Characterization and analysis of neurologic adverse events associated with COVID-19 vaccination (S12.006)

• Main Authors: Boruah, Abhilasha, Westenberg, Erica, Khan, Abdul Hanif, Fan, Kee Hoo, Guekht, Alla, Spatola, Marianna, Calandri, Ismael, Netravathi, M, Wijeratne, Tissa, Warburton, Elyce, Doheim, Mohamed Fahmy, Pulickal, Carolin, Chen, Jakin, Thakur, Kiran, Mulchan, Nicholas, Ssonko, Vivian, Tetreault, Lindsay, Sejvar, Jim, Faissner, Simon, James, Jeyanthan Charles, Hunter, Jessica, Garcia-Azorin, David, Tamborska, Arina, Bresjanac, Maja, Delgado-Garcia, Guillermo, Singh, Nina, Baykan, Betül, Gezegen, Hasim, Kyei-Frimpong, Nana, Winkler, Andrea, Frontera, Jennifer
• Format: Article
• Published: Wolters Kluwer Health 2022
• Online Access: http://psasir.upm.edu.my/id/eprint/100671/; https://n.neurology.org/content/98/18_Supplement/3784

Objective: To characterize the incidence and spectrum of neurological adverse events (AE) after COVID-19 vaccination. Background: The devastating COVID-19 pandemic has led to 230 million people diagnosed and greater than 4.8 million deaths worldwide. Widespread vaccination efforts have resulted in administration of over 6 million vaccine doses to curb the significant health and socioeconomic impacts of the disease. While there are numerous reports of adverse events following COVID-19 vaccine, there is limited characterization of the spectrum of neurological AEs post-vaccination. Design/Methods: Data was gathered from the publicly available Vaccine Adverse Event Reporting System (VAERS), a passive reporting system not implying causality. Among individuals who received the J&J, Moderna, and Pfizer vaccines from 1/1/2021–6/14/2021, 314,610 adverse events were reported and these were reviewed by Neurology trained clinicians to determine the presence of various neurological AEs (40 conditions coded). Results: 306,473,169 COVID vaccine dose were administered in the USA during the study period with 314,610 total AEs (0.10%) and 105,930 neurological AEs (0.03%) reported. J&J vaccine was associated with the most AEs (17,670, 0.15%), followed by Moderna (42656, 0.03%) and Pfizer (42267, 0.03%). On average more events were reported in women (71%) and a majority occurred after the first dose (54%). < 1 events were reported per million vaccine doses for serious neurological conditions such as Bell’s palsy (0.0007%), Guillain-Barre syndrome (0.00009%), cerebral venous thrombosis (0.00005%), transverse myelitis (0.00003%), and acute disseminated encephalomyelitis (0.00006%). Overall neurological complications following vaccine were drastically lower than complications post-COVID infection (14–80%). Conclusions: Adverse neurological events following COVID-19 vaccination are extremely rare and significantly less common than adverse neurological effects following SARS-CoV-2 infection. Current evidence suggests that along with being up to 100,000 times more likely to experience a major complication from COVID infection vs. vaccine, the risk of neurological complication is up to 5000 times more likely from infection itself.