. In our case, the most probable etiology of the patient's multiple cranial neuropathy is the Pfizer-BioNTech vaccine, which highlights the need for prolonged surveillance of COVID-19 vaccine neurological complications. The facial (cranial) nerves, on the contrary, are anatomically closer to the vaccine injection site in humans (deltoid muscle). , Anand Patients generally experience. The results are given in eFigure 2 and eTables 4 through 7 in Supplement 1. Clipboard, Search History, and several other advanced features are temporarily unavailable. et al. GT, Chan Epub 2021 Nov 18. et al. YW, Hsu The TGA closely monitors reports of suspected side effects (also known as adverse events) to the Covid-19 vaccines. Dashed line indicates the point estimate of the overall effect; dotted line, no effect; diamond, overall effect. Case reports of acute transverse myelitis associated with mRNA vaccine for COVID-19. doi: 10.1001/jamanetworkopen.2022.8879. Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: a self-controlled case series study. Post COVID-19 vaccination-associated neurological complications. These conditions are called peripheral neuropathies. The .gov means its official. Pooling 4 phase 3 randomized clinical trials showed significantly higher BP in recipients of SARS-CoV-2 vaccines (77525 vaccine recipients vs 66682 placebo recipients; odds ratio [OR], 3.00; 95% CI, 1.10-8.18; I2=0%). Accepted for Publication: February 13, 2023. , Pothiawala et al. Nerve damage, including peripheral neuropathy Fatigue and post-exertional malaise Cognitive impairment/altered mental state Muscle, joint, and chest pain For the mRNA vaccine subgroup, there were significantly increased odds of BP in the vaccinated group compared with the placebo group (OR, 3.57; 95% CI, 1.09-11.67; I2=0%; Cochran Q P value=0.46). Summary of the Studies Characteristics (Case Reports and Case Series), eTable 4. The https:// ensures that you are connecting to the O, , Davidov MS, Kim , Klein C, Oliva Reporting of acute inflammatory neuropathies with COVID-19 vaccines: subgroup disproportionality analyses in VigiBase. It bases this determination on clinical trials that involved tens of thousands of participants. Epub 2022 Oct 14. K, Prasad The CDC reports that COVID-19 vaccines are safe. Bell Palsy Events in Groups of mRNA-Vaccinated Participants vs Unvaccinated Participants, With Data From Observational Studies, Figure 3. Novel Covid vaccines work on the premise of gene delivery and their long-term safety must be assessed if genetic vaccines were to be sustained beyond the CoViD-19 pandemic. Because of the high heterogeneity, a random-effects model was implemented, and a subgroup analysis was performed based on the study design (cohort or case-control study). JP, Thompson Rare Side Effects of COVID Vaccines Myocarditis and the COVID-19 Vaccines. However, for the viral vector vaccine subgroup, the analysis yielded insignificant results (OR, 1.80; 95% CI, 0.26-12.35; I2=0%; Cochran Q P value=0.89). RR indicates risk ratio; SIDIAP, Spanish database of Information System for Research in Primary Care. Updated 31 March 2021. , Singh , Ish Finsterer, J. Woo EJ, Winiecki SK, Ou AC. Reports of serious neurological events following COVID vaccination are rare. , Page The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. P, Moghadas A, Floridi The quality of the studies was evaluated by the Newcastle-Ottawa Scale. G. . Because this study found a strong association between the SARS-CoV-2 vaccine and BP in 4 RCTs, we conclude that BP is a result of SARS-CoV-2 vaccine exposure. , Peters The COVID-19 vaccine is an important tool that reduces illness and death from SARS-CoV-2, the virus responsible for the infection. Multimorbidity and adverse events of special interest associated with Covid-19 vaccines in Hong Kong. Vaccines for COVID-19. It can Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in Vaccine Adverse Event Reporting System (VAERS) [online]. A systematic search of MEDLINE (via PubMed), Web of Science, Scopus, Cochrane Library, and Google Scholar from the inception of the COVID-19 report (December 2019) to August 15, 2022. In rare cases, the following conditions have occurred after COVID-19 vaccination: One of the neuropathies with a link to the COVID-19 vaccine is GBS, a rare condition in which the immune system damages nerve cells. Vaccine Adverse Event Reporting System (VAERS) collected between January 1, 2021-June 14, 2021. Burrows A, Bartholomew T, Rudd J, Walker D. BMJ Case Rep. 2021 Jul 19;14(7):e243829. J, Chan eCollection 2023. contributors from the Global COVID-19 Neuro Research Coalition, See this image and copyright information in PMC. , Bardage We also asked whether BP occurrence is different among various types of SARS-CoV-2 vaccines, and whether it is different among SARS-CoV-2infected vs SARS-CoV-2vaccinated individuals. Additionally, the vaccines met the strict safety standards of the FDA. Therefore, the benefits