Thyroid Adverse Events after SARS-CoV-2 Vaccination

ABSTRACT

Introduction: Subacute thyroiditis and autoimmune thyroiditis are known complications of COVID-19 infection. With the development of SARS-CoV-2 vaccine, new cases of thyroiditis following vaccination have been reported. In accordance, we report on a series of patients who present with hyperthyroidism, elevated TSH receptor activating antibodies, concerning for activation of Graves disease after receiving SARS-Cov-2 messenger RNA (mRNA) vaccine. This association underpins the possible immune modulation affecting the presentation of autoimmune thyroiditis post vaccination. Case Description We describe four patients who present with symptoms of hyperthyroidism after receiving SARS-CoV-2 mRNA vaccine. All were females, median age 49 (range 44-59). Two patients presented with de novo hyperthyroidism 25-29 days following SARS-CoV-2 mRNA vaccine. Two patients have previously had diagnosed Graves disease in remission for longer than 3 years and presented after 40-60 days after receiving SARS-CoV-2 mRNA vaccine. All four patients had TSH receptor antibodies positive (range 6.21-11.87IU/L) Discussion: Although vaccines are one of the most successful medical advances clarifying associated conditions and risks is of interest to practicing physicians. It is not known if these 4 cases of Graves disease were diagnosed coincidentally following SARS-CoV-2 vaccine and association between this vaccine and autoimmune manifestations remains to be further investigated. This report adds information to current knowledge and understanding of autoimmune manifestations following SARS-CoV-2 vaccine.Copyright © 2023