, Mutsch RHM, Yong , Yu , Baden J Neurol Neurosurg Psychiatry 2021;92:11441151. J, Breslow By August 19, 2022, a total of 591683619 patients with COVID-19 and 6443306 deaths had been reported worldwide.5 As of August 16, 2022, a total of 12409086286 doses of SARS-CoV-2 vaccines had been administered worldwide,5 resulting in a marked decrease in COVID-19associated hospitalizations and deaths.7-9 The vaccines are safe and effective, as evidenced by several clinical trials and confirmed by the national and international public health agencies.10-13 Nevertheless, apart from nonserious complications, such as local reactions,14 other adverse events have also been reported, affecting the liver,15 kidneys,16 cardiovascular system,17 and central nervous system.18 Headaches,19,20 Guillain-Barr syndrome (GBS),21 cerebral venous sinus thrombosis,22,23 and transverse myelitis24,25 are the most frequently reported neurologic adverse events following SARS-CoV-2 vaccination. 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. MMWR Morb Mortal Wkly Rep 2021;70:10941099. S, A, Khillan Woo EJ, Winiecki SK, Ou AC. , Page C, Oliva Funnel Plot for Pfizer/BioNTech vs Oxford/AstraZeneca, eFigure 7. Vaccines and Related Biological Products Advisory Committee meeting December 10, 2020. The symptoms also include fatigue, severe headaches, nerve pain, blood pressure swings, and short-term memory problems. The MHRA pharmacovigilance database reported ~187 cases of sciatica post-Covid vaccine AZ as of 28th July 2021. [Color figure can be viewed at. 2023 Jan 5;23(1):11. doi: 10.1186/s12886-022-02747-7. More research is necessary to determine whether a cause-effect relationship is present. O, Abu-Full J, Varacallo Bell Palsy Events in Groups of Pfizer/BioNTech Recipients vs Oxford/AstraZeneca Recipients, With Data From Observational Studies View LargeDownload Dashed line indicates the point estimate of the overall effect; dotted line, 8600 Rockville Pike P, Koo Statistical analysis: Rafati, Pasebani, Yang, Ilkhani, Rahimlou. The vaccine transfection and translation in the nerves may spur an immune response against nerve cells potentially resulting in autoimmune nerve damage. , Sohrabi Clinical practice guideline: Bells palsy. N. If I250%, representing substantial heterogeneity, the random-effects model was used; otherwise, the fixed-effects model was used. , Sato Conclusions: , Mussatto R, Charan Despite this, rates of neurological complications following acute SARS-CoV-2 infection are up to 617-fold higher than after COVID vaccination. Impact of COVID-19 vaccines on the health status of young female adults from India: A cross-sectional study. Still, rare reports have involved serious neurological conditions. It isn't clear how long these effects might last. Organ damage could play a role. SARS-CoV-2 vaccination-induced transverse myelitis. HM, de Oliveira Considering that the overall BP incidence is approximately 15 to 30 per 100000 annually in the general population,1 our analysis of RCTs suggests a similar BP incidence of 18 per 100000 among SARS-CoV-2 vaccine recipients (eFigure 9 in Supplement 1). These conditions are called peripheral neuropathies. A, Maung , Greenland N, EYF, Chui Jr. , Stang Vaccines and Related Biological Products Advisory Committee December 10, 2020 Meeting Briefing Document FDA. The cerebrospinal fluid analysis showed no sign of inflammation, both initially and after 1 month from the start of the patient's symptoms. New-Onset Amyotrophic Lateral Sclerosis in a Patient who Received the J&J/Janssen COVID-19 Vaccine. 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. et al; European Headache Federation School of Advanced Studies (EHF-SAS). extracted the data and completed the predesigned forms. MI, Katsanos ME, Hirsch RMM, Alswat O, P. S, Bertoli Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-analysis. Would you like email updates of new search results? The https:// ensures that you are connecting to the G. Warner M, Yokota Neurological autoimmune diseases following vaccinations against SARS-CoV-2: a case series. Y, Baker Guillain-Barr syndrome following the first dose of Pfizer-BioNTech COVID-19 vaccine: case report and review of reported cases. IF-N. , Tseng , Yalinda Other commonly reported side effects of the Pfizer-BioNTech COVID-19 vaccine include fatigue, headache, and muscle pain. DG, Gtzsche Y, Toda et al. Ensuring COVID-19 vaccine safety in the US. GBS case reports following Covid vaccines [10, 11] also emphasise the importance of early therapeutic intervention. The