WORST SIDE EFFECT OF COVID VACCINE REGISTRATIONHeadache was characterized as dull in 40%, and intensity was very severe in 8.2%, severe in 32.1%, and moderate in 46.2%.Īccording to one of the registration studies for the AZV, headache was the most frequent neurological complication of SARS‐CoV‐2 vaccinations without providing an exact figure of the headache frequency. In 38% and 32% of the cases, headache occurred in a frontal or temporal distribution, respectively. In two thirds of these cases, headache manifested with a single episode. Headache started on the average 18 h after the shot and lasted on the average for 14 h. In a recent multinational, multicenter observational cohort study by means of a standardized questionnaire, among inhabitants of residential care homes of the elderly and patients from hospitals, 2349 patients reported headache after vaccination with the Pfizer vaccine. Since the virus and the adverse reactions to vaccinations show a tropism for neuronal structures and tissues this narrative review about the neurological side effects was conducted to collect and discuss published data in order to discover type, frequency, treatment, and outcome of these side effects and to eventually discover if certain patients are prone to experience them, if they can be prevented, and which therapeutic management is the most appropriate. Only, rarely these side effects can be fatal. However, in some cases, these side effects are severe and require hospitalization or even admission to an intensive care unit (ICU). Neurological side effects to SARS‐CoV‐2 vaccinations are usually mild, of short duration, self‐limiting, and ambulatorily manageable. This shortage of published information about type, frequency, severity, and therapeutic management of vaccination‐related side effects is in contradiction to the daily experience of healthcare workers and affected probands, and may contribute to the individual or organized resistance and reservations against the vaccination from parts of the populations, the only moderate effect of vaccination campaigns, and the tendency to introduce compulsory vaccination. Usually, single case reports, case series, or registration studies report these side effects but systematic, transnational, multicenter, post‐marketing investigations on this matter are infrequently done. There is also an anti‐vaccine movement in the world nowadays that also contributes to the biased assessment of these adverse effects. Since the benefit for the global population outweighs these adverse reactions, and since political and pecuniary interests create the image of a “safe and indispensable” tool against the currently dominant global burden, there is only moderate reporting and discussion about them. Though SARS‐CoV‐2 vaccinations are usually sold as well tolerated, they can cause mild‐to‐severe side effects in some patients. Healthcare professionals, particularly neurologists involved in the management of patients having undergone SARS‐CoV‐2 vaccinations, should be aware of these side effects and should stay vigilant to recognize them early and treat them adequately. The most frequent of them are headache, GBS, VST, and transverse myelitis. In conclusion, safety concerns against SARS‐CoV‐2 vaccines are backed by an increasing number of studies reporting neurological side effects. The worst outcome of these side effects is associated with VST, why it should not be missed and treated appropriately in due time. Treatment of these side effects is not at variance from similar conditions due to other causes. Neurological side effects occur with any of the approved vaccines but VST particularly occurs after vaccination with vector‐based vaccines. Other neurological side effects occur in a much lower frequency. The most frequent neurological side effects of SARS‐CoV‐2 vaccines are headache, Guillain‐Barre syndrome (GBS), venous sinus thrombosis (VST), and transverse myelitis. This narrative review was conducted to collect and discuss published data about neurological side effects of SARS‐CoV‐2 vaccines in order to discover type, frequency, treatment, and outcome of these side effects. SARS‐CoV‐2 and adverse reactions to SARS‐CoV‐2 vaccinations show a tropism for neuronal structures and tissues.
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