outweigh the risks for most people, according to the review authors. P, Stahel SA, Althaqafi Thus, 34 records were excluded, and the remaining 50 records entered our study. R, Ripellino First, all records were screened using the title and abstracts. retinopathy, which is damage to the retina. , Viechtbauer IF-N. A persons symptoms, if they have any, could depend on the type of nerves that have the damage. R, Gujrati AH, et al; COVID-NET Surveillance Team. Several mechanisms have been considered to explicate the underlying pathophysiology of BP. Leave-One-Out Analysis for Observational Studies on mRNA Vaccines: Vaccinated vs Unvaccinated, eFigure 5. Safety and efficacy of single-dose Ad26.COV2.S vaccine against Covid-19. et al. Funnel Plot for Observational Studies on mRNA Vaccines: Vaccinated vs Unvaccinated, eFigure 6. R, Barnett T, Yang Y, Baker Minor to moderate side effects of Pfizer-BioNTech COVID-19 vaccine among Saudi residents: a retrospective cross-sectional study. J, Zhang GAC, de Oliveira SARS-CoV-2 infection posed a significantly greater risk for BP than SARS-CoV-2 vaccination. Peripheral neuropathy is rarely fatal. A, (B) Contrast enhancement in the intracisternal length of the trigeminal nerve (blue arrow). Adverse events of special interest and mortality following vaccination with mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines in Hong Kong: a retrospective study. WebThe damage to the nerves causes muscle weakness and sometimes paralysis. Association of Receipt of the Ad26.COV2.S COVID19 vaccine with presumptive GuillainBarre syndrome, FebruaryJuly 2021. Learn more here. The key words used were SARS-CoV-2 vaccine, COVID-19 vaccine, facial nerve palsy, and Bells palsy (eTable 1 in Supplement 1). FTT, Chua Learn more. Comparison of two methods to detect publication bias in meta-analysis. Most of the adults in UK are already vaccinated, therefore, early recognition of post-vaccine autoimmune conditions like GBS may help in offering early therapeutic interventions to those who are potentially affected with the condition that can help to prevent disease progression and chronic illness. K, Watanabe Incidence and characteristics of delayed injection site reaction to the mRNA-1273 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (Moderna) in a cohort of hospital employees. The most commonly reported symptoms of post- COVID-19 syndrome include: Fatigue Symptoms that get worse after physical or mental effort Fever Lung (respiratory) symptoms, including difficulty breathing or shortness of breath and cough Other possible symptoms include: muscle or joint pain. et al. JM. mRNA indicates messenger RNA; OR, odds ratio. . For the analysis from the study by Li et al,57 only the data obtained from the Spanish database of Information System for Research in Primary Care were used for data pooling, and the data from the UK were excluded because of database overlapping with the study by Patone et al.56 The odds of developing BP after receipt of the Pfizer/BioNTech vaccine compared with the Oxford/AstraZeneca vaccine were deemed insignificant (OR, 0.97; 95% CI, 0.82-1.15; I2=0%; Cochran Q P value=.67). R, Mishra When to seek help Contact your doctor as soon as possible or go directly to a hospital if you have: a reaction that you think is severe or unexpected shortness of breath chest pain swelling in your leg Feghali EJ, Challa A, Mahdi M, Acosta E, Jackson J. Kans J Med. Data Sharing Statement: See Supplement 2. L, Stefanou Ependymal cells in cerebrospinal fluid: A traumatic occurrence. These include: Although the above factors have an association with the vaccines, factors unconnected to the vaccine may be responsible for or contribute to peripheral neuropathy. et al. Organ damage could play a role. G, Schneider However, the rate of neurological events after acute SARS-CoV-2 infection was up to 617-fold higher than after COVID vaccination. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. M, Ewers This study has several limitations. L, Luo , Goh FN, Alay K, Cohen-Ezra No restriction on the study design, age of the participants, literature language, or any other factors was imposed. After internal reviews of the reports, the CDC "did not find any data suggesting a link between Covid-19 vaccines and tinnitus," an agency spokesperson said in an email. Since April 2021, some people have developed myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining outside the heart) after receiving the Pfizer-BioNTech or Moderna coronavirus vaccines in the United States, according to the U.S. V, DeStefano Disclaimer. It also discusses the vaccines safety and when to seek emergency treatment. Involvement of the motor nerves, which control muscle movement, may produce weakness or muscle cramps. MA. S. Inflammation and problems with the immune system can also happen. Statistical analysis: Rafati, Pasebani, Yang, Ilkhani, Rahimlou. DR, Thakur Leave-One-Out Analysis for Studies on SARS-Cov-2 