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Good recovery of immunization stress-related responses presenting as a cluster of stroke-like events following CoronaVac and ChAdOx1 vaccinations.
Apiwattanakul, Metha; Suanprasert, Narupat; Rojana-Udomsart, Arada; Termglinchan, Thanes; Sinthuwong, Chaichana; Tantirittisak, Tasanee; Hanchaiphiboolkul, Suchat; Angchaisuksiri, Pantep; Srimahachota, Suphot; Wongsawat, Jurai; Stiudomkajorn, Somjit; Kiertiburanakul, Sasisopin; Techasaensiri, Chonnamet; Laisuan, Wannada; Manosuthi, Weerawat; Doungngern, Pawinee; Jaroenkunathum, Wereyarmarst; Jivapaisarnpong, Teeranart; Panjangampatthana, Apinya; Chimmanee, Jirapa; Chokephaibulkit, Kulkanya.
  • Apiwattanakul M; Department of Neurology, Neurological Institute of Thailand, Ministry of Public Health, Nonthaburi, Thailand.
  • Suanprasert N; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
  • Rojana-Udomsart A; Department of Neurology, Neurological Institute of Thailand, Ministry of Public Health, Nonthaburi, Thailand.
  • Termglinchan T; Department of Neurology, Neurological Institute of Thailand, Ministry of Public Health, Nonthaburi, Thailand.
  • Sinthuwong C; Department of Neurology, Neurological Institute of Thailand, Ministry of Public Health, Nonthaburi, Thailand.
  • Tantirittisak T; Department of Neurology, Neurological Institute of Thailand, Ministry of Public Health, Nonthaburi, Thailand.
  • Hanchaiphiboolkul S; Department of Neurology, Neurological Institute of Thailand, Ministry of Public Health, Nonthaburi, Thailand.
  • Angchaisuksiri P; Department of Neurology, Neurological Institute of Thailand, Ministry of Public Health, Nonthaburi, Thailand.
  • Srimahachota S; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
  • Wongsawat J; Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  • Stiudomkajorn S; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
  • Kiertiburanakul S; Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
  • Techasaensiri C; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
  • Laisuan W; Department of Diseases Control, Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand.
  • Manosuthi W; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
  • Doungngern P; Division of Neurology, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Ministry of Public Health, College of Medicine, Rangsit University, Bangkok, Thailand.
  • Jaroenkunathum W; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
  • Jivapaisarnpong T; Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  • Panjangampatthana A; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
  • Chimmanee J; Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  • Chokephaibulkit K; Department of Disease Control, the National AEFI Committee, Ministry of Public Health, Nonthaburi, Thailand.
PLoS One ; 17(8): e0266118, 2022.
Article in English | MEDLINE | ID: covidwho-2196883
ABSTRACT

BACKGROUND:

Immunization stress-related responses presenting as stroke-like symptoms could develop following COVID-19 vaccination. Therefore, this study aimed to describe the clinical characteristics of immunization stress-related responses causing stroke-like events following COVID-19 vaccination in Thailand.

METHODS:

We conducted a retrospective study of the secondary data of reported adverse events after COVID-19 immunization that presented with neurologic manifestations. Between March 1 and July 31, 2021, we collected and analyzed the medical records of 221 patients diagnosed with stroke-like symptoms following immunization. Two majority types of vaccines were used at the beginning of the vaccination campaign, including CoronaVac (Sinovac) or ChAdOx1 (AstraZeneca). Demographic and medical data included sex, age, vaccine type, sequence dose, time to event, laboratory data, and recovery status as defined by the modified Rankin score. The affected side was evaluated for associations with the injection site.

RESULTS:

Overall, 221 patients were diagnosed with immunization stress-related responses (stroke-like symptoms) following CoronaVac (Sinovac) or ChAdOx1 (AstraZeneca) vaccinations. Most patients (83.7%) were women. The median (interquartile range) age of onset was 34 (28-42) years in patients receiving CoronaVac and 46 (33.5-60) years in those receiving ChAdOx1. The median interval between vaccination and symptom onset for each vaccine type was 60 (16-960) min and 30 (8.8-750) min, respectively. Sensory symptoms were the most common symptomology. Most patients (68.9%) developed symptoms on the left side of the body; 99.5% of the patients receiving CoronaVac and 100% of those receiving ChAdOx1 had a good outcome (modified Rankin scores ≤2, indicating slight or no disability).

CONCLUSIONS:

Immunization stress-related responses presenting as stroke-like symptoms can develop after COVID-19 vaccination. Symptoms more likely to occur on the injection side are transient (i.e., without permanent pathological deficits). Public education and preparedness are important for administering successful COVID-19 vaccination programs.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / COVID-19 Vaccines / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0266118

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / COVID-19 Vaccines / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0266118