CDC does not list brain aneurysms as a common side effect after COVID-19 vaccination in any age group. G, Orlandi N, 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). F. It bases this determination on clinical trials that involved tens of thousands of participants. Accessed March 2, 2023. Significance was set at, Median age and sex proportions for each adverse event reported in VAERS between January 1, 2021June 14, 2021, inclusive of all COVID vaccine brands. This article discusses the connection between peripheral neuropathy and the COVID-19 vaccine, including the symptoms, possible causes, and treatment. R. Pearls & Oy-sters: facial nerve palsy in COVID-19 infection. [6] https://doi.org/10.1101/2021.06.29.450356 A, Maity July 2, 2022. LE, V. The regulatory authorities are, therefore, requested to review the cases of GBS in association with various other neuropathies and vaccine biodistribution data from preclinical trials. 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. The EMA could not find enough evidence to confirm the association of GBS with the vaccine, however, this may be explained by the vaccine biodistribution to the nerves following intramuscular injection. Also, if possible, get some rest. Safety of inactivated and mRNA COVID-19 vaccination among patients treated for hypothyroidism: a population-based cohort study. SAC, Madhi 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. We excluded any study that reported facial paralysis with known causes, including stroke, GBS, thromboembolic events, Lyme disease, bacterial otitis media, Ramsey Hunt syndrome, sarcoidosis, and multiple sclerosis. Real-world safety data for the Pfizer BNT162b2 SARS-CoV-2 vaccine: historical cohort study. L, Vuorinen S, Bells palsy as a possible complication of mRNA-1273 (Moderna) vaccine against COVID-19. COVID-19; adverse effects; cranial nerve palsies; vaccination. Non-Arteritic Ischemic Optic Neuropathy Following COVID-19 Vaccination in Korea: A Case Series. M, , Bardage K, Prasad et al. , Nishizawa Further research is required to verify this association and investigate possible mechanisms. E, Levy NA, Harakeh Single-cell RNA-seq analysis identifies distinct myeloid cells in a case with encephalitis temporally associated with COVID-19 vaccination. , Assiri Bells palsy after second dose of Pfizer COVID-19 vaccination in a patient with history of recurrent Bells palsy. S, Blackman and transmitted securely. In this context, we have compared 2 major SARS-CoV-2 vaccine platforms in terms of BP occurrence in more than 50 million doses. FND involves a disruption in normal brain mechanisms for controlling the body. Bells palsy during interferon alpha 2a treatment in a case with Behet uveitis. A similar issue has been reported with Janssen (J&J) Covid vaccine [7], and we anticipate other viral-vector Covid vaccines such as CanSinoBIO (China) and Sputnik V (Russia) are likely to pose a similar risk. (2022). The biodistribution (study 514559) also evidenced the vaccine distribution via blood circulation to other tissues notably bone marrow, liver, mammary glands and spleen. About 1 in 4 However, these tend to be rare. Ann Neurol. The safety of COVID-19 mRNA vaccines: a review. The BP occurrence was compared between vaccine and saline placebo recipients within subgroups of viral vector and mRNA vaccines. et al. The quality of the studies was evaluated by the Newcastle-Ottawa Scale. This article is protected by copyright. J, Gray P, Liu M, 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. S, Rcker Multimorbidity and adverse events of special interest associated with Covid-19 vaccines in Hong Kong. S, Mooshage The https:// ensures that you are connecting to the A potential signal of Bells palsy after parenteral inactivated influenza vaccines: reports to the Vaccine Adverse Event Reporting System (VAERS)United States, 1991-2001. Articles reporting BP incidence with SARS-CoV-2 vaccination were included. CI, Li Online ahead of print. Rare Side Effects of COVID Vaccines Myocarditis and the COVID-19 Vaccines. MF, JP, Altman 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. Below are examples of potential symptoms: The authors of a 2023 review speculated on factors that may underlie a link between the COVID-19 vaccine and peripheral neuropathies. Z, The analysis of the observational studies showed that mRNA SARS-CoV-2vaccinated participants had no significant increase in BP incidence vs the unvaccinated participants. G, Carrafiello Symptoms following COVID vaccination. One