Interpretation of vaccine associated neurological adverse events: a methodological and historical review

J Neurol. 2022 Jan;269(1):493-503. doi: 10.1007/s00415-021-10747-8. Epub 2021 Aug 16.

Abstract

As a result of significant recent scientific investment, the range of vaccines available for COVID-19 prevention continues to expand and uptake is increasing globally. Although initial trial safety data have been generally reassuring, a number of adverse events, including vaccine induced thrombosis and thrombocytopenia (VITT), have come to light which have the potential to undermine the success of the vaccination program. However, it can be difficult to interpret available data and put these into context and to communicate this effectively. In this review, we discuss contemporary methodologies employed to investigate possible associations between vaccination and adverse neurological outcomes and why determining causality can be challenging. We demonstrate these issues by discussing relevant historical exemplars and explore the relevance for the current pandemic and vaccination program. We also discuss challenges in understanding and communicating such risks to clinicians and the general population within the context of the 'infodemic' facilitated by the Internet and other media.

Keywords: COVID-19; Thrombosis with thrombocytopenia syndrome; Vaccination; Vaccine-induced thrombocytosis with thrombocytopenia.

Publication types

  • Review

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • Humans
  • Infodemic
  • SARS-CoV-2
  • Vaccines* / adverse effects

Substances

  • COVID-19 Vaccines
  • Vaccines