Optic Neuritis After COVID-19 Vaccination: An Analysis of the Vaccine Adverse Event Reporting System

Abstract

Background: To investigate the association of optic neuritis (ON) after the COVID-19 vaccines. Methods: Cases of ON from Vaccine Adverse Event Reporting System (VAERS) were collected and divided into the prepandemic, COVID-19 pandemic, and COVID-19 vaccine periods. Reporting rates were calculated based on estimates of vaccines administered. Proportion tests and Pearson χ2 test were used to determine significant differences in reporting rates of ON after vaccines within the 3 periods. Kruskal–Wallis testing with Bonferroni-corrected post hoc analysis and multivariable binary logistic regression was used to determine significant case factors such as age, sex, concurrent multiple sclerosis (MS) and vaccine manufacturer in predicting a worse outcome defined as permanent disability, emergency room (ER) or doctor visits, and hospitalizations. Results: A significant increase in the reporting rate of ON after COVID-19 vaccination compared with influenza vaccination and all other vaccinations (18.6 vs 0.2 vs 0.4 per 10 million, P < 0.0001) was observed. However, the reporting rate was within the incidence range of ON in the general population. Using self-controlled and case-centered analyses, there was a significant difference in the reporting rate of ON after COVID-19 vaccination between the risk period and control period (P < 0.0001). Multivariable binary regression with adjustment for confounding variables demonstrated that only male sex was significantly associated with permanent disability. Conclusions: Some cases of ON may be temporally associated with the COVID-19 vaccines; however, there is no significant increase in the reporting rate compared with the incidence. Limitations of this study include those inherent to any passive surveillance system. Controlled studies are needed to establish a clear causal relationship.

Ocular inflammatory events following COVID-19 vaccination: reporting of suspected adverse drug reactions to regulatory authorities in the UK

“…Several individual case reports of optic neuritis following COVID-19 vaccination have been published in the literature, with optic neuritis being considered the most commonly reported neuro-ophthalmic event following COVID-19 vaccination. [25][26][27][28] Jaffrey et al calculated the reporting rates of optic neuritis, collecting cases from the Vaccine Adverse Event Reporting System, and divided them into the pre-pandemic, COVID-19 pandemic and COVID-19 vaccine periods. 28 The authors showed no significant increase in the reporting rate of optic neuritis following COVID-19 vaccination when compared with the range of incidence in the general population.…”

“…[25][26][27][28] Jaffrey et al calculated the reporting rates of optic neuritis, collecting cases from the Vaccine Adverse Event Reporting System, and divided them into the pre-pandemic, COVID-19 pandemic and COVID-19 vaccine periods. 28 The authors showed no significant increase in the reporting rate of optic neuritis following COVID-19 vaccination when compared with the range of incidence in the general population. 28 Similarly, our study did not detect an increase in the reporting rate of optic neuritis when compared with the cases expected from the UK incidence data.…”

Optic Neuritis After COVID-19 Vaccination: Comment

“…Jaffry et al 1 noted that limitations of this study include those inherent to any passive surveillance system. Jaffry et al 1 mentioned that controlled studies are needed to establish a clear causal relationship. ON after the COVID-19 vaccines.…”

“…We would like to share ideas on the publication “Optic Neuritis (ON) After COVID-19 Vaccination: An Analysis of the Vaccine Adverse Event Reporting System. 1 ” Jaffry et al 1 investigated the association of some cases of ON may be temporally associated with the COVID-19 vaccines; however, there is no significant increase in the reporting rate compared with the incidence. Jaffry et al 1 noted that limitations of this study include those inherent to any passive surveillance system.…”

“…1 ” Jaffry et al 1 investigated the association of some cases of ON may be temporally associated with the COVID-19 vaccines; however, there is no significant increase in the reporting rate compared with the incidence. Jaffry et al 1 noted that limitations of this study include those inherent to any passive surveillance system. Jaffry et al 1 mentioned that controlled studies are needed to establish a clear causal relationship.…”