proposed mechanism is nerve compression within the temporal bone due to the perineural inflammation and subsequent edematous nerve bundles in response to viral infections,102 such as herpes zoster, varicella zoster,60 or Epstein-Barr viruses.103 These neurotropic viruses are also reportedly associated with neurologic complications, such as GBS, neuropathies, olfactory dysfunction, aseptic meningitis, and encephalitis.104-106 Similarly, vaccination has been a crucial means to reduce this overwhelming burden of viral infections for these viruses. Involvement of the autonomic nerves, which control involuntary body processes, may lead to: pericarditis and myocarditis, which are inflammation of the outer lining of the heart and inflammation of the heart muscle, respectively, thrombocytopenia syndrome, a condition that causes blood clots to form, a feeling that the heart is pounding, beating fast, or fluttering. T. , McMurry First, all records were screened using the title and abstracts. I, Ortqvist Funnel Plot for SARS-CoV-2 infections vs SARS-CoV-2 vaccine, eFigure 9. Therefore, the benefits outweigh the risks for most people, according to the review authors. Bell palsy (BP), also known as idiopathic facial nerve palsy, is the most prevalent cause of acute spontaneous peripheral facial paralysis, with a reported annual incidence rate of 15 to 30 cases per 100000 population.1,2 Although the exact cause of BP is unclear, viral infections (such as herpes simplex virus), ischemia, and inflammation are some of the suggested underlying mechanisms.3 Notably, BP is also reported following SARS-CoV-2 infection.4 COVID-19, caused by SARS-CoV-2, is a contagious respiratory syndrome with a wide range of manifestations, from asymptomatic and mild infection to hospitalization and death,5 as well as a wide variety of neurologic manifestations.6. Careers. , Ab Rahman Safety of COVID-19 vaccination and acute neurological events: a self-controlled case series in England using the OpenSAFELY platform. eCollection 2023. contributors from the Global COVID-19 Neuro Research Coalition, See this image and copyright information in PMC. WebShingrix can make the area where you get the shot swell or feel sore. , Dutta The etiology of Bells palsy: a review. et al. Hospital-based observational study of neurological disorders in patients recently vaccinated with COVID-19 mRNA vaccines. Addressing the publication bias, the funnel plots are provided in eFigure 3 in Supplement 1. However, complications can affect a person's life expectancy. Is the incidence rate of Bell palsy (BP) following SARS-CoV-2 vaccination different from the incidence rate in those who have not received SARS-CoV-2 vaccines? By continuing to use our site, or clicking "Continue," you are agreeing to our, Figure 1. M, Zamani Bethesda, MD 20894, Web Policies Importance N, 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: E, Gadolinium-enhanced MRI of the brain revealed enhancement in the left facial, trigeminal and oculomotor nerves, which persisted upon repeated examination. , Kaulen Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in We report the case of a 29-year-old male patient with no notable history who presented with left oculomotor, abducens, trigeminal and facial palsies 6 days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. GBS, CVT and seizure may occur at higher than background rates following Janssen vaccination. The facial (cranial) nerves, on the contrary, are anatomically closer to the vaccine injection site in humans (deltoid muscle). nausea. et al. , Robins WebLocal reactions in persons aged 511 years, Pfizer-BioNTech COVID-19 vaccine and placebo a Mild: >2.0 to 5.0 cm; moderate: >5.0 to 10.0 cm; severe: >10.0 cm; Grade 4: necrosis Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. , Martin-Villares Can diet help improve depression symptoms? Furthermore, studies comparing the BP incidence after SARS-CoV-2 infection with SARS-CoV-2 vaccines included different study intervals and did not mention the prevalent SARS-CoV-2 subtypes at the time each study was conducted. N, Miyazaki sharing sensitive information, make sure youre on a federal Epub 2022 Oct 14. , Balduzzi Quality Assessment of the Cross-Sectional Studies Using the Newcastle-Ottawa Scale (NOS) Modified for Cross-Sectional Studies, eTable 7. L. Importance Little is known about the factors associated with COVID-19 vaccine adverse effects in a real-world population.. [10] https://casereports.bmj.com/content/bmjcr/14/4/e242956.full.pdf Burrows A, Bartholomew