New York, NY—One of the challenges in offering COVID-19 vaccines in pharmacies is making sure those administering the shots could appropriately respond to any immediate reactions and to make sure any longer-term effects were tracked.
One of the most concerning challenges has been reports of neurologic events following administration of mRNA (Pfizer, Moderna) or adenovirus vector (Janssen) vaccines in the United States. That is why a study team—led by researchers from New York University Grossman School of Medicine—sought to learn more about them.
Their study, published in Annals of Neurology, used publicly available data from the U.S. Vaccine Adverse Event Reporting System collected between January 1, 2021, and June 14, 2021. The researchers manually reviewed all free-text symptoms that were reported within 42 days of vaccine administration and grouped them into 36 individual neurologic diagnostic categories. They then compared postvaccination neurological event rates between vaccine types and to age-matched baseline incidence rates in the U.S., as well as rates of neurologic events following COVID.
The authors noted that, of the nearly 307 million COVID vaccine doses administered during the study timeframe, 314,610 (0.1%) people reported any adverse event and 105,214 (0.03%) reported neurologic adverse events in a median of 1 day (Interquartile Range 0-3) from inoculation.
In fact, Guillain-Barre Syndrome (GBS) and cerebral venous thrombosis (CVT) occurred in fewer than 1 per 1,000,000 doses, researchers pointed out.
"Significantly more neurological adverse events were reported following Janssen (Ad26.COV2.S) vaccination compared to either Pfizer-BioNtech (BNT162b2) or Moderna (mRNA-1,273; 0.15% vs. 0.03% vs. 0.03% of doses, respectively, P <0.0001)," the authors wrote. "The observed-to-expected ratios for GBS, CVT and seizure following Janssen vaccination were >1.5-fold higher than background rates. However, the rate of neurological events after acute SARS-CoV-2 infection was up to 617-fold higher than after COVID vaccination."
Overall, the study team concluded that reports of serious neurologic events following COVID vaccination are rare, although GBS, CVT, and seizure may occur at higher than background rates following Janssen vaccination.
Researchers also emphasized that rates of neurologic complications following acute SARS-CoV-2 infection are up to 617-fold higher than after COVID vaccination.
The CDC has issued warnings for GBS and vaccine-induced immune thrombotic thrombocytopenia following Janssen/Johnson & Johnson (Ad26.COV2.S) vaccination, and myocarditis following mRNA vaccines (Pfizer-BioNtech [BNT162b2] and Moderna [mRNA-1,273]).
This study sought to quantify rates of a wider spectrum of neurologic symptoms/diagnoses and compare neurologic events between mRNA and adenovirus vector vaccines in the U.S.
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