Infectious Disease

COVID-19 infection carries greater neurological risks than vaccination

October 28, 2021

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Patone does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Researchers found rare neurological side effects associated with two COVID-19 vaccines as well as infection with the virus itself, but concluded that the risks are greater in those infected, according to a study in Nature Medicine.

“The English National Immunization (NIMS) database on COVID-19 vaccination contains data on the type, date and dose of the vaccine for all persons vaccinated in England.” Martina Patone, PhD, from the Nuffield Department of Primary Health Care Sciences at the University of Oxford in the UK, and colleagues wrote. “We linked NIMS at the individual patient level to national mortality, hospital admissions and SARS-CoV-2 infection data to investigate the relationship between the first dose of the ChAdOx1nCoV-19 or BNT162b2 vaccine and neurological complications: acute central nervous system (CNS) demyelinating events, encephalitis, meningitis and myelitis, Guillain-Barré syndrome, Bell palsy, myasthenic disorders, hemorrhagic stroke, and subarachnoid hemorrhage.

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“We are using the same population to examine the associations between a positive SARS-CoV-2 test as secondary exposure and the same neurological disorders,” they added.

Researchers conducted a self-controlled case series study to avoid hospital admissions related to neurological complications in the 28 days following an initial dose of the Oxford / AstraZeneca vaccine (n = 20,417,752) or the BioNTech / Pfizer vaccine (n = 12,134,782) to be examined as after a positive test for SARS-CoV-2 (n = 2,005,280).

The results showed an association between the Oxford / AstraZeneca vaccine and an increased risk of Guillain-Barré syndrome (incidence rate ratio [IRR] = 2.9; 95% CI, 2.15-3.92 between 15 and 21 days after vaccination) and Bell’s palsy (IRR = 1.29; 95% CI, 1.08-1.56 between 14 and 21 days after vaccination ). The BioNTech / Pfizer vaccine appeared to be associated with an increased risk of hemorrhagic stroke (IRR = 1.38; 95% CI, 1.12-1.71 between 15 and 21 days after vaccination). The results of an independent Scottish cohort supported the apparent association between the Oxford / AstraZeneca vaccine and Guillain-Barré syndrome (IRR = 2.32; 95% CI, 1.08-5.02 between 1 and 28 days after the Vaccination).

Patone and colleagues found a significantly higher risk of all neurological outcomes, including Guillain-Barré syndrome (IRR = 5.25; 95% CI, 3-9, 18). They estimated 38 additional cases of Guillain-Barré syndrome per 10 million people who received the Oxford / AstraZeneca vaccine and 145 additional cases per 10 million people after a positive SARS-CoV-2 test.

“We believe these results are likely to be of relevance to other countries using these vaccines and it would be useful to replicate these results internationally in similarly sized data sets,” wrote Patone and colleagues. “Clinicians should be aware of these rare complications, and the results of this study will be of paramount importance to policymakers in risk-benefit assessment and resource allocation in healthcare. It is important that the risks of adverse neurological events following SARS-CoV-2 infection are much greater than those associated with vaccinations, which underscores the benefits of ongoing vaccination programs. “

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