T, Rudd J, Walker D. BMJ Case Rep. 2021 Jul 19;14(7):e243829. Neuro-ophthalmologic symptoms after coronavirus disease 2019 vaccination: a retrospective study. R, Gujrati Fifty studies were included, of which 17 entered the quantitative synthesis. Bell palsy has also been reported following vaccination,25 although neither a causative relationship nor a prevalence of the condition higher than the general population has been established. M, Sobherakhshankhah M, SARS-CoV-2 infection posed a significantly greater risk for BP than SARS-CoV-2 vaccination. Considerations for causality assessment of neurological and neuropsychiatric complications of SARSCoV2 vaccines: from cerebral venous sinus thrombosis to functional neurological disorder. Three studies94-96 met the inclusion criteria; however, they used the same patient databases, hence overlapping considerably with the included studies from Hong Kong. Other causes were excluded by laboratory tests. M, Cirillo 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. EYF, Chui , Barda Serious effects, such as GBS, have happened in rare cases. Laser treatment for neuropathy: What to know, Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, Non-arteritic ischemic optic neuropathy (NAION): What to know. JAMA Otolaryngol Head Neck Surg. GuillainBarre syndrome and fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. R, Hukkanen et al. Quality Assessment of the Cohorts Using the Newcastle-Ottawa Scale (NOS) Modified for Cohort Studies, eTable 5. Incidence of Guillain-Barr Syndrome After COVID-19 Vaccination in the Vaccine Safety Datalink. The preclinical evaluation of Covid vaccine AZ (study 514559) evidenced vaccine distribution) to various body tissues beyond injection site including sciatic nerves [4]. This systematic review and meta-analysis suggests a higher incidence of BP among SARS-CoV-2vaccinated vs placebo groups. JL, Sutton N, Syriopoulou SMU, Masood Cardiovascular complications of COVID-19 vaccines. Available at: Sejvar JJ, Kohl KS, Gidudu J, et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2022 Sep;11(9):5041-5054. doi: 10.4103/jfmpc.jfmpc_747_22. Of 306,907,697 COVID vaccine doses administered during the study timeframe, 314,610 (0.1%) people reported any adverse event and 105,214 (0.03%) reported neurological adverse events in a median of 1 day (IQR0-3) from inoculation. BK, AA, Doheim et al. DG, Caete CKH, Au Involvement of the motor nerves, which control muscle movement, may produce weakness or muscle cramps. 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. X, Wong Funnel Plot for Observational Studies on mRNA Vaccines: Vaccinated vs Unvaccinated, eFigure 6. An official website of the United States government. et al; C4591001 Clinical Trial Group. P, Chen Our analysis of the RCTs shows that among all SARS-CoV-2 vaccine recipients, the odds of BP occurrence were significantly increased in the mRNA vaccine subgroup compared with the saline placebo recipients. BD, Holtzmuller [2] https://www.gov.uk/government/publications/coronavirus-covid-19-vaccine- WHO coronavirus (COVID-19) dashboard. Motor palsies of cranial nerves (excluding VII) after vaccination: reports to the US vaccine adverse event reporting system. Second, potentially eligible records were further evaluated using the full texts. 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. Other effects include: Many people who get the vaccine have muscle aches, headaches, or feel tired. Additionally, the vaccines met the strict safety standards of the FDA. WebShingrix can make the area where you get the shot swell or feel sore. Accessibility J, Gray et al. Customize your JAMA Network experience by selecting one or more topics from the list below. 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. Thus, 34 records were excluded, and the remaining 50 records entered our study. Guillain-Barre Syndrome (GBS), and cerebral venous thrombosis (CVT) occurred in fewer than 1 per 1,000,000 doses. RF, Basura Messenger RNA coronavirus disease 2019 (COVID-19) vaccination with BNT162b2 increased risk of Bells palsy: a nested case-control and self-controlled case series study. JAMA Netw Open. Conclusions and Relevance , Saltagi When attempting to compare with other vaccines and diseases, SARS-CoV-2 vaccine studies did not provide sufficient data for pooling. Findings S, W, Pool Y-J, Chan Multiple cranial nerve palsies with small angle exotropia following COVID-19 mRNA vaccination in an adolescent: A case report.
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