, Sekiguchi 2013;2:38. All in all, these limitations may have affected heterogeneity among studies, leading to potential confounders for analysis. US Food and Drug Administration. Final analysis of efficacy and safety of single-dose Ad26.COV2.S. A review of the literature reveals several studies reporting BP occurrence following SARS-CoV-2 vaccination.28,29 The first documented case was in a 36-year-old woman with a previous history of BP who developed facial palsy 2 days after receiving the first dose of the Sinovac vaccine.30 Currently, it is not known whether BP incidence is associated with SARS-CoV-2 vaccination, because studies differ in their time intervals, vaccine types, follow-up periods, and methods. Published Online: April 27, 2023. doi:10.1001/jamaoto.2023.0160. , Li Reply to "VAERS Could Miss or Misinterpret Neurological Side Effects of COVID Vaccinations". FPNs Scientific Advisory Board Chairman, Dr. Ahmet Hoke of Johns Hopkins University, encourages patients to get the COVID-19 vaccine when offered. 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. First, all records were screened using the title and abstracts. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The collected literature indicated that the neurological side effects associated with SARS-CoV-2 vaccines included headache, transverse myelitis, Guillain-Barre W, Rhodes , Hanson As an adverse event of vaccination, BP is not only encountered with SARS-CoV-2 vaccines. Guillain-Barre Syndrome (GBS), and cerebral venous thrombosis (CVT) occurred in fewer than 1 per 1,000,000 doses. , Patone P, Koo A, Bergman Neurological side effects of SARS The symptoms also include fatigue, severe headaches, nerve pain, blood pressure swings, and short-term memory problems. N, Lim SG. , Martin-Villares [Peripheral facial palsy following COVID-19 vaccination: a case report]. We avoid using tertiary references. , Viechtbauer C. Other neurological side effects occur in a much lower frequency. N, Dagan The COVID-19 vaccine has some associations with Bells palsy. 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? Can COVID-19 vaccination lead to neurological complications? JH, Kim All 84 records were retrieved, and full texts were assessed in terms of eligibility for our study. Myocarditis and pericarditis after COVID-19 vaccination are rare. S, V, DeStefano Side Effects After Getting a COVID-19 Vaccine Dashed line indicates the point estimate of the overall effect; dotted line, no effect; diamonds, overall effects. optic neuritis, a swelling of the optic nerve. JL, Schultze Disclaimer. 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). , Yu Bells palsy after second dose of Moderna covid-19 vaccine: coincidence or causation? T, Rudd I, Calvit R, Barnett , Ozonoff Finsterer, J. Link between peripheral neuropathy symptoms and COVID vaccine Findings Because vaccination has been conducted globally, identifying the related short- and long-term adverse events is of great significance. C, Dessypris This stems from rare reports of people experiencing neuropathy symptoms after receiving one of the vaccines. , Castaldo Coronavirus (COVID-19) update: July 13, 2021. et al; contributors from the Global COVID-19 Neuro Research Coalition. C, Teoh Involvement of the motor nerves, which control muscle movement, may produce weakness or muscle cramps. et al. , Shasha COVID B, Patients generally experience. MA. Clipboard, Search History, and several other advanced features are temporarily unavailable. Adverse events of special interest following the use of BNT162b2 in adolescents: a population-based retrospective cohort study. 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. nerve We assessed the quality of included studies and evaluated the risk of bias using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies, self-controlled case series (SCCSs), case-control studies, and cohort studies (studies with an overall score of 7 points were considered high quality)32,33 and the Cochrane assessment tool for RCTs (classifying studies as unclear, low risk, or high risk).34 Two independent researchers (M.A. Adverse events following mRNA SARS-CoV-2 vaccination among U.S. nursing home residents. RR indicates risk ratio; SIDIAP, Spanish database of Information System for Research in Primary Care. Y, Beh . 