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Covid-19 and Vaccination in the Setting of Neurologic Disease: An Emerging Issue in Neurology

14 November 2021

“…However, the rapidity of approval, and history of prior vaccination regimens resulting in neurological and other complications, creates concern surrounding widespread vaccination. This is particularly so in groups with pre-existing neurological conditions…

“Though neurological side effects were not more commonly observed following active vaccine over the extended follow-up period for any of the vaccines, a number of neurological complications of these vaccines are now being reported in the most comprehensive registry, the Vaccine Adverse Events Reporting System (VAERS) database. These include strokes, cranial neuropathies including Bell’s palsy, tinnitus and trigeminal neuralgia, peripheral neuropathies, dysautonomia, acute disseminated encephalomyelitis, transverse myelitis and AIDP. Case reports are also starting to emerge in the published literature, and the popular press. Most recently, the possibility of increased risk of AIDP in the weeks following vaccination was formally added to the label for the Johnson and Johnson vaccine. These complications are rare when compared to the large number of vaccinated individuals; however, it is too early to know the true incidence and risk factors for these complications. They are thought to be immune mediated and early recognition and treatment with immunomodulatory therapies might be warranted…

“Prior studies have shed light on the likelihood of neurological complications following vaccination. These data can be difficult to interpret and are often seen as controversial, suffering from potential reporting bias and lack of clear causality, but illustrate theoretical concerns for both patients and physicians and must be acknowledged.” -

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