Neurological adverse events following COVID-19 vaccination among Canadians referred to the special immunization clinic network

Tiffany Fitzpatrick; Peter Yamoah; David Summerby-Murray; Juthaporn Cowan; Manish Sadarangani; Alissa Wright; Sara Belga; Cora Constantinescu; Alex Carignan; Athena McConnell; Karina A Top; Canadian Immunization Research Network Investigators

doi:10.1016/j.vaccine.2025.127254

Neurological adverse events following COVID-19 vaccination among Canadians referred to the special immunization clinic network

Vaccine. 2025 Jun 20:59:127254. doi: 10.1016/j.vaccine.2025.127254. Epub 2025 May 20.

Affiliations

¹ Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada; Canadian Center for Vaccinology, IWK Health and Dalhousie University; Halifax, NS, Canada; Public Health Ontario; Toronto, ON, Canada.
² Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
³ Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
⁴ Department of Medicine, University of Ottawa, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁵ Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
⁶ Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁷ Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada.
⁸ Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, QC, Canada.
⁹ Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹⁰ Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada; Canadian Center for Vaccinology, IWK Health and Dalhousie University; Halifax, NS, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. Electronic address: ktop@ualberta.ca.

PMID: 40398329
DOI: 10.1016/j.vaccine.2025.127254

Abstract

Neurological adverse events have been reported rarely following COVID-19 vaccination. This study describes the characteristics of adolescents and adults assessed in the Canadian Special Immunization Clinic (SIC) Network for neurological adverse events following immunization (AEFIs) and outcomes of revaccination. Among 60 participants enrolled from January 2021 to February 2023, paresthesia/anesthesia was the most common diagnosis (15/60; 25.0 %), followed by Bell's Palsy (6/60; 10.0 %). Twenty-eight percent (17/60) of participants were hospitalized for their AEFI. Revaccination was recommended to 32/46 (69.6 %) participants due for subsequent doses when assessed in the SIC. Twenty-three participants were revaccinated and 4/23 (17.4 %) had recurrent symptoms of the AEFI; three were milder than the first event and none required hospitalization. Revaccination was generally safe in selected patients after a neurological AEFI. Expert assessment of patients with neurological AEFIs may help to support further vaccination.

MeSH terms

Adolescent
Adult
Aged
Bell Palsy / epidemiology
Bell Palsy / etiology
COVID-19 Vaccines* / administration & dosage
COVID-19 Vaccines* / adverse effects
COVID-19* / prevention & control
Canada / epidemiology
Female
Hospitalization / statistics & numerical data
Humans
Immunization, Secondary / adverse effects
Male
Middle Aged
Nervous System Diseases* / epidemiology
Nervous System Diseases* / etiology
North American People
Paresthesia / epidemiology
Paresthesia / etiology
SARS-CoV-2 / immunology
Vaccination* / adverse effects
Young Adult

Substances

COVID-19 Vaccines

Supplementary concepts

Canadian people