Autoimmune Encephalitis, Neuromyelitis Optica Spectrum Disorder and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Analysis of the Vaccine Adverse Event Reporting System (VAERS)

IntroductionAutoimmune encephalitis (AE), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are complex and debilitating neurological disorders. MethodsThis study uses the Vaccine Adverse Event Reporting System (VAERS) to investigate the potential relationship between vaccinations and the incidence of NMOSD, AE, and MOGAD. Potential risk factors, such as age, sex, type of vaccine, and previous history of autoimmune diseases, were examined using multivariate logistic regression analysis. ResultsOur analysis included 161 cases: 72 NMOSD, 82 AE, and 7 MOGAD. The COVID-19 vaccine was implicated in 19/72 (26.3%) NMOSD, 43/82 (52.4%) of AE and 6/7 (85.7%) of MOGAD. The subacute temporal profile (OR 24.4, p = 0.004) and the presence of any comorbidity (OR 12.49, p = 0.004) were significantly associated with hospitalization for those with NMOSD. The subacute onset of symptoms and encephalopathy was statistically significant for hospitalization (OR 6.15, p = 0.048) and (OR 10.3, p = 0.005) respectively for patients with AE. Anti-NMDAR (N-methyl D-aspartate) antibodies were observed in 16/24 (66.7%) of AE. Treatment often involved high-dose corticosteroids or intravenous immunoglobulin (IVIG). ConclusionsMost cases of vaccine induced NMOSD, AE, and MOGAD occurred secondary to the SARS-CoV-2 vaccine. The subacute onset of symptoms and the presence of encephalopathy was most associated with hospitalization.