ABSTRACT
BACKGROUND: Several vaccines against the severe acute respiratory syndrome coronavirus 2 have been approved and widely distributed, raising public concerns regarding the side effects of immunization, as the incidence of ease. Although many adverse events following the coronavirus disease 2019 (COVID-19) vaccine have been reported, neurological complications are relatively uncommon. Herein, we report a rare case of multiple cranial palsies following COVID-19 vaccination in an adolescent patient. CASE SUMMARY: A previously healthy, 14-year-old Asian girl with facial palsy presented to the emergency department with inability to close the right eye or wrinkle right side of the forehead, and pain in the right cheek. She had received second dose of the COVID-19 mRNA vaccine (Pfizer-BioNTech) 18 days before onset of symptoms. She was diagnosed with Bell's palsy and prescribed a steroid (1 mg/kg/day methylprednisolone) based on symptoms and magnetic resonance imaging findings. However, the next day, all sense of taste was lost with inability to swallow solid food; the gag reflex was absent. Horizontal diplopia was also present. Due to worsening of her condition, she was given high-dose steroids (1 g/day methylprednisolone) for 3 days and then discharged with oral steroids. Improvement in the symptoms was noted 4 days post steroid treatment completion. At the most recent follow-up, her general condition was good with no symptoms except diplopia; ocular motility disturbances were noted. Hence, prism glasses were prescribed for diplopia relief. CONCLUSION: Small-angle exotropia was observed in the facial, trigeminal, and glossopharyngeal nerve palsies, in our patient. The etiology of this adverse effect following vaccination was thought to be immunological.
ABSTRACT
While the COVID-19 pandemic has dramatically affected the lives of people around the world, select populations (e.g., elderly, immune-compromised, and incarcerated individuals) are among the most likely to contract the virus and among the least likely to overcome the illness and regain full health. This paper focuses on the incarcerated individuals and how the coronavirus has added a new and unprecedented threat to correctional facilities that are already overcrowded and ill-equipped to identify and address the medical needs of the inmate population. The risk-need-responsivity model (RNR) should be used to make empirically-informed decisions about the targeted release. The identification and release of inmates who pose the least threat to society will help alleviate some of the burdens associated with prison crowding. Specifically, with fewer inmates, correctional facilities can comply with social distancing guidelines, introduce enhanced cleaning measures, and make necessary institutional adjustments. In so doing they will limit the transmission of COVI-19 within correctional institutions, ensure the safety of staff and their charges, and enable prisons and jails to better accommodate the needs of the inmate population.