All Rights Reserved, Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine, Published online April 27, 2023. doi:10.1001/jamaoto.2023.0160. 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. , Yu Final analysis of efficacy and safety of single-dose Ad26.COV2.S. 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. To the best of our knowledge, this is the first systematic review and meta-analysis addressing the incidence of BP subsequent to SARS-CoV-2 vaccination. Our search also included review publications, editorials, letters to editors, and conference papers, as well as the references of all the studies included. 2023 Feb 23;14:998233. doi: 10.3389/fimmu.2023.998233. The collected literature indicated that the neurological side effects associated with SARS-CoV-2 vaccines included headache, transverse myelitis, Guillain-Barre VK, Peixoto T. Despite the possible side effects, the vaccine is safe. This rate is comparable with the previous reports55,57 with an incidence of 19 or lower per 100000 population after SARS-CoV-2 vaccination. performed the risk of bias assessment, and conflicts were resolved via consensus. OR indicates odds ratio; SIDIAP, Spanish database of Information System for Research in Primary Care. F. et al. et al; contributors from the Global COVID-19 Neuro Research Coalition. It also discusses the vaccines safety and when to seek emergency treatment. The third section compared the odds of BP in Pfizer/BioNTech vs Oxford/AstraZeneca recipients. Vaccine 2011;29:599612. 2020. Because both subgroups showed high heterogeneity, the leave-1-out analysis was performed, which showed that 1 study42 mainly contributed to the heterogeneity (eFigure 4 in Supplement 1). 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. , Sohrabi All in all, these limitations may have affected heterogeneity among studies, leading to potential confounders for analysis. While the K, , Vilches Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. , Tseng , Gupta A, Khillan FTT, Emergency use authorization review memorandum for the Pfizer-BioNTech COVID-19 vaccine/BNT162b2. , Iftikhar Learn more. Incidence of Guillain-Barr Syndrome After COVID-19 Vaccination in the Vaccine Safety Datalink. Cerebral venous sinus thrombosis and thrombotic events after vector-based COVID-19 vaccines: a systematic review and meta-analysis. 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). We avoid using tertiary references. P, Ghidossi Bells palsy after second dose of Moderna covid-19 vaccine: coincidence or causation? M, Mansourabadi et al. , Huang Neurological events reported after COVID-19 vaccines: an analysis of VAERS. July 2, 2022. B, Kochan Kizilkilic eCollection 2023. No restriction on the study design, age of the participants, literature language, or any other factors was imposed. 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. 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. sharing sensitive information, make sure youre on a federal 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). J, Zhang This site needs JavaScript to work properly. 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? You can learn more about how we ensure our content is accurate and current by reading our. Discrepancies were dealt with through the consensus of 2 authors (A.R. Federal government websites often end in .gov or .mil. AK, (B) Contrast enhancement in the intracisternal length of the trigeminal nerve (blue arrow). The symptoms also include fatigue, severe headaches, nerve pain, blood pressure swings, and short-term memory problems. BMJ Case Rep. 2023 Jan 30;16(1):e253302. et al. BD, Holtzmuller Abara WE, Gee J, Marquez P, Woo J, Myers TR, DeSantis A, Baumblatt JAG, Woo EJ, Thompson D, Nair N, Su JR, Shimabukuro TT, Shay DK. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in Y. April 9, 2021. WI, Huang A persons symptoms, if they have any, could depend on the type of nerves that have the damage. EYF, Chui Interpretation: 2022 Mar;145(3):375. doi: 10.1111/ane.13561. Who Is Eligible for a Second Bivalent Booster? This contrasts markedly with the dangers of a severe COVID-19 infection. Glob Adv Heal Med. GBS is rare. Available at: Sejvar JJ, Kohl KS, Gidudu J, et al. COVID-19-associated hospitalizations among adults during SARS-CoV-2 Delta and Omicron variant predominance, by race/ethnicity and vaccination statusCOVID-NET, 14 states, July 2021-January 2022. The BP diagnosis was determined based on the neurologist-confirmed clinical criteria and/or the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, as mentioned by each study. Incidence Proportion of Bells palsy after SARS-CoV-2 Vaccines (Derived From RCTs). , Polack Bilateral facial nerve palsy and COVID-19 vaccination: causation or coincidence? https://imagebank.hematology.org/image/60670/ependymalcellsincerebros NCI CPTC Antibody Characterization Program. R, Gujrati Learn more here. 