in 1973 from the University of Florida. After leading a highly successful merger with Big Brothers Big Sisters of Tampa Bay, she retired in 2014. Al Ruechel, a graduate of Iowa State University, is a retired Television News Anchor from Bay News 9 serving the greater Tampa Bay area. Image Credit:Rolling Stones/ Shutterstock, This news article was a review of a preliminary scientific report that had not undergone peer-review at the time of publication. The Article Processing Charge was funded by the authors. An additional challenge is vaccine hesitancy related to relative mistrust of the medical community, which stems from a variety of historical events and experiences.e45,e46 Of course, it is important to note that vaccine hesitancy is not restricted to underrepresented populations and transcends age, sex, race, and socioeconomic class, although the historical experiences producing hesitancy are often unique to these groups. Consideration of this population is critical when considering the risks and benefits of vaccination. Doctors are warning of the possibility of a surge in cases of a debilitating nervous-system disorder that may be associated with long COVID. I. Haq has received funding for his research from the NINDS and NIA and has served on advisory boards for Boston Scientific and Medtronic. Covid vaccine side effects: Tinnitus may be linked to Vaccination presents an opportunity to decrease transmission and reduce severity of infection within vulnerable populations. To lower overall viral transmission through herd immunity and decrease disease severity, particularly in vulnerable populations, 3 vaccines using distinct approaches have been approved by the FDA for emergency use. Susan Alex, Shanet. Data are also sparse, although emerging, regarding the vaccines use in pregnant women.e37 Although no obvious safety signals were seen, we await further evidence of safety and efficacy. Tanya is a lifelong resident of St. Petersburg and an associate broker and sales consultant at Baird Realty Group, a family-owned full service real estate firm. Underrepresented populations, including the Black, Latinx, and indigenous communities, also merit special consideration due to disproportionate risk of morbidity and mortality related to SARS-CoV-2 infectione38-e41 and disparities in access to available vaccines,e42-e44 although no data exist specifically regarding the interaction between COVID-19 and preexisting neurologic illness in these groups. on behalf of the Quality Committee of the American Academy of Neurology, DOI: https://doi.org/10.1212/WNL.0000000000012578, The burden of neurological disease in the United States: a summary report and call to action, Moderna COVID-19 vaccine EUA letter of authorization, FDA issues emergency use authorization for third COVID-19 vaccine, Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China, Postinfectious brainstem encephalitis associated with SARS-CoV-2, Neurologic features in severe SARS-CoV-2 infection, Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19, Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study, COVID-19 neuropathology at Columbia University Irving Medical Center/New York Presbyterian Hospital, Microvascular injury in the brains of patients with covid-19, SARS-CoV-2 and nervous system: from pathogenesis to clinical manifestation, Loss of smell in patients with COVID-19: MRI data reveal a transient edema of the olfactory clefts, Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia, Risk of ischemic stroke in patients with coronavirus disease 2019 (COVID-19) vs patients with influenza, Acute cerebellar ataxia and myoclonus with or without opsoclonus: a parainfectious syndrome associated with COVID19, Opsoclonus-myoclonus-ataxia syndrome (OMAS) associated with SARS-CoV-2 infection: post-infectious neurological complication with benign prognosis, PostCOVID19 inflammatory syndrome manifesting as refractory status epilepticus, A historical analysis of the relationship between encephalitis lethargica and postencephalitic parkinsonism: a complex rather than a direct relationship, The neurological sequelae of pandemics and epidemics, Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up, Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis, Rates of pneumococcal disease in adults with chronic medical conditions, Myasthenic crisis demanding mechanical ventilation: a multicenter analysis of 250 cases, Clinical characteristics and outcomes in patients with coronavirus disease 2019 and multiple sclerosis, Disease modifying therapies and covid-19 severity in multiple sclerosis, Persistence and evolution of SARS-CoV-2 in an immunocompromised host, Acute stroke in times of the COVID-19 pandemic: a multicenter study, COVID-19 vaccine frontrunners and their nanotechnology design, Vaccines based on replication incompetent Ad26 viral vectors: standardized template with key considerations for a risk/benefit assessment, Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine, Thrombosis with thrombocytopenia syndrome (also termed vaccine-induced thrombotic thrombocytopenia), US case reports of cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2.S vaccination, March 2 to April 21, 2021, Updated recommendations from the advisory committee on immunization practices for use of the Janssen (Johnson & Johnson) COVID-19 vaccine after reports of thrombosis with thrombocytopenia syndrome among vaccine recipients: United States, April 2021, Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: population based cohort study, VAERS: Vaccine Adverse Event Reporting System, Post covid-19 vaccine small fiber neuropathy, Persistent self-reported changes in hearing and tinnitus in post-hospitalisation COVID-19 cases, COVID-19 vaccine guidance for people living with MS, Doctor: Should I get the COVID19 vaccine? However, along with the optimal timing of vaccination, there are additional considerations for many groups, prompting national societies to offer statements in support of vaccine administration. Go to Neurology.org/N for full disclosures. Go to Neurology.org/N for full disclosures. More info. