute inflammatory transverse myelitis after two weeks from second dose of the Pfizer-BioNTech COVID-19 vaccine. The diagnosis was based on normal laboratory workup but significant radiological findings. She was discharged after a full recovery.There are multiple cases of post-vaccine acute inflammatory transverse myelitisshared by medical journals, but due to lack of literature review for the teenager population, we think our case may be the first case of acute inflammatory transverse myelitis following second dose of Pfizer-BioNTech COVID-19 vaccine in this population.

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SARS-CoV-2 Vaccination-Induced Transverse Myelitis

Cited by 43 publications

References 17 publications

Neurological side effects of SARS‐CoV‐2 vaccinations

Neurological side effects of SARS‐CoV‐2 vaccinations

Acute Transverse Myelitis after COVID-19 Vaccination

Acute inflammatory Transverse Myelitis post Pfizer-BioNTech-COVID-19 vaccine in 16-year-old

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