Neurological Complications Following COVID-19 Vaccination

Abstract

Purpose of Review A variety of neurological complications have been reported following the widespread use of the COVID-19 vaccines which may lead to vaccine hesitancy and serve as a major barrier to the public health aim of achieving protective herd immunity by vaccination. In this article, we review the available evidence regarding these neurological adverse events reported, to provide clarity regarding the same so that unfounded fears maybe put to rest. Recent Findings There is a greater than expected occurrence of severe neurological adverse events such as cortical sinus venous thrombosis, Bell’s palsy, transverse myelitis, and Guillain–Barré syndromes along with other common effects such as headaches following different kinds of COVID-19 vaccination. Precipitation of new onset demyelinating brain lesions with or without detection of specific antibodies and worsening of pre-existing neurological disorders (like epilepsy, multiple sclerosis) are also a matter of great concern though no conclusive evidence implicating the vaccines is available as of now. Summary The COVID-19 pandemic is far from being over. Till such time that a truly effective anti-viral drug is discovered, or an appropriate therapeutic strategy is developed, COVID-appropriate behavior and highly effective mass vaccination remain the only weapons in our armamentarium to fight this deadly disease. As often occurs with most therapeutic means for the treatment and prevention of any disease, vaccination against COVID-19 has its hazards. These range from the most trivial ones like fever, local pain and myalgias to several potentially serious cardiac and neurological complications. The latter group includes conditions like cerebral venous thrombosis (curiously often with thrombocytopenia), transverse myelitis and acute inflammatory demyelinating polyneuropathy amongst others. Fortunately, the number of reported patients with any of these serious complications is far too low for the total number of people vaccinated. Hence, the current evidence suggests that the benefits of vaccination far outweigh the risk of these events in majority of the patients. As of now, available evidence also does not recommend withholding vaccination in patients with pre-existing neurological disorders like epilepsy and MS, though adenoviral vaccines should be avoided in those with history of thrombotic events.

Acute disseminated encephalomyelitis following the COVID-19 Vaccine Sinopharm in low- and middle-income country: a case report

“…In our case, the vaccine was Sinopharm (China). There is a greater than expected occurrence of severe neurological adverse events such as cortical sinus venous thrombosis, Bell’s palsy, transverse myelitis, and GBSs along with other common effects such as headaches following different kinds of COVID-19 vaccination 7 .…”

COVID-19 vaccine adverse events: Evaluating the pathophysiology from an undersulfated and degraded glycocalyx perspective

“…A deficiency in sulfur-containing thiamine has been linked to many neuropsychiatric adverse effects. As in long-COVID, activated immune-inflammatory and oxidative and nitrosative stress pathways (IO&NS) can underlie the physiological symptoms of COVID-19 vaccine-induced chronic fatigue syndrome, major depression, and generalized anxiety disorder 140,258,259 , which are characterized by activated IO&NS pathways. Therefore, the combination of toxicity from neuro-oxidative stress and diminished antioxidant defenses can result in increased neurotoxicity, ultimately leading to physiological symptoms 187 .…”

“…Symptoms related to pituitary gland involvement may include headaches and vision changes, while damage to the cerebellum and cortex can cause neurological symptoms such as ataxia, dizziness, and impaired consciousness 216,265 . Numerous cases of acute, temporary, unilateral peripheral facial paralysis, or Bell's palsy, have been reported as AE 49,259,266 .…”

“…GBS is a commonly reported vaccine-induced AE 6,259,[270][271][272] . GBS is linked to the release of cytokines and chemokines induced by vaccination, resulting in damage to the central and peripheral nervous system 216 .…”

COVID-19 vaccine-related pathologies: cardiac and neurological side effects and Long-term COVID-19

“…Young males between the ages of 12 and 29 had the highest relative incidence of myocarditis following the second dosage of the Moderna mRNA vaccine compared to the Pfizer-BioNTech vaccine [49]. Administration of the second dose after 30 days of the first dose, decreased the risk of myocarditis/pericarditis [48,50]. External causes registered in England had a higher proportion of deaths registered in 2021 occurring in 2020 and prior years compared with diseases of the circulatory system (Table 2).…”