4.7 Review

Nervous and Muscular Adverse Events after COVID-19 Vaccination: A Systematic Review and Meta-Analysis of Clinical Trials

期刊

VACCINES
卷 9, 期 8, 页码 -

出版社

MDPI
DOI: 10.3390/vaccines9080939

关键词

COVID-19; vaccine; adverse events; nervous system; muscular system

资金

  1. Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases [2020B1212060017]
  2. Guangdong Provincial Clinical Research Center for Neurological Diseases [2020B1111170002]
  3. Southern China International Cooperation Base for Early Intervention and Functional Rehabilitation of Neurological Diseases [2020A0505020004]
  4. Guangzhou Clinical Research and Translational Center for Major Neurological Diseases [201604020010]
  5. Guangdong Provincial Engineering Center for Major Neurological Disease Treatment, Guangdong Provincial Translational Medicine Innovation Platform for Diagnosis and Treatment of Major Neurological Disease

向作者/读者索取更多资源

The study found that NMAEs (nervous and muscular adverse events) after COVID-19 vaccination are common, particularly headache and myalgia. Although these adverse events are mostly mild reactions, continuous monitoring is still necessary during the vaccination process.
Background: Nervous and muscular adverse events (NMAEs) have garnered considerable attention after the vaccination against coronavirus disease (COVID-19). However, the incidences of NMAEs remain unclear. We aimed to calculate the pooled event rate of NMAEs after COVID-19 vaccination. Methods: A systematic review and meta-analysis of clinical trials on the incidences of NMAEs after COVID-19 vaccination was conducted. The PubMed, Medline, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure databases were searched from inception to 2 June 2021. Two independent reviewers selected the study and extracted the data. Categorical variables were analyzed using Pearson's chi-square test. The pooled odds ratio (OR) with the corresponding 95% confidence intervals (CIs) were estimated and generated with random or fixed effects models. The protocol of the present study was registered on PROSPERO (CRD42021240450). Results: In 15 phase 1/2 trials, NMAEs occurred in 29.2% vs. 21.6% (p < 0.001) vaccinated participants and controls. Headache and myalgia accounted for 98.2% and 97.7%, and their incidences were 16.4% vs. 13.9% (OR = 1.97, 95% CI = 1.28-3.06, p = 0.002) and 16.0% vs. 7.9% (OR = 3.31, 95% CI = 2.05-5.35, p < 0.001) in the vaccine and control groups, respectively. Headache and myalgia were more frequent in the newly licensed vaccines (OR = 1.97, 95% CI = 1.28-3.06, p = 0.02 and OR = 3.31, 95% CI = 2.05-5.35, p < 0.001) and younger adults (OR = 1.40, 95% CI = 1.12-1.75, p = 0.003 and OR = 1.54, 95% CI = 1.20-1.96, p < 0.001). In four open-label trials, the incidences of headache, myalgia, and unsolicited NMAEs were 38.7%, 27.4%, and 1.5%. Following vaccination in phase 3 trials, headache and myalgia were still common with a rate of 29.5% and 19.2%, although the unsolicited NMAEs with incidence rates of <= 0.7% were not different from the control group in each study. Conclusions: Following the vaccination, NMAEs are common of which headache and myalgia comprised a considerable measure, although life-threatening unsolicited events are rare. NMAEs should be continuously monitored during the ongoing global COVID-19 vaccination program.

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