"Introduction
... The objective of this study was to investigate the association between the COVID-19 vaccination and ATM [acute transverse myelitis], employing a self-controlled case series (SCCS) design using a nationwide database.
Methods
Study design and population
... The study population included individuals aged 18 years or older who received the first COVID-19 vaccine dose and patients newly diagnosed with ATM... The COVID-19 vaccine included monovalent BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), ChAdOx1-S (AstraZeneca), Ad26.COV2.S (Johnson & Johnson), and NVX-CoV2373 (Novavax)...
Results
The total number of COVID‐19 vaccination [sic] between February 26, 2021, and August 31, 2022 was 128,223,471. We identified a total of 368 individuals aged 18 or older who received their first COVID‐19 vaccination and were diagnosed with ATM during the study period. Among the 159 eligible patients included in the analysis, 82 (51.6%) were male and the mean age was 55.4 years (±17.4 years) ...
Discussion
This nationwide population-based SCCS study identified a significant increase in the incidence of ATM within 1–42 days following COVID-19 vaccination. This elevated risk was consistent across various subgroups, including different types of vaccine products and patients...
The pathogenesis of TM [transverse myelitis] appears to be immune-mediated from infection, para-infection, and autoimmune disease. Post-vaccination TM may be associated with various types of immune pathways. Infectious agents and vaccine adjuvants are thought to induce autoimmunity in several ways, and there are several proposed mechanisms...
... Various immunopathological mechanisms have been proposed to explain the association between vaccines and ATM. These include molecular mimicry, where vaccine components mimic body tissues leading to an autoimmune response, and bystander activation, where the vaccine-induced immune response inadvertently activates self-reactive immune cells."
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© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.