2022 Feb;43(2):755-761. doi: 10.1007/s10072-021-05733-x. M, Anglin Y, Hoshina P, Chen A, Tazare 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. , Hls , Taylor Fifty studies were included, of which 17 entered the quantitative synthesis. 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). Unable to load your collection due to an error, Unable to load your delegates due to an error, Images were acquired by use of T1weighted, contrastenhanced MPRAGE TRA ISO sequences, in the axial plane. O, Barzegar (2022). Evaluation of prognostic factors in patients with Bells palsy. It isn't clear how long these effects might last. Our search also included review publications, editorials, letters to editors, and conference papers, as well as the references of all the studies included. Y, Toda Covid vaccine injury et al. Still, rare reports have involved serious neurological conditions. Affiliations, Neurological adverse events per 1,000,000 vaccine doses reported in VAERS stratified by COVID vaccine type. Vaccines and Related Biological Products Advisory Committee December 10, 2020 Meeting Briefing Document FDA. retinopathy, which is damage to the retina. FTT, Huang Involvement of the motor nerves, which control muscle movement, may produce weakness or muscle cramps. Association of facial paralysis with mRNA COVID-19 vaccines: a disproportionality analysis using the World Health Organization pharmacovigilance database. DG, Gtzsche 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. B, Li To compare the incidence of BP in SARS-CoV-2 vaccine recipients vs unvaccinated individuals or placebo recipients. 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. Vaccine Adverse Event Reporting System (VAERS) [online]. I, 2023 Apr 18:S1043-2760(23)00055-3. doi: 10.1016/j.tem.2023.03.002. M, Koutsokera FH, J AAPOS. In the viral vector vaccine subgroup, however, no such significant difference was observed. Real-world safety data for the Pfizer BNT162b2 SARS-CoV-2 vaccine: historical cohort study. Of these, 180 were removed because they were duplicate records. , McMurry Gadolinium-enhanced MRI of the brain revealed enhancement in the left facial, trigeminal and oculomotor nerves, which persisted upon repeated examination. P. A, Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. The CARE guidelines: consensusbased clinical case reporting guideline development. (B) Contrast enhancement in the intracisternal length of the trigeminal nerve (blue arrow). G, Orlandi et al; European Headache Federation School of Advanced Studies (EHF-SAS). 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. LR, Essink et al. S, Kaur Three of the 5 RCTs had a low risk of bias,35-37 and 2 were unclear38,58 in the criterion D5: detection bias of the Cochrane assessment tool but were low risk in the rest of the criteria. EB, Dellis E, X. Safety and efficacy of COVID-19 vaccines: a systematic review and meta-analysis of different vaccines at phase 3. EMA has advised people to seek immediate medical attention if they develop weakness and paralysis in the extremities progressing to the chest or face following the Covid vaccine. Case reports of acute transverse myelitis associated with mRNA vaccine for COVID-19. KTK, Xiong Administrative, technical, or material support: Yang. British Man Died of Rare Blood Syndrome Linked to AstraZenecas Y, Tsaraf S, Robins B, Results: Several mechanisms have been considered to explicate the underlying pathophysiology of BP. Accessibility Epub 2022 Oct 14. Is it possible to die from peripheral neuropathy? fever. Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. N. -. A, Iwatsubo WebMultiple cranial nerve palsies following COVID-19 vaccination-Case report In our case, the most probable etiology of the patient's multiple cranial neuropathy is the Pfizer-BioNTech The risk of developing BP subsequent to SARS-CoV-2 infection significantly surpassed the risk of developing BP after receipt of the SARS-CoV-2 vaccine (RR, 3.23; 95% CI, 1.57-6.62; I2=95%; Cochran Q P value<.001). GBS is a rare but serious condition in which the immune system starts attacking the bodys healthy nerve cells in the peripheral nervous system that can result in pain, numbness, muscle weakness usually in