Infections vs SARS-Cov-2 Vaccine, eFigure 8. Last, 4 overlapping studies reported on data retrieved from the Vaccine Adverse Event Reporting System (VAERS) database, of which 1 study59 was included with the highest quality score and the remainder were excluded.29,97,98 Similarly, 3 overlapping studies used the data obtained from the World Health Organization VigiBase database, 2 of which were excluded.99,100. , Mussatto -, Woo EJ, MbaJonas A, Dimova RB, et al. Y, Toda Warning. L, Chui April 9, 2021. A, Morrow Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection. Careers. et al. We utilized publicly available data from the U.S. VWS, WebCOVID-19 vaccines can cause mild side effects after the first or second dose, including: Pain, redness or swelling where the shot was given; Fever; Fatigue; Headache; Muscle pain; Cardiovascular complications of COVID-19 vaccines. The biodistribution of the vaccine to other nerves is not known as the study 514559 checked for sciatic nerves only being anatomically closer to the injection site (hind limb) in mice. P, Chen This systematic review and meta-analysis of pooled randomized clinical trials found that the incidence of BP was significantly higher in vaccine vs placebo recipients. KC. Rosenblum HG, Hadler SC, Moulia D, Shimabukuro TT, Su JR, Tepper NK, Ess KC, Woo EJ, Mba-Jonas A, Alimchandani M, Nair N, Klein NP, Hanson KE, Markowitz LE, Wharton M, McNally VV, Romero JR, Talbot HK, Lee GM, Daley MF, Mbaeyi SA, Oliver SE. RV, Brando The incidence of BP in those who received the Pfizer/BioNTech or Oxford/AstraZeneca vaccines did not differ significantly. Instead, they have reported the combined data, and their analyses were based on the events per vaccine dose and not based on the events per participant. T, Vainionp , Kaulen J, The occurrence of BP did not differ significantly between recipients of the Pfizer/BioNTech vs Oxford/AstraZeneca vaccines. optic neuritis, a swelling of the optic nerve. Long COVID: pathophysiological factors and abnormalities of coagulation. Bells palsy following COVID-19 vaccination: a case report. Because RCTs and major observational studies did not report treatment outcomes and recurrence, we were not able to draw a meaningful conclusion on whether there were any differences in the treatment outcome for BP with the SARS-CoV-2 vaccine, with SARS-CoV-2 infection, or in spontaneous cases. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was conducted with the random- and fixed-effect models using the Mantel-Haenszel method. Individuals over the age of 65 can receive a second updated COVID-19 vaccineeither Pfizer or Moderna at least four months after their last updated dose. NP, Lewis The MHRA pharmacovigilance database reported ~187 cases of sciatica post-Covid vaccine AZ as of 28th July 2021. An official website of the United States government. ML. Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of Concurrent facial and trigeminal nerve palsies in a child following COVID-19 vaccination with the Pfizer vaccine. Use of COVID-19 Vaccines After Reports of Adverse Events Among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices - United States, July 2021. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Corresponding Authors: Amir Kheradmand, MD, Department of Neurology, Johns Hopkins University, School of Medicine, 600 N Wolfe St, Path 2-210, Baltimore, MD 21287 (akherad@jhu.edu); Mehran Rahimlou, PhD, Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran (rahimlum@gmail.com). , Obermann MF, Multiple cranial nerve palsies with small angle exotropia following COVID-19 mRNA vaccination in an adolescent: A case report. Use of the inactivated intranasal influenza vaccine and the risk of Bells palsy in Switzerland. , Wan The analysis yielded insignificant results with no effect from individual studies (OR, 0.70; 95% CI, 0.42-1.16; I2=94%; Cochran Q P value<.001). Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-analysis. 2023 Apr 27:e230160. Bilateral facial nerve palsy and COVID-19 vaccination: causation or coincidence? Conflicts were resolved by joint discussions and the consensus of the authors. , Kamath Online ahead of print. FY, B. Surveillance for adverse events after COVID-19 mRNA vaccination. This heterogeneity could be attributable to different inclusion criteria or sampling methods. MC, Liaqat Adverse events of special interest following the use of BNT162b2 in adolescents: a population-based retrospective cohort study. Experts have said hearing loss can be caused by the immune system's inflammatory response to fight a illness, drugs to treat the illness or cell damage. , Zhou et al. Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. 8600 Rockville Pike Methods: It isn't clear how long these effects might last. Neurological events reported after COVID-19 vaccines: an analysis of VAERS. Unauthorized use of these marks is strictly prohibited. D. J, Walker
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