ADEM after ChAdOx1 nCoV-19 vaccine: A case report

Abstract

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system (CNS), clinically defined by an acute polyfocal neurological syndrome usually with monophasic course. ADEM often occurs after infections, but 5%–10% of cases are preceded by vaccinations. Several cases of ADEM have been described after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, whereas no case has been reported after adenovirus-vectored or mRNA COVID-19 vaccine administration. Here we describe a case of ADEM presenting 2 weeks after receiving the first dose of ChAdOx1 nCoV-19 vaccine. Patient clinical/magnetic resonance imaging (MRI) status spontaneously improved and rapidly resolved with corticosteroids. A 4-month follow-up showed complete recovery and no relapses.

An 88-year-old woman with acute disseminated encephalomyelitis following messenger ribonucleic acid-based COVID-19 vaccination

“…As the new COVID-19 vaccines have been administered to a wide range of age groups, it is possible that ADEM could occur following COVID-19 vaccination at any age. To the best of our knowledge, there have been two published reports of ADEM following mRNA COVID-19 vaccination and two reports following other types of COVID-19 vaccination ( Table 1 ) [ [4] , [5] , [6] , [7] ].…”

“…The rare occurrence of ADEM, a treatable complication, following COVID-19 vaccination does not detract from the public health imperative to vaccinate against COVID-19. Even the rare cases that have been reported were found to have favorable outcomes [ [4] , [5] , [6] , [7] ]. However, clinicians should be aware that ADEM can potentially occur following mRNA-based COVID-19 vaccination, even among older adults.…”

Case Series: Acute Hemorrhagic Encephalomyelitis After SARS-CoV-2 Vaccination

“…On the one hand, isolated cases of potential acute disseminated encephalomyelitis, ADEM, which is a rare autoimmune event potentially occurring after an immunological challenge, such as a vaccination, have been linked to COVID-19 vaccines (7)(8)(9)(10)(11). On the other hand, COVID-19 itself has been associated with cases of hyperacute hemorrhagic variants of ADEM (acute hemorrhagic encephalomyelitis, AHEM, Weston-Hurst syndrome or acute hemorrhagic leukoencephalitis, AHLE) (12)(13)(14)(15)(16). We now report three cases of AHEM occurring in the context of COVID-19 vaccination, namely within 9 days after the first shot of ChAdOx1 nCoV-19.…”

Fighting Fire with Fire: Immunogenicity of Viral Vectored Vaccines against COVID-19

“…This decrease in incidence hints that vector immunity may mitigate certain vaccine-induced adverse reactions. Besides VITT, rare neurological disorders including acute transverse myelitis, acute disseminated encephalomyelitis, and Guillain-Barré syndrome have also been associated with the ChAdOx1 vaccine [130][131][132][133].…”