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, Niloufar Yazdanpanah and Nima Rezaei Abstract
The devastating characteristic of COVID-19 pandemic calls for immediate and effective solutions to tackle it. Vaccines seem to be the only promising and effective way to fight against the novel coronavirus – even against new mutated variants. Because of the rapid development and distribution of numerous COVID-19 vaccines in different platforms, meticulous evaluation of vaccines’ safety is more critical than ever – especially given the fact that most of the candidates have not completed the clinical phase. Therefore, to optimize the vaccines’ safety and efficacy, it is highly important to carefully report and scientifically discuss the serious adverse effects following vaccination. In this respect, we discuss different neurological and neuropsychological adverse effects of COVID-19 vaccines including demyelinating diseases, Bell’s palsy (BP), cerebrovascular complications, seizures, functional neurological disorders (FNDs), and some other rare adverse events, and hypothetical mechanisms which can lead to the reported side effects. Given the fact that the incidence of such events are rare and most of them are treatable, the current review aims to shed light on how much the relationship between COVID-19 vaccines and these complications can be reliable and provide an insight for future studies with much more meticulous methodologies to discuss the possible correlational or causal relationship between these complications and COVID-19 vaccines and elucidate whether or not the neurological side effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines can count as a considerable threat to public health.
Introduction
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel member of Coronaviridae family, which first emerged in Wuhan, China in December 2019. Like the two other human coronaviruses that appeared in 2002 and 2012 respectively, SARS-CoV-2 is an enveloped, single-stranded, and positive-sense RNA virus responsible for a potentially fatal respiratory infection in humans (Hu et al. 2021; Saghazadeh and Rezaei 2020). In January 2020, the World Health Organization (WHO) announced the SARS-CoV-2 outbreak as a public health emergency of international concern (PHEIC). Later on, in February 2020, WHO named the corresponding disease COVID-19 and finally declared it as a pandemic in March 2020 (Hanaei and Rezaei 2020). At the time of writing this manuscript, the cumulative number of confirmed COVID-19 cases has surpassed 328 million people and over 5.5 million individuals have died because of this disease worldwide (Organization 2022).
So far, several strategies have been implemented to overcome the disease at both levels of prevention and treatment including social distancing, wearing masks, pharmacological interventions, oxygen therapy, and invasive methods such as endotracheal intubation and mechanical ventilation. However, among currently available solutions, vaccines seem to be the most promising and effective way to fight against the virus – even against new mutated variants (Chen and Lu 2021; Cohen and Corey 2020; Parasher 2021; Sanderson 2021).
Although common side effects following vaccination usually reflect its effectiveness and efficient immune response, severe reactions to vaccines may also occur (Andrzejczak-Grządko et al. 2021; Sharifian-Dorche et al. 2021). Similarly, COVID-19 vaccines are not exceptions, and common side effects including pain in the site of injection, fatigue, fever and chills, headache, nausea, myalgia, and swollen lymph nodes have been reported in this regard (Andrzejczak-Grządko et al. 2021). However, there are also dozens of reports concerning severe adverse effects of SARS-CoV-2 vaccines, a well-known example of which is vaccine-induced immune thrombotic thrombocytopenia (VITT) (Sharifian-Dorche et al. 2021). Similar to neurological sequelae of novel coronavirus disease, it is also hypothesized that COVID-19 vaccines may not be without neurological complications (Finsterer and Scorza 2021). The current review aims to provide insight into different kinds of serious neurological and neuropsychological adverse effects reported after COVID-19 vaccination and discuss whether or not clinicians’ attention should be drawn in this respect. Since such events are rare and most of them can be treated, further studies with much more meticulous methodologies are needed to discuss the possible correlational or causal relationships between the aforementioned complications and COVID-19 vaccines and shed the light on whether or not the neurological and neuropsychological adverse effects of SARS-CoV-2 vaccines can count as a considerable threat to public health.
Methods
We searched for all types of documents in PubMed, Scopus, and Web of Science, using the keywords including “SARS-CoV-2 vaccines,” “COVID-19 vaccines,” “COVID-19 vaccination,” “neurological,” “neuropsychological,” “side effects,” and “adverse effects.” Based on the neurological and neuropsychological adverse effects yielded in the initial search, we completed our search strategy and searched for the documents which discussed the relationship between the aforementioned conditions and COVID-19 vaccines in all platforms undergone clinical studies. Although we aimed to comprehensively review the neurological complications of COVID-19 vaccines, the selection strategy of the studies was not strictly defined since our paper was a narrative – and not a systematic – review.
MORE AT LINK: https://www.degruyter.com/document/doi/10.1515/revneuro-2022-0006/html