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. Bethesda, MD 20894, Web Policies The authors declare they have no conflicts of interests. , Eom E, O, Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. The outcome of interest was BP occurring as an adverse event in the time frame after the vaccination or the respective time frame in the placebo recipients or unvaccinated matched participants. Ann Clin Lab Sci. et al. W, Rhodes Bells palsy after second dose of Pfizer COVID-19 vaccination in a patient with history of recurrent Bells palsy. A, Iwatsubo Jr, Kitchin Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of Rafati A, Pasebani Y, Jameie M, Yang Y, Jameie M, Ilkhani S, Amanollahi M, Sakhaei D, Rahimlou M, Kheradmand A. JAMA Otolaryngol Head Neck Surg. Serious adverse reaction associated with the COVID-19 vaccines of BNT162b2, Ad26.COV2.S, and mRNA-1273: Gaining insight through the VAERS. Reuters, "COVID vaccine injury plaintiffs face long odds in U.S. compensation program," June 16, 2022 Federal Aviation Administration statements, April 27 and April 28, 2023 [8] https://assets.publishing.service.gov.uk/government/uploads/system/uploa The facial (cranial) nerves, on the contrary, are anatomically closer to the vaccine injection site in humans (deltoid muscle). H, Kim Conclusions and Relevance Link between peripheral neuropathy symptoms and COVID vaccine DR, Thakur et al. T, Vainionp In the second section, all observational studies39-46comparing BP in mRNA vaccine recipients and the unvaccinated matched individuals were investigated. COVID-19 vaccination of individuals with Down syndromedata from the Trisomy 21 Research Society Survey on safety, efficacy, and factors associated with the decision to Be vaccinated. B, Terms of Use| MMWR Morb Mortal Wkly Rep 2021;70:10941099. , Palaiodimou Before IF-N. Bookshelf Bias and efficiency of meta-analytic variance estimators in the random-effects model. The reporting completeness of a passive safety surveillance system for pandemic (H1N1) 2009 vaccines: a capture-recapture analysis. Data Sharing Statement: See Supplement 2. . While it offers valuable benefits, it can cause side effects, including neuropathic symptoms such as tingling and burning. N, Doan J, Varacallo Comparison of two methods to detect publication bias in meta-analysis. A, This study followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).31 The study protocol has been registered with PROSPERO (CRD42022313299). Funnel Plot for SARS-CoV-2 infections vs SARS-CoV-2 vaccine, eFigure 9. Some people experience side effects such as tiredness, fever, and headaches after getting a COVID-19 vaccine, but these usually disappear within a few days. All rights reserved. Of the excluded studies, 3 records91-93 were the reports of preliminary results of the major SARS-CoV-2 vaccine phase 3 clinical trials, of which the records reporting the final analyses were included instead. ED GBS case reports following Covid vaccines [10, 11] also emphasise the importance of early therapeutic intervention. NP, Lewis E, Einan-Lifshitz This systematic review and meta-analysis suggests a higher incidence of BP among SARS-CoV-2vaccinated vs placebo groups. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. , El-Shitany Last week, the U.S. Centers for Disease Control and Prevention said it had not found a link between heart inflammation and COVID-19 vaccines. Inflammation Neurological complications after first dose of COVID-19 - Nature et al; COVID-NET Surveillance Team. GAC, de Oliveira Accessed March 2, 2023. [4] https://assets.publishing.service.gov.uk/government/uploads/system/uploa [5] https://www.statnews.com/2020/09/09/astrazeneca-covid19-vaccine-trial-ho Incidence of Guillain-Barr syndrome after COVID-19 vaccination in the Vaccine Safety Datalink. T, Yang , Xiong Leave-One-Out Analysis for Observational Studies on mRNA Vaccines: Vaccinated vs Unvaccinated, eFigure 5. N, Taneja The analysis of the observational studies showed that mRNA SARS-CoV-2vaccinated participants had no significant increase in BP incidence vs the unvaccinated participants. World J Clin Cases. After removing duplicate records, 2 independent researchers (Y.P. A. G, Gil Daz N, Koorapati CSL, Ng Among them, 17 records overlapped other studies, 9 records were commentaries and corrections on other articles, and 8 did not meet the inclusion criteria. 