Thyroiditis After COVID-19 mRNA Vaccine: A Case Series

Abstract

Background While SARS-COV-2 virus infection was reported to cause subacute thyroiditis, the mRNA vaccine for SARS-COV-2 was suspected to induce thyroiditis with thyrotoxicosis. Case Report We describe three patients without a history of thyroid disease who presented with symptomatic, biochemical, and radiological evidence of thyroiditis with thyrotoxicosis, 10-20 days after receiving either the Pfizer Bio-NTech or the Moderna COVID-19 mRNA vaccine. All presented with thyrotoxicosis, but with negative thyroid stimulating immunoglobulins for Graves’ disease and no autonomous nodules. Two patients underwent thyroid uptake and scan which confirmed thyroiditis. One patient had significantly increased erythrocyte sedimentation rate (ESR) and Interleukin-6 (IL-6). All had improvement in symptoms with non-steroidal anti-inflammatory drugs (NSAIDs), with one patient eventually requiring steroids for symptom control. Discussion The mRNA vaccine for SARS-COV-2 was associated with thyroiditis and presented with thyrotoxicosis. Elevated proinflammatory markers and cytokines after vaccines may play a major role. Conclusion Our case series report highlights a possible relationship between the COVID-19 mRNA vaccine and thyroiditis with thyrotoxicosis, which previously not recognized by health providers.

Significance of HLA Haplotypes in Two Patients with Subacute Thyroiditis Triggered by mRNA-Based COVID-19 Vaccine

“…In response to the worldwide spread of the COVID-19 pandemic, several vaccine preparations have been developed, including mRNA-based SARS-CoV-2 vaccines (BNT162b2-Pfizer-BioNTech and mRNA-1273-Moderna), an inactivated SARS-CoV-2 vaccine (CoronaVac-Sinovac Life Sciences), and viral vector vaccines (ChAdOx1 nCoV-19-Oxford-AstraZeneca and Ad26.COV2.S-Janssen-Johnson & Johnson). Several cases of SAT triggered by different types of COVID-19 vaccines have already been described [9][10][11][12][13][14][15][16][17][18][19]. However, taking into account the number of 9.79 billion doses of COVID-19 vaccines administered worldwide, SAT appears to be a rare side effect of vaccination.…”

“…Up to January 2022, 9.79 billion doses have been administered globally [8]. Several reports of SAT after various types of COVID-19 vaccines have already been published [9][10][11][12][13][14][15][16][17][18][19]. Rare cases of SAT triggered by other vaccinations have been described before, mainly in regard to influenza or hepatitis B vaccines [20,21].…”

Subacute thyroiditis after SARS-Cov2 vaccination: A review of the cases being described and personal experience

“…In addition, an individual predisposition might explain the flare-up of subacute thyroiditis (Iremli et al 2021). Prediabetes (Pandya et al 2022), Hashimoto thyroiditis (Sigstad et al 2021;Sozen et al 2021), hypertension (Sahin Tekin et al 2021, asthma (Oyibo 2021), and colon carcinoma (Plaza-Enriquez et al 2021) have been reported in the previous medical history of some patients, but most of them were previously healthy, without autoimmunity or diabetes history.…”

Investigating thyroid dysfunction in the context of COVID-19 infection

“…A case report detailing eleven patients showed that they experienced symptoms of SAT 22 days after vaccination [ 31 ]. In another clinical case study, three patients with no previous history of thyroid disease presented with thyrotoxicosis 10–20 days after receiving the Pfizer, Bio-NTech, or Moderna mRNA vaccine [ 32 ]. A literature review conducted by Jhon et al revealed that out of the 22 SAT cases reported, 13 patients required steroid therapy and the remaining cases subsided with supportive treatment [ 33 ].…”