{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:16:57Z","timestamp":1784557017974,"version":"3.55.0"},"reference-count":17,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Subacute thyroiditis is an inflammatory disorder of the thyroid gland that has previously been described following viral illnesses and occasionally post vaccination such as influenza vaccine. 2021 was a revolutionary year for the development of SARS-CoV-2 vaccinations with multiple different vaccines now available. There are increasing numbers of case reports of thyroiditis following these vaccinations. We report a case of a 50-year-old female who developed subacute thyroiditis 6 days post ChAdOx1 nCoV-19 vaccine (AZD1222 produced by AstraZeneca Vaxzevria). The initial thyrotoxic phase was followed by overt hypothyroidism. This resolved spontaneously within 5 months without levothyroxine replacement. We hope that our case will add to the growing literature of cases of thyroiditis occurring after multiple different types of SARS-CoV-2 vaccination and create awareness of this rare but treatable adverse effect. We also review the literature on the proposed mechanisms behind this adverse effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Subacute thyroiditis is an inflammatory disorder of the thyroid gland that can occur after a viral illness or vaccination against certain infections.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Subacute thyroiditis is a rare adverse effect that has been reported to occur after different types of SARS-CoV-2 vaccinations.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Subacute thyroiditis post vaccination is relatively straightforward to manage, with some patients requiring non-steroidal anti-inflammatory drugs and beta-blockers, while more severe cases may require corticosteroid therapy. This adverse effect should not dissuade vaccination use at a population level.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>There are many postulated mechanisms for the development of subacute thyroiditis following vaccination including the presence of the ACE-2 receptor for SARS-CoV-2 on the thyroid gland, an inflammatory\/immune response as is seen in COVID-19 infection itself and molecular mimicry between SARS-CoV-2 spike protein and healthy thyroid antigen.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-21-0193","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T09:55:28Z","timestamp":1662112528000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":2,"title":["Subacute thyroiditis post viral vector vaccine for COVID-19"],"prefix":"10.1530","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5968-3649","authenticated-orcid":true,"given":"Caoimhe","family":"Casey","sequence":"first","affiliation":[{"name":"University Hospital Kerry, Tralee, Co. Kerry, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Higgins","sequence":"additional","affiliation":[{"name":"University Hospital Kerry, Tralee, Co. Kerry, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"COVID-19 Vaccines. Vaccine Knowledge Project","year":"2021","unstructured":"COVID-19 Vaccines. Vaccine Knowledge Project. University of Oxford, 2021. (available at: https:\/\/vk.ovg.ox.ac.uk\/vk\/covid-19-vaccines)"},{"key":"bib2","series-title":"Vaxzevria","year":"2021","unstructured":"Vaxzevria. European Medicines Agency, 2021. (available at: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/vaxzevria-previously-covid-19-vaccine-astrazeneca)"},{"key":"bib3","series-title":"American Family Physician","first-page":"1047","article-title":"Thyroiditis: differential diagnosis and management","volume":"61","author":"Slatosky","year":"2000","unstructured":"Slatosky JShipton BWahba H. Thyroiditis: differential diagnosis and management. American Family Physician2000611047\u20131052."},{"key":"bib4","series-title":"Thyroid","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis","volume":"26","author":"Ross","year":"2016","unstructured":"Ross DSBurch HBCooper DSGreenlee MCLaurberg PMaia ALRivkees SASamuels MSosa JAStan MN2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid2016261343\u20131421. (https:\/\/doi.org\/10.1089\/thy.2016.0229)10.1089\/thy.2016.0229"},{"key":"bib5","series-title":"Journal of Endocrinological Investigation","article-title":"Subacute thyroiditis following the H1N1 vaccine","volume":"33","author":"Girgis","year":"2010","unstructured":"Girgis CMRusso RRBenson K. Subacute thyroiditis following the H1N1 vaccine. Journal of Endocrinological Investigation201033 506. (https:\/\/doi.org\/10.1007\/BF03346633)"},{"key":"bib6","series-title":"Eurosurveillance","article-title":"Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021","volume":"26","author":"Mesle","year":"2021","unstructured":"Mesle MMBrown JMook PHagan JPastore RBundle NSpiteri GRavasi GNicolay NAndrews NEstimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021. Eurosurveillance202126 2101021. (https:\/\/doi.org\/10.2807\/1560-7917.ES.2021.26.47.2101021)"},{"key":"bib7","series-title":"WHO Coronavirus (COVID-19) Dashboard","year":"2022","unstructured":"World Health Organisation. WHO Coronavirus (COVID-19) Dashboard. WHO, 2022. (available at: Covid19.who.int)"},{"key":"bib8","series-title":"Metabolism Open","article-title":"Thyroiditis following vaccination against COVID-19: report of two cases and review of the literature","volume":"12","author":"Siolos","year":"2021","unstructured":"Siolos AGartzonika KTigas S. Thyroiditis following vaccination against COVID-19: report of two cases and review of the literature. Metabolism Open202112 