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QJM. 2022 Nov 10:hcac251. doi: 10.1093/qjmed/hcac251. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals who suffered a neurological adverse event after COVID-19 vaccine could hesitate and defer reimmunization.

AIM: We examine the risk of recurrence following reimmunization among patients who developed a neurological event after first dose of COVID-19 mRNA vaccine.

DESIGN: Observational study.

METHODS: Individuals who developed an adjudicated neurological adverse event (based on Brighton Collaboration criteria) within 6 weeks of first dose of COVID-19 vaccine requiring hospitalization were enrolled into a multi-center national registry in Singapore. Neurological recurrence, defined by development of another neurological event within 6 weeks of second vaccine dose, was reviewed. Clinical characteristics were compared between patients who chose to proceed or withhold further vaccination, and between those who received timely (3-6 weeks) or delayed (>6 weeks) reimmunization.

RESULTS: From 235 patients (median age, 67 years; 63% men) who developed an adjudicated neurological event after their first dose of mRNA vaccine between 30 December 2020 and 20 April 2021, 181 (77%) chose to undergo reimmunization. Those who decided against reimmunization were older (median age, 74 vs 66 years) and had greater physical disability following their primary neurological event (46% vs 20%, p < 0.001). Patients who suffered greater physical disability were 3 times more likely to delay their reimmunization (odds ratio 3.36, 95% CI: 1.76-6.40). Neurological recurrence was observed in only 4 individuals (3 with seizures and 1 with myasthenia gravis exacerbation).

CONCLUSION: A prior neurological event should not necessarily preclude reimmunization and the decision to proceed with reimmunization should consider the overwhelming benefits conferred by vaccination towards ending this pandemic.

PMID:36355458 | DOI:10.1093/qjmed/hcac251


Source: https://pubmed.ncbi.nlm.nih.gov/3635545 ... 7&v=2.17.8