8600 Rockville Pike N, Dagan Meaning Bells palsy following COVID-19 vaccination: a case report. S, Ish Other causes were excluded by laboratory tests. Updated 31 March 2021. HM, Essink Conflicts were resolved by joint discussions and the consensus of the authors. April 20, 2023. M, Rezaei , Shemer Estimators of the Mantel-Haenszel variance consistent in both sparse data and large-strata limiting models. , Kupila government site. Motor palsies of cranial nerves (excluding VII) after vaccination: reports to the US vaccine adverse event reporting system. K, Prasad doi: 10.1001/jamanetworkopen.2022.53845. I, Calvit Instead, the virus mRNA in the vaccines might interact with the immune cellular membranes and elicit an innate immune response,107 which in turn may trigger BP, similar to the cases reported with interferon treatment.115,116. eCollection 2022. Data Sources Quality Assessment of the Randomized Controlled Trials Using the Cochrane Risk of Bias (ROB1) Tool, eFigure 3. Acute abducens nerve palsy following COVID-19 vaccination. SA, Althaqafi In the United States, health oversight agencies will continue to monitor the Pfizer-BioNTech, Moderna, Johnson & Johnson/Janssen, and Novavax COVID-19 vaccines. , Yagi Claim: A scientific study "confirmed" that the Pfizer vaccine causes neurological damage. [Peripheral facial palsy following COVID-19 vaccination: a case report]. 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). Association of clinical and epidemiological characteristics with COVID-19 BNT162b2 mRNA vaccine short-term adverse reactions in healthcare workers. Dashed line indicates the point estimate of the overall effect; dotted line, no effect; diamonds, overall effects. Bells palsy, a weakness or paralysis affecting one side of the face. Before C, Dessypris Ann Neurol. Autoimmune damage to the nerves following Covid vaccines: EMA (2022). COVID-19 Vaccine and Your Eyes - Healthline F. KTK, Xiong Background: WebBackground. Clinical practice guideline: Bells palsy. Likewise, the case-control studies39,40 yielded a nonsignificant result (OR, 1.37; 95% CI, 0.64-2.90; I2=54%; Cochran Q P value=.14). Addressing the publication bias, the funnel plots are provided in eFigure 3 in Supplement 1. SM, et al. E, Ziaei P. RJ, Kotilainen Organ damage could play a role. F, Zhao What are the signs and symptoms of neuropathy? We urge regulatory authorities to mandate manufacturers to perform adequate biodistribution studies on vaccine formulations and request further data to better understand the implications of vaccine transfection in distant tissues before mass vaccine rollout in children or recommending additional adult booster doses. MA. Dentists: Unexplained Pain, Tooth Loss and Bone Problems May Be , Mason FN, Alay Before business owner and busy mom Alana Parker experienced severe oral pain and facial swelling after receiving Pfizers COVID-19 vaccine in 2021, she had good dental health with never so much as a cavity. Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure, Activity 'snacks' could lower blood sugar, complication risk in type 1 diabetes, In Conversation: Investigating the power of music for dementia, COVID-19 vaccine: What to do about side effects. G, Carrafiello (2022). , Dutta et al. JAMA Netw Open. K, Lewis 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. Impact of COVID-19 vaccines on the health status of young female adults from India: A cross-sectional study. J, Haeberle The biodistribution (study 514559) also evidenced the vaccine distribution via blood circulation to other tissues notably bone marrow, liver, mammary glands and spleen. 2022 May;52(3):511-525. MF, coronavirus M. , Lim 2022. 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. Learn more about the link between the COVID-19 vaccine and Bells palsy. Recently, vaccine distribution to the vasculature and interaction with circulatory platelets have been proposed as a likely mechanism for thrombosis with thrombocytopenia syndrome (TTS) [6]. M, Zamani Cardiovascular complications of COVID-19 vaccines. Organ damage could play a role. Single-cell RNA-seq analysis identifies distinct myeloid cells in a case with encephalitis temporally associated with COVID-19 vaccination. The novel COVID-19 vaccines have side effects that require efficient and close monitoring. The Egger test yielded a P value of .64; hence, no publication bias was present. Safety of quadrivalent meningococcal conjugate vaccine in 11- to 21-year-olds. We utilized publicly available data from the U.S. 