100136. (https:\/\/doi.org\/10.1016\/j.metop.2021.100136)"},{"key":"bib9","series-title":"Journal of Clinical Endocrinology and Metabolism","doi-asserted-by":"publisher","first-page":"2600","DOI":"10.1210\/clinem\/dgab373","article-title":"Three cases of subacute thyroiditis following SARS-CoV-2 vaccine: post-vaccination ASIA syndrome","volume":"106","author":"Iremli","year":"2021","unstructured":"Iremli BGSendur SNUnluturk U. Three cases of subacute thyroiditis following SARS-CoV-2 vaccine: post-vaccination ASIA syndrome. Journal of Clinical Endocrinology and Metabolism20211062600\u20132605. (https:\/\/doi.org\/10.1210\/clinem\/dgab373)10.1210\/clinem\/dgab373"},{"key":"bib10","series-title":"Journal of Endocrinological Investigation","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1007\/s40618-022-01747-0","article-title":"SARS-CoV-2 vaccine-associated subacute thyroiditis: insights from a systematic review","volume":"45","author":"Ippolito","year":"2022","unstructured":"Ippolito SGallo DRossini APatera BLanzo NFazzino GFMPiantanida ETanda ML. SARS-CoV-2 vaccine-associated subacute thyroiditis: insights from a systematic review. Journal of Endocrinological Investigation2022451189\u20131200. (https:\/\/doi.org\/10.1007\/s40618-022-01747-0)10.1007\/s40618-022-01747-0"},{"key":"bib11","series-title":"Expert Review of Clinical Immunology","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1080\/1744666X.2021.1932467","article-title":"SARS-COV-2-related immune-inflammatory thyroid disorders: facts and perspectives","volume":"17","author":"Ruggeri","year":"2021","unstructured":"Ruggeri RMCampenn\u00ec ADeandreis DSiracusa MTozzoli RPetranovi\u0107 Ov\u010dari\u010dek PGiovanella L. SARS-COV-2-related immune-inflammatory thyroid disorders: facts and perspectives. Expert Review of Clinical Immunology202117737\u2013759. (https:\/\/doi.org\/10.1080\/1744666X.2021.1932467)10.1080\/1744666X.2021.1932467"},{"key":"bib12","series-title":"Journal of Endocrinological Investigation","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1007\/s40618-021-01554-z","article-title":"Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects","volume":"44","author":"Lisco","year":"2021","unstructured":"Lisco GDe Tullio AJirillo EGiagulli VADe Pergola GGuastamacchia ETriggiani V. Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects. Journal of Endocrinological Investigation2021441801\u20131814. (https:\/\/doi.org\/10.1007\/s40618-021-01554-z)10.1007\/s40618-021-01554-z"},{"key":"bib13","series-title":"European Journal of Endocrinology","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1530\/EJE-20-0335","article-title":"Thyrotoxicosis in patients with COVID-19: the THYRCOV study","volume":"183","author":"Lania","year":"2020","unstructured":"Lania ASandri MTCellini MMirani MLavezzi EMazziotti G. Thyrotoxicosis in patients with COVID-19: the THYRCOV study. European Journal of Endocrinology2020183381\u2013387. (https:\/\/doi.org\/10.1530\/EJE-20-0335)10.1530\/EJE-20-0335"},{"key":"bib14","series-title":"Indian Journal of Endocrinology and Metabolism","doi-asserted-by":"publisher","first-page":"532","DOI":"10.4103\/ijem.IJEM_779_20","article-title":"Thyroid function test in COVID-19 patients: a cross-sectional study in a tertiary care hospital","volume":"24","author":"Sen","year":"2020","unstructured":"Sen KSinha ASen SChakraborty SAlam MS. Thyroid function test in COVID-19 patients: a cross-sectional study in a tertiary care hospital. Indian Journal of Endocrinology and Metabolism202024532\u2013536. (https:\/\/doi.org\/10.4103\/ijem.IJEM_779_20)10.4103\/ijem.IJEM_779_20"},{"key":"bib15","series-title":"Frontiers in Immunology","article-title":"Reaction of human monoclonal antibodies to SARS-CoV-2 proteins with tissue antigens: implications for autoimmune diseases","volume":"11","author":"Vojdani","year":"2020","unstructured":"Vojdani AVojdani EKharrazian D. Reaction of human monoclonal antibodies to SARS-CoV-2 proteins with tissue antigens: implications for autoimmune diseases. Frontiers in Immunology202011 617089. (https:\/\/doi.org\/10.3389\/fimmu.2020.617089)"},{"key":"bib16","series-title":"Thyroid","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1089\/1050725041517048","article-title":"Familial occurrence of subacute thyroiditis associated with human leukocyte antigen-B35","volume":"14","author":"Kramer","year":"2004","unstructured":"Kramer ABRoozendaal CDullaart RP. Familial occurrence of subacute thyroiditis associated with human leukocyte antigen-B35. Thyroid200414544\u2013547. (https:\/\/doi.org\/10.1089\/1050725041517048)10.1089\/1050725041517048"},{"key":"bib17","series-title":"Journal of Clinical Endocrinology and Metabolism","article-title":"SARS-CoV-2 vaccine-induced thyroiditis: safety of revaccinations and clinical follow-up","volume":"107","author":"O\u011fuz","year":"2022","unstructured":"O\u011fuz SH\u015eendur SN\u0130remli BGG\u00fcrlek AErbas T\u00dcnl\u00fct\u00fcrk U. SARS-CoV-2 vaccine-induced thyroiditis: safety of revaccinations and clinical follow-up. Journal of Clinical Endocrinology and Metabolism2022107 e1823\u2013e1834. (https:\/\/doi.org\/10.1210\/clinem\/dgac049)"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2022\/1\/EDM21-0193.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2022\/1\/EDM21-0193.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2022\/1\/EDM21-0193.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:47:51Z","timestamp":1784555271000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,1]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1530\/edm-21-0193","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,1]]}}}