the feet, hands and limbs) that can also spread to the chest and the face. Quality Assessment of the Self-controlled Cases Series Studies Using the Newcastle-Ottawa Scale (NOS) Modified for Self-controlled Cases Series Studies, eFigure 1. COVID-19: Long-term effects - Mayo Clinic GBS causes inflammation of the nerves and can lead to numbness, weakness and pain, usually in the feet, hands and limbs and can spread to the chest and face. P, Liu M, SARS-CoV-2 vaccines (mRNA and viral vector) in the analysis of RCTs demonstrated significantly increased odds of developing BP vs placebo. Not all of the studies have split the results of the first and second vaccine doses. 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. et al. H, Kim Systematic Search Syntax for Databases With Results as of August 15, 2022, eTable 3. In rare cases, coronavirus vaccines may cause Long Covid CSL, Lai et al. S. -. Cardiovascular complications of COVID-19 vaccines. Use of COVID19 vaccines after reports of adverse events among adult recipients of Janssen (Johnson & Johnson) and mRNA COVID19 vaccines (PfizerBioNTech and Moderna): update from the advisory committee on immunization practices United States, July 2021. Neurological side effects of SARS-CoV-2 vaccinations. SK. The study participants were individuals who had undergone SARS-CoV-2 vaccination with all widely administered SARS-CoV-2 vaccine platforms, including mRNA, viral vector, inactivated, and protein subunit. VWS, , Falsey The observed-to-expected ratios for GBS, CVT and seizure following Janssen vaccination were 1.5-fold higher than background rates. et al. The incidence of BP in those who received the Pfizer/BioNTech or Oxford/AstraZeneca vaccines did not differ significantly. et al. Selected Adverse Events Reported after COVID-19 Vaccination Bouattour N, Hdiji O, Sakka S, Fakhfakh E, Moalla K, Daoud S, Farhat N, Damak M, Mhiri C. Neurol Sci. , Danza Critical revision of the manuscript for important intellectual content: Rafati, Pasebani, Melika Jameie, Yang, Mana Jameie, Sakhaei, Rahimlou, Kheradmand. This limitation hampered our ability to perform subgroup analyses based on parameters such as age, sex, vaccine dose, or vaccination-to-event time span. Accessed July 1, 2022. TN, Sah 2023 Healthline Media UK Ltd, Brighton, UK. Use or keep moving your arm. 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, sharing sensitive information, make sure youre on a federal , Barda MNT is the registered trade mark of Healthline Media. C, Sun G, Gil Daz Published by John Wiley & Sons Ltd. , Goh In rare cases, serious side effects occur. Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-analysis. 2023 American Medical Association. ML. Vaccines for COVID-19. Y, Khurana doi: 10.3346/jkms.2023.38.e95. Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of J, Walker Surprisingly, as of 28th July 2021, there are 77 cases of transverse myelitis, 16 cases of myelitis and another 13 cases of encephalomyelitis following Covid vaccine AZ in the MHRA database. , Frontera A, Maity 2014;10:301. Data Sharing Statement: See Supplement 2. J Family Med Prim Care. Neurological complications after first dose of COVID-19 - Nature Article in French. M, Clemens Among them, 17 records overlapped other studies, 9 records were commentaries and corrections on other articles, and 8 did not meet the inclusion criteria. D. Bell's Palsy and COVID-19 Vaccines: A Systematic Review and Meta-Analysis. , Liu Incidence Proportion of Bells palsy after SARS-CoV-2 Vaccines (Derived From RCTs). , Fan WebBackground. J, Last medically reviewed on March 30, 2023, This Special Feature gives tips about dealing with COVID-19 vaccine side effects, including which home care techniques can help and when to contact a, The majority of cases of neuropathy, often referred to as peripheral neuropathy, affect the motor and sensory nerves. The facial (cranial) nerves, on the contrary, are anatomically closer to the vaccine injection site in humans (deltoid muscle). Importantly, although this study shows evidence of increased BP incidence following SARS-CoV-2 vaccination compared with placebo receipt, SARS-CoV-2 infection was associated with a 3.23-fold increase in BP incidence.
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