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. Dotted line indicates no effect; diamond, overall effect. Epub 2021 May 24. The quality of the studies was evaluated by the Newcastle-Ottawa Scale. F, Iskander N, , Viechtbauer 2022 Jul;92(1):157-158. doi: 10.1002/ana.26369. , Tamaki Bells palsy following the Ad26.COV2.S COVID-19 vaccination. Because vaccination has been conducted globally, identifying the related short- and long-term adverse events is of great significance. Multimorbidity and adverse events of special interest associated with Covid-19 vaccines in Hong Kong. July 2, 2022. B. DG, Gtzsche We compared a total of 2822072 SARS-CoV-2infected individuals with 37912410 SARS-CoV-2 vaccine recipients regarding the occurrence of BP41,55-57 (Figure 4). 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. See this image and copyright information in PMC. MT, Lee JO. Patients generally experience. Please enable it to take advantage of the complete set of features! LAQ, Dos Santos optic neuritis, a swelling of the optic nerve. Burrows A, Bartholomew T, Rudd J, Walker D. BMJ Case Rep. 2021 Jul 19;14(7):e243829. [Color figure can be viewed at, Median time (days) from vaccine injection to adverse event onset, inclusive of all COVID vaccine types, and proportion of events which were reported after the first or second dose of a mRNA vaccine (using data available in 235,293/275,575 [85%] of patients who received either Pfizer or Moderna vaccines). A 32-year-old psychologist in Britain developed blood clots and died 10 days after he took his first dose of AstraZenecas Covid Concurrent facial and trigeminal nerve palsies in a child following COVID-19 vaccination with the Pfizer vaccine. A, Bartholomew AA, Doheim The key words Left Bells palsy following the first dose of mRNA-1273 SARS-CoV-2 vaccine: a case report. A, Cabrera , Gonzlez-Enrquez et al. CI, Li Guillain-Barr syndrome and vaccines. 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. It is worth noting that the Covid vaccine AZ clinical trials were paused twice and, on both occasions, the trial subjects developed a neurological condition, transverse myelitis. FOIA Safety and efficacy of COVID-19 vaccines: a systematic review and meta-analysis of different vaccines at phase 3. COVID B, , Hls SI, 2022 Jul;92(1):158. doi: 10.1002/ana.26372. NA, Harakeh MS, Kim Inflammation and problems with the immune system can also happen. Based on the high morbidity and unpredictable course of COVID-19, and the need to achieve herd immunity, vaccination has been recommended for patients with MS. A summary of the inclusion process is represented in a PRISMA flow diagram in eFigure 1 in Supplement 1. Our search also included review publications, editorials, letters to editors, and conference papers, as well as the references of all the studies included. , Goh Published Online: April 27, 2023. doi:10.1001/jamaoto.2023.0160. A, Maity FND involves a disruption in normal brain mechanisms for controlling the body. doi: 10.1001/jamaoto.2023.0160. . Symptoms following COVID vaccination. Zhang BH, Gravenstein N, References , Poudel [6] https://doi.org/10.1101/2021.06.29.450356 Jacobson WebShingrix can make the area where you get the shot swell or feel sore. The detailed tissue-specific distribution of mRNA vaccines encoding SARS-CoV-2 spike proteins (Pfizer or Moderna) is not fully known that could offer invaluable insights into the long-term safety of mRNA vaccines. Sequential contralateral facial nerve palsies following COVID-19 vaccination first and second doses. EB, Dellis et al. Phase 3 safety and efficacy of AZD1222 (ChAdOx1 nCoV-19) COVID-19 vaccine. MH, Unable to load your collection due to an error, Unable to load your delegates due to an error, Collaborators, By July 13, 2021, healthcare professionals had administered 12.5 million vaccine doses and reported only 100 cases of GBS. Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-analysis. muscle or joint pain. V. SAC, Madhi Would you like email updates of new search results? In the first section, 4 studies35-38 corresponding to the phase 3 RCTs of the major SARS-CoV-2 vaccines (ie, Pfizer/BioNTech, Moderna, Janssen, and Oxford/AstraZeneca) were evaluated. G, Schneider SM, The records that did not meet the preestablished eligibility criteria were excluded. Bells palsy during interferon alpha 2a treatment in a case with Behet uveitis. Quality Assessment of the Self-controlled Cases Series Studies Using the Newcastle-Ottawa Scale (NOS) Modified for Self-controlled Cases Series Studies, eFigure 1. , Balduzzi Since the vaccines were rolled out, Hartsfield has seen an exponential increase in patients with head and facial neurovascular and myofascial pain, including headaches, toothaches not caused by the tooth, osteonecrosis of the jaw, sleep issues, tinnitus, and oral and facial autoimmune conditions. Subsequently, for sections 3 and 4, the metagen function was used to pool the measures of effect (OR and RR with the corresponding 95% CIs). N, Syriopoulou , Noseda J, N. R, Ceschi , Voysey , Wan doi: 10.3346/jkms.2023.38.e95. Covid Two independent researchers (Mana Jameie and S.I.) D, Sullivan GBS, CVT and seizure may occur at higher than background rates following Janssen With a high heterogeneity, a random-effects model was used, and a leave-1-out analysis was performed, which showed that 1 study57 mainly contributed to the heterogeneity (eFigure 7 in Supplement 1). Sequential contralateral facial nerve palsies following COVID-19 vaccination first and second doses. Facial paralysis following influenza vaccination: a disproportionality analysis using the Vaccine Adverse Event Reporting System Database. Despite this, rates of neurological complications following acute SARS-CoV-2 infection are up to 617-fold higher than after COVID vaccination. According to the Centers for Disease Control and Prevention (CDC), GBS has occurred after people received the Johnson and Johnson (Janssen) vaccine but not after the Pfizer-BioNTech or Moderna vaccine. Cerebral venous sinus thrombosis after mRNA-based COVID-19 vaccination. Main Outcomes and Measures 2023 Mar 27;38(12):e95. 2013;2:38. N, Fayad The cerebrospinal fluid analysis showed no sign of inflammation, both initially and after 1 month from the start of the patient's symptoms. HHS Vulnerability Disclosure, Help COVID-19: Long-term effects - Mayo Clinic Bell's Palsy and COVID-19 Vaccines: A Systematic Review and Meta-Analysis. , Lai To address this issue, we conducted a systematic review and meta-analysis of studies reporting BP following SARS-CoV-2 vaccination to examine whether SARS-CoV-2 vaccination is associated with a higher incidence of BP compared with unvaccinated or placebo-vaccinated individuals. S, Badr-Eldin 10.1136/bcr-2021-243829 S. T, Wu Y, Kyoya Accessibility This article discusses the connection between peripheral neuropathy and the COVID-19 vaccine, including the symptoms, possible causes, and treatment. One of the subjects was later diagnosed with multiple sclerosis [5], declared unrelated to the vaccine. M, Lai The occurrence of BP did not differ between recipients of the Pfizer/BioNTech and Oxford/AstraZeneca vaccines, and there was a greater risk of BP with SARS-CoV-2 infection compared with SARS-CoV-2 vaccination. This study has several limitations. 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). Other effects include: Many people who get the vaccine have muscle aches, headaches, or feel tired. Accessed July 1, 2022. JAMA Otolaryngol Head Neck Surg. JH, Kim et al; C4591001 Clinical Trial Group. , Finsterer Objective To evaluate factors potentially associated with participant-reported adverse effects after COVID-19 vaccination.. Design, Setting, and Participants The COVID-19 Citizen Science Study, an online cohort study, The outcomes of interest were to compare BP incidence among (1) SARS-CoV-2 vaccine recipients, (2) nonrecipients in the placebo or unvaccinated cohorts, (3) different types of SARS-CoV-2 vaccines, and (4) SARS-CoV-2infected vs SARS-CoV-2vaccinated individuals. K, Cohen-Ezra The 50 included studies comprised 22 case reports and case series,30,60-80 2 SCCSs,54,81 2 case-control studies,39,40 3 cross-sectional studies,55,82,83 16 cohort studies,41-46,56,57,59,84-90 and 5 RCTs.35-38,58 A summary of the characteristics of the included studies is represented in the Table (case reports and case series are summarized in eTable 3 in Supplement 1) and detailed in eTable 2 in Supplement 1. The CDC does not list brain aneurysms as a common side effect after COVID-19 vaccination in any age group. 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. 2023 Feb 1;6(2):e2253845. Who Is Eligible for a Second Bivalent Booster?
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