Reporting of Acute Inflammatory Neuropathies with COVID-19 Vaccines: Subgroup Disproportionality Analyses in VigiBase
Since marketing authorization, cases of neuralgic amyotrophy (NA), facial paralysis/Bell’s palsy (FP/BP), and Guillain-Barré syndrome (GBS) were reported with COVID-19 vaccines of different technologies. This study aimed to assess whether NA, FP/BP, and GBS were more frequently reported in VigiBase...
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| Published in: | Vaccines (Basel) Vol. 9; no. 9; p. 1022 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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Basel
MDPI AG
14.09.2021
MDPI |
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| ISSN: | 2076-393X, 2076-393X |
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| Abstract | Since marketing authorization, cases of neuralgic amyotrophy (NA), facial paralysis/Bell’s palsy (FP/BP), and Guillain-Barré syndrome (GBS) were reported with COVID-19 vaccines of different technologies. This study aimed to assess whether NA, FP/BP, and GBS were more frequently reported in VigiBase with COVID-19 vaccines (of any technologies) than with other viral vaccines, over the full database and across potential risk groups by sex and age. The reporting odds ratio (ROR) with 95% confidence interval (95% CI) was used as the measure of disproportionality and subgroup disproportionality analyses were performed by sex and age. Out of 808,906 safety reports with COVID-19 vaccines, 57 (0.01%) reported NA, 3320 (0.4%) FP/BP, and 632 (0.1%) GBS. There were not signals of disproportionate reporting for NA and GBS with COVID-19 vaccines against other viral vaccines. FP/BP was disproportionately more frequently reported with COVID-19 vaccines than with other viral vaccines over the full database (ROR 1.12, 95%CI 1.07–1.17), in males (ROR 1.65, 95%CI 1.54–1.78) and in age subgroups 65–74 years (ROR 1.21, 95%CI 1.05–1.39) and ≥75 years (ROR 1.84, 95%CI 1.52–2.22). Albeit not proving causation, these findings might support clinicians in decision-making for patients potentially at risk for developing an acute inflammatory neuropathy with COVID-19 vaccines. |
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| AbstractList | Since marketing authorization, cases of neuralgic amyotrophy (NA), facial paralysis/Bell's palsy (FP/BP), and Guillain-Barré syndrome (GBS) were reported with COVID-19 vaccines of different technologies. This study aimed to assess whether NA, FP/BP, and GBS were more frequently reported in VigiBase with COVID-19 vaccines (of any technologies) than with other viral vaccines, over the full database and across potential risk groups by sex and age. The reporting odds ratio (ROR) with 95% confidence interval (95% CI) was used as the measure of disproportionality and subgroup disproportionality analyses were performed by sex and age. Out of 808,906 safety reports with COVID-19 vaccines, 57 (0.01%) reported NA, 3320 (0.4%) FP/BP, and 632 (0.1%) GBS. There were not signals of disproportionate reporting for NA and GBS with COVID-19 vaccines against other viral vaccines. FP/BP was disproportionately more frequently reported with COVID-19 vaccines than with other viral vaccines over the full database (ROR 1.12, 95%CI 1.07-1.17), in males (ROR 1.65, 95%CI 1.54-1.78) and in age subgroups 65-74 years (ROR 1.21, 95%CI 1.05-1.39) and ≥75 years (ROR 1.84, 95%CI 1.52-2.22). Albeit not proving causation, these findings might support clinicians in decision-making for patients potentially at risk for developing an acute inflammatory neuropathy with COVID-19 vaccines.Since marketing authorization, cases of neuralgic amyotrophy (NA), facial paralysis/Bell's palsy (FP/BP), and Guillain-Barré syndrome (GBS) were reported with COVID-19 vaccines of different technologies. This study aimed to assess whether NA, FP/BP, and GBS were more frequently reported in VigiBase with COVID-19 vaccines (of any technologies) than with other viral vaccines, over the full database and across potential risk groups by sex and age. The reporting odds ratio (ROR) with 95% confidence interval (95% CI) was used as the measure of disproportionality and subgroup disproportionality analyses were performed by sex and age. Out of 808,906 safety reports with COVID-19 vaccines, 57 (0.01%) reported NA, 3320 (0.4%) FP/BP, and 632 (0.1%) GBS. There were not signals of disproportionate reporting for NA and GBS with COVID-19 vaccines against other viral vaccines. FP/BP was disproportionately more frequently reported with COVID-19 vaccines than with other viral vaccines over the full database (ROR 1.12, 95%CI 1.07-1.17), in males (ROR 1.65, 95%CI 1.54-1.78) and in age subgroups 65-74 years (ROR 1.21, 95%CI 1.05-1.39) and ≥75 years (ROR 1.84, 95%CI 1.52-2.22). Albeit not proving causation, these findings might support clinicians in decision-making for patients potentially at risk for developing an acute inflammatory neuropathy with COVID-19 vaccines. Since marketing authorization, cases of neuralgic amyotrophy (NA), facial paralysis/Bell’s palsy (FP/BP), and Guillain-Barré syndrome (GBS) were reported with COVID-19 vaccines of different technologies. This study aimed to assess whether NA, FP/BP, and GBS were more frequently reported