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. With regard to vaccination in patients with neurologic disease, several concerns arise. * A lower score on the RAND 36-Item Health Survey indicates greater disability. Possible Side Effects After Getting a COVID-19 Vaccine There are little to no data regarding the safety or efficacy of the COVID-19 vaccines in patients with preexisting neurologic conditions or patients receiving immunomodulatory therapies. For instance, a recent autopsy study of 41 consecutive patients who died of SARS-CoV-2 infection found low to very low viral RNA levels in some of the brains by qRT-PCR, but viral proteins were not detected, and the level of detectable RNA did not correlate with histopathologic alterations.14 Other studies have not been able to detect viral RNA or protein in the brain.11,15 Based on rodent studies with other coronaviruses, researchers have speculated that the virus might be able to enter the CNS via retrograde dissemination. According to the authors, this was the broadest study that used validated autonomic questionnaire scores to show that autonomic dysfunction was frequent in PASC yet available. In this adult population research, about 87% of PASC participants were between the ages of 31 and 65, comparable with the age distribution reported in prior studies. The Johnson & Johnson vaccine, in contrast, utilizes a replication-deficient adenovirus vector to deliver DNA encoding the SARS-CoV-2 spike protein into host cells, which is then transcribed/translated into antigenic protein. The strongest association of ADEM has been with the Semple rabies vaccine, likely because it was made in cells derived from the nervous system.60 With regard to MS, theoretical concerns about vaccines precipitating relapses have existed for decades,e6 although published studies have failed to identify any correlation between vaccination and either initial or subsequent clinical attacks.e7-e10 In contrast, several vaccines have been possibly linked to a lower risk of subsequent MS diagnosis.e8 Thus far, a single study of adult patients with MS receiving the Pfizer COVID-19 vaccine (555 having received the first dose and 435 having received the second dose) demonstrated no safety concerns and no increased risk of relapse.49, Studies of COVID-19 vaccine efficacy in patients receiving immunotherapies are limited. The 1918 H1N1 pandemic's association with postencephalitic parkinsonism (PEP) and Zika virusinduced congenital Zika syndrome are prominent examples. Severe adverse events attributable to vaccine or placebo were uncommon, and similar between the vaccine and placebo groups (0.5% vs 0.2%). Similar results were seen with the Moderna vaccine.3. Monika tedul on Twitter: "11/17 Small fiber neuropathy The trial showed high efficacy (94.1%) and a low rate of complications in individuals at high risk for infection and mortality due to COVID-19 who received active vaccine.39 Whereas neurologic illness was not an inclusion criterion, other high-risk comorbidities such as heart failure, pulmonary hypertension, diabetes, and HIV infection resulted in a diverse population with multiple comorbidities that would be expected to encompass some patients with neurologic disease. This includes not only those treated with immunosuppressive therapies for their neurologic disorders (e.g., myasthenia gravis or multiple sclerosis [MS]) but also those with significant functional disability from their disease and elderly patients with a history of cerebrovascular disease and dementia. Global registries will be crucial for determining whether SARS-CoV-2 infection, like other viral infections, will be associated with increased incidence of psychiatric disease, dementia, thrombosis, or demyelination later in life. E.B. None of the patients had prior neurologic illnesses. Alexandra is pleased to contribute to this worthy cause by using her past experience in non-profit work and is greatly encouraged by the strides made since TDPs inception. We also review the potential risks associated with vaccination using data from the existing COVID-19 vaccination trials and known history of responses to vaccines for other diseases. They are thought to be immune-mediated and early recognition and treatment with immunomodulatory therapies might be warranted. Vaccine administration for the majority of patients with stroke and cardiovascular disease is also supported by the American Heart Association,e33 as infection with COVID-19 can exacerbate neurologic sequelae of prior strokes. Her professional career as a physical therapist assistant for over 25 years serves her in educating patients about Dysautonomia and whats happening to their bodies. More guidelines and information on Disputes & Debates, Prospective Long-term Follow-up of Focused Ultrasound Unilateral Subthalamotomy for Parkinson Disease, Neurology | Print ISSN:0028-3878 Vaccination against SARS-CoV-2 infection may inspire confidence and allow the anxious to seek the care required to prevent increased morbidity and mortality. Good News Both the American Academy of Neuromuscular and Electrodiagnostic Medicine and the National Multiple Sclerosis Society are in favor of vaccination for patients with neuromuscular disease and MS, regardless of immunosuppressive status. It found a 66% reduction in moderate to severe COVID-19 in its treatment arm, with 85% reduction in severe disease and no hospitalizations or COVID-19related deaths compared to controls. Moderna COVID Tanya was director and head coach for 9 years of Tampa Bay Fit marathon training program and coached middle school track & field. Even though PASC is not widely described, it is most commonly defined as COVID-19 symptoms that continue longer than 30 days. A similar platform has been used in a prior Ebola virus vaccine approved for use in the European Union.38 Because none of the currently approved vaccines utilize live-attenuated SARS-CoV-2 virus, none has the potential to cause SARS-CoV-2 infection. In the current sample, the severity of COVID-19 did not link with the degree of autonomic dysfunction, implying that even mild SARS-CoV-2 infections can cause considerable autonomic dysfunction. Although neurologic side effects were not more commonly observed following active vaccine over the extended follow-up period for any of the vaccines, a number of neurologic complications of these vaccines are now being reported in the most comprehensive registry, the Vaccine Adverse Events Reporting System (VAERS) database.