China’s COVID-19 vaccine tied to slight risk of Bell’s palsy
China’s CoronaVac COVID-19 vaccine is tied to a slight increased risk of Bell’s palsy, while the Fosun/BioNTech (Pfizer/BioNTech’s parallel product in China) did not show a significantly increased risk, according to a study yesterday in The Lancet Infectious Diseases. Both the researchers and a related commentary conclude that COVID-19 vaccines’ benefits outweigh the risks.
Bell’s palsy mainly manifests as one-sided facial paralysis and resolves itself 70% of the time—90% of the time if the patient receives early treatment with corticosteroids.
The researchers looked at Hong Kong residents who were vaccinated with either COVID-19 vaccine from Feb 23 to May 4, first using population-based data to determine prevalence and then using a case-control study to tease out odds ratios. Out of 451,939 adults who received at least the first dose of CoronaVac, there were 28 clinically confirmed cases of Bell’s palsy, or 3.61 cases per 100,000 vaccinated people. For Fosun/BioNTech, 16 cases were identified among 537,205 recipients, or 2.04 people per 100,000.
The nested case-control study matched Bell’s palsy patients with other emergency department or hospital patients 1:4. Data indicated that the CoronaVac vaccine was associated with a 2.4-fold increased risk of Bell’s palsy (95% confidence interval [CI], 1.4 to 4.0), and the Fosun/BioNTech vaccine was tied with a 1.8-fold increased risk that was not statistically significant (95% CI, 0.9 to 3.5). The researchers note that the data for the Fosun/BioNTech vaccine may be underpowered.
“From a clinical, patient-oriented perspective, none of the studies published so far provide definitive evidence to inform the choice of a specific vaccine in individuals worldwide with a history of Bell’s palsy,” write Nicola Cirillo, DMD, PhD, and Richard Doan, MD, in a related commentary.
“However, the data published by Wan and colleagues do offer valuable information for a rational and informed choice of COVID-19 vaccines for patients in Hong Kong, and for those in countries where both BNT162b2 and CoronaVac are available. While waiting for conclusive evidence on vaccine-associated facial paralysis, one certainty remains: The benefit of getting vaccinated outweighs any possible risk.”
Aug 16 Lancet Infect Dis study and commentary
COVID vaccine well-tolerated in pregnancy, lactation, study says
Most pregnant and lactating people had at least one short-term reaction after receiving COVID-19 vaccines but tolerated them well overall, according to a research letter today in JAMA Network Open.
The researchers analyzed data on 17,525 primarily US adults (mean age, 33.6 years; 87.6% White) who were pregnant (44.6%), lactating (38.7%), or neither but planning to be pregnant in the near future (16.5%) who had just gotten their first dose of the COVID-19 vaccine by Mar 16. Most were employed in healthcare, and of the 17,431 with known vaccination types, 61.9% received Pfizer/BioNTech while 38.7% received Moderna.
Almost all (97.0%) had some sort of reaction after the first dose, most commonly injection-site pain (91.4%) or fatigue (31.3%), and even more had reactions after the second dose.
Obstetric-related reactions were reported in 4.4% after the first dose and 7.5% after the second dose. Pregnant people were statistically less likely to have certain reactions (eg, fever after a second Pfizer/BioNTech or Moderna dose; odds ratio, 0.44 to 0.48) compared with those who were not pregnant nor lactating. Interrupted breastfeeding occurred in 2.3% of lactating recipients after the first dose and 2.2% after the second, while decreased milk supply for less than 24 hours occurred in 5.0% after the first dose and 7.2% after the second dose.
Overall, 84.3% of pregnant vaccine recipients had a second dose by the time of data analysis, of whom 4.3% had delivered their baby and 0.7% had a miscarriage.
“This large prospective cohort study found that COVID-19 vaccines were well-tolerated among individuals who were pregnant, lactating, or planning pregnancy,” the researchers conclude.
Aug 17 JAMA Netw Open study