in VigiBase with COVID-19 vaccines (of any technologies) than with other viral vaccines, over the full database and across potential risk groups by sex and age. The reporting odds ratio (ROR) with 95% confidence interval (95% CI) was used as the measure of disproportionality and subgroup disproportionality analyses were performed by sex and age. Out of 808,906 safety reports with COVID-19 vaccines, 57 (0.01%) reported NA, 3320 (0.4%) FP/BP, and 632 (0.1%) GBS. There were not signals of disproportionate reporting for NA and GBS with COVID-19 vaccines against other viral vaccines. FP/BP was disproportionately more frequently reported with COVID-19 vaccines than with other viral vaccines over the full database (ROR 1.12, 95%CI 1.07–1.17), in males (ROR 1.65, 95%CI 1.54–1.78) and in age subgroups 65–74 years (ROR 1.21, 95%CI 1.05–1.39) and ≥75 years (ROR 1.84, 95%CI 1.52–2.22). Albeit not proving causation, these findings might support clinicians in decision-making for patients potentially at risk for developing an acute inflammatory neuropathy with COVID-19 vaccines. |
| Author | Ceschi, Alessandro Ripellino, Paolo Noseda, Roberta Ghidossi, Sara Bertoli, Raffaela |
| AuthorAffiliation | 1 Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; Roberta.noseda@eoc.ch (R.N.); Sara.ghidossi@eoc.ch (S.G.); raffaela.bertoli@eoc.ch (R.B.) 5 Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, 8091 Zurich, Switzerland 3 Clinical Trial Unit, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland 2 Neurology Department, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; Paolo.ripellino@eoc.ch 4 Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland |
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| CitedBy_id | crossref_primary_10_3390_life12091338 crossref_primary_10_1016_j_nrleng_2022_09_007 crossref_primary_10_1016_j_clinimag_2021_12_008 crossref_primary_10_1007_s40261_022_01164_4 crossref_primary_10_3390_ctn6010007 crossref_primary_10_3390_biomedicines12061248 crossref_primary_10_1016_j_neurol_2023_02_063 crossref_primary_10_1111_ene_16462 crossref_primary_10_1016_j_clinimag_2021_10_010 crossref_primary_10_20986_resed_2025_4120_2023 crossref_primary_10_1136_jnnp_2021_328182 crossref_primary_10_3390_vaccines11020236 |
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| References_xml | – ident: ref_12 doi: 10.1001/jamainternmed.2021.2219 – volume: 53 start-page: 337 year: 2016 ident: ref_1 article-title: Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment publication-title: Muscle Nerve doi: 10.1002/mus.25008 – volume: 21 start-page: 450 year: 2021 ident: ref_16 article-title: Bell’s palsy and SARS-CoV-2 vaccines publication-title: Lancet Infect. Dis. doi: 10.1016/S1473-3099(21)00076-1 – ident: ref_6 doi: 10.1007/s00415-021-10462-4 – volume: 373 start-page: n1046 year: 2021 ident: ref_15 article-title: Covid-19: Unusual blood clots are “very rare side effect” of Janssen vaccine, says EMA publication-title: BMJ doi: 10.1136/bmj.n1046 – ident: ref_5 doi: 10.1002/pmrj.12619 – volume: 43 start-page: 999 year: 2020 ident: ref_13 article-title: Risk Factor Considerations in Statistical Signal Detection: Using Subgroup Disproportionality to Uncover Risk Groups for Adverse Drug Reactions in VigiBase publication-title: Drug Saf. doi: 10.1007/s40264-020-00957-w – volume: 39 start-page: 355 year: 2016 ident: ref_14 article-title: Performance of Stratified and Subgrouped Disproportionality Analyses in Spontaneous Databases publication-title: Drug Saf. doi: 10.1007/s40264-015-0388-3 – volume: 64 start-page: E3 year: 2021 ident: ref_4 article-title: Parsonage Turner syndrome after COVID-19 vaccination publication-title: Muscle Nerve doi: 10.1002/mus.27255 – volume: 13 start-page: e13426 year: 2021 ident: ref_10 article-title: Neurological Complications of COVID-19: Guillain-Barre Syndrome Following Pfizer COVID-19 Vaccine publication-title: Cureus – volume: 388 start-page: 717 year: 2016 ident: ref_3 article-title: Guillain-Barré syndrome publication-title: Lancet doi: 10.1016/S0140-6736(16)00339-1 – volume: 14 start-page: e243629 year: 2021 ident: ref_9 article-title: Case of Guillain-Barré syndrome following COVID-19 vaccine publication-title: BMJ Case Rep. doi: 10.1136/bcr-2021-243629 – ident: ref_11 doi: 10.1002/ana.26144 – ident: ref_7 doi: 10.1007/s00415-021-10617-3 – ident: ref_8 doi: 10.1093/qjmed/hcab143 – volume: 35 start-page: 1972 year: 2017 ident: ref_2 article-title: Facial nerve palsy including Bell’s palsy: Case definitions and guidelines for collection, analysis, and presentation of immunisation safety data publication-title: Vaccine doi: 10.1016/j.vaccine.2016.05.023 |
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| SubjectTerms | acute inflammatory neuropathy Age Bell's palsy Brief Report Confidence intervals Coronaviruses COVID-19 COVID-19 vaccines Decision making disproportionality Guillain-Barre syndrome Inflammation Influenza Males Neuropathy Paralysis Patients Risk factors Risk groups safety Sex Subgroups Vaccines VigiBase |
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| Title | Reporting of Acute Inflammatory Neuropathies with COVID-19 Vaccines: Subgroup Disproportionality Analyses in VigiBase |
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