Type I interferons as the potential mechanism linking mRNA COVID-19 vaccines to Bell's palsy

Soeiro, Thomas; Salvo, Francesco; Pariente, Antoine; Grandvuillemin, Aurélie; Jonville‐Béra, Annie‐Pierre; Micallef, Joëlle

doi:10.1016/j.therap.2021.03.005

Cited by 26 publications

(28 citation statements)

References 7 publications

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“…Soeiro et al proposed type I interferons as the potential mechanism linking mRNA COVID-19 vaccines to Bell’s palsy. Therefore, the mRNA COVID-19 vaccine should be considered as an additional risk factor for Bell's palsy [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Bell’s Palsy After 24 Hours of mRNA-1273 SARS-CoV-2 Vaccine

Iftikhar¹,

Noor²,

Masood³

et al. 2021

Cureus

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Section: Discussionmentioning

confidence: 99%

Bell’s Palsy After 24 Hours of mRNA-1273 SARS-CoV-2 Vaccine

Iftikhar¹,

Noor²,

Masood³

et al. 2021

Cureus

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“…Up to July 2021, tozinameran (BNT162b2; Pfizer‐BioNTech) and elasomeran (mRNA 1273; Moderna) have been distributed in 104 and 49 countries worldwide, respectively, and more than 341 million doses have been administered in the United States 17 . Rare but severe adverse drug reactions have been highlighted in clinical trials and thereafter reported after mRNA COVID‐19 vaccination, such as anaphylaxis or Bell’s palsy 18–20 . In April and May 2021, a growing signal concerning inflammatory heart reactions has emerged in several regions of the world with early coverage in the press 21–24 .…”

mentioning

confidence: 99%

Features of Inflammatory Heart Reactions Following mRNA COVID‐19 Vaccination at a Global Level

Chouchana

Blet

Al-Khalaf

et al. 2021

Clin Pharma and Therapeutics

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Myocarditis and pericarditis may constitute adverse reactions of mRNA coronavirus disease 2019 (COVID‐19) vaccines. This study aimed to document these reactions and to assess the association with patient sex and age. This is as an observational retrospective study using a case–non‐case design (also called disproportionality study) on inflammatory heart reactions reported with mRNA COVID‐19 vaccines within the World Health Organization (WHO) global safety database (VigiBase), up to June 30, 2021. Results are expressed using reporting odds ratios (RORs) and their 95% confidence interval (95% CI). Of 716,576 reports related to mRNA COVID‐19 vaccines, 2,277 were cases of inflammatory heart reactions, including 1241 (55%) myocarditis and 851 (37%) pericarditis. The main age group was 18–29 years (704, 31%), and mostly male patients (1,555, 68%). Pericarditis onset was delayed compared with myocarditis with a median time to onset of 8 (3–21) vs. 3 (2–6) days, respectively (P = 0.001). Regarding myocarditis, an important disproportionate reporting was observed in adolescents (ROR, 22.3, 95% CI 19.2–25.9) and in 18–29 years old (ROR, 6.6, 95% CI 5.9–7.5) compared with older patients, as well as in male patients (ROR, 9.4, 95% CI 8.3–10.6). Reporting rate of myocarditis was increased in young adults and adolescents. Inflammatory heart reactions may rarely occur shortly following mRNA COVID‐19 vaccination. Although an important disproportionate reporting of myocarditis was observed among adolescents and young adults, particularly in male patients, reporting rates support a very rare risk, that does not seem to compromise the largely positive benefit‐risk balance of these vaccines. Furthermore, this study confirmed the value of disproportionality analyses for estimation of relative risks among subgroups of patients.

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“…[13] - [16] Proposed biological mechanisms which might explain the observed association between the use of mRNA vaccines, such as the Pfizer-BioNTech vaccine, and the imbalance in the incidence of Bell's palsy in the vaccine groups compared to placebo groups, include that mRNA vaccines are associated with a marked type I interferon response which, in some individuals, may trigger and mediate a breakdown of tolerance to myelin sheath antigens leading to autoimmune neuropathy. [17] Unlike vaccines using mRNA technology, however, the Oxford-AstraZeneca vaccine consists of a replication-deficient (inactivated) chimpanzee adenovirus vector expressing the fulllength SARS-CoV-2 spike (S) protein. Following intramuscular administration of the vaccine, the spike proteins are expressed locally allowing the immune system to mount a neutralising cellular and humoral response.…”

Section: Discussionmentioning

confidence: 99%

Vocal fold paralysis following first dose of Oxford-AstraZeneca coronavirus disease 2019 vaccine

et al. 2022

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Background: In a bid to end the ongoing coronavirus disease 2019 (COVID-19) pandemic, many countries, including the United Kingdom, have rolled out mass immunisation programmes. While considered generally safe and effective, vaccines against COVID-19 have been reported to be associated with rare and potentially adverse reactions and side effects.Case report: We report an unusual case of a patient who developed a unilateral vocal cord paralysis shortly after receiving the first dose of the Oxford-AstraZeneca ChAdOx1 nCov-19 vaccine. Conclusion:To our knowledge, this is the first reported case of vocal cord paralysis following administration of the Oxford-AstraZeneca vaccine. The authors support the position that currently approved COVID-19 vaccines remain safe and effective, however, further surveillance and vigilance using real-world data is highly encouraged.

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Type I interferons as the potential mechanism linking mRNA COVID-19 vaccines to Bell's palsy

Cited by 26 publications

References 7 publications

Bell’s Palsy After 24 Hours of mRNA-1273 SARS-CoV-2 Vaccine

Bell’s Palsy After 24 Hours of mRNA-1273 SARS-CoV-2 Vaccine

Features of Inflammatory Heart Reactions Following mRNA COVID‐19 Vaccination at a Global Level

Vocal fold paralysis following first dose of Oxford-AstraZeneca coronavirus disease 2019 vaccine

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