{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T09:04:46Z","timestamp":1774343086147,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea","award":["RS-2023-00245620"],"award-info":[{"award-number":["RS-2023-00245620"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Neurological complications after the coronavirus disease 2019 (COVID-19) vaccine administration have been reported. However, the incidence rates of these complications have not been compared in vaccinated and unvaccinated individuals. This study used a nationwide cohort from South Korea to investigate the incidence and prognostic factors of facial-related neurological disorders, such as facial palsy, trigeminal neuralgia, and hemifacial spasms, after COVID-19 vaccination. A population-based cohort design was used to examine data from a randomly selected 50% of the adult population in Seoul, South Korea. Information on demographics, vaccination status, vaccination type, and medical history was collected. The incidence rates and adjusted hazard ratios (aHRs) for facial-related neurological disorders were calculated. This study included 2,482,481 adults, 85.94% of whom were vaccinated. Vaccinated individuals showed a higher incidence of facial palsy, hemifacial spasm, and trigeminal neuralgia than unvaccinated individuals, with significant aHRs of 1.821, 3.203, and 6.621, respectively. Dyslipidemia, female sex, and young age were identified as risk factors for hemifacial spasms and trigeminal neuralgia. This study demonstrates an increased incidence of facial-related neurological disorders after COVID-19 vaccination, particularly among individuals with dyslipidemia and younger women. These findings underscore the need for further investigations into the mechanisms and management of vaccine-related neurological issues.<\/jats:p>","DOI":"10.3390\/jpm14070671","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T12:27:33Z","timestamp":1718972853000},"page":"671","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Coronavirus Disease 2019 Vaccination with Facial-Related Neurological Disorders: A Nationwide Retrospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1496-433X","authenticated-orcid":false,"given":"Younggoo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Informatization Department, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunmi","family":"Chun","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7116-9052","authenticated-orcid":false,"given":"Dosang","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"m408","DOI":"10.1136\/bmj.m408","article-title":"China coronavirus: Who declares international emergency as death toll exceeds 200","volume":"368","author":"Mahase","year":"2020","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Al Fayez, N., Nassar, M.S., Alshehri, A.A., Alnefaie, M.K., Almughem, F.A., Alshehri, B.Y., Alawad, A.O., and Tawfik, E.A. (2023). Recent advancement in mRNA vaccine development and applications. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15071972"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s12943-023-01807-w","article-title":"The use of RNA-based treatments in the field of cancer immunotherapy","volume":"22","author":"Chehelgerdi","year":"2023","journal-title":"Mol. Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the bnt162b2 mRNA COVID-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJMoa2035389","article-title":"Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine","volume":"384","author":"Baden","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1089\/fpsam.2022.0394","article-title":"Bell\u2019s palsy and COVID-19: Insights from a population-based analysis","volume":"26","author":"Balchander","year":"2024","journal-title":"Facial. Plast. Surg. Aesthet. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1002\/ohn.385","article-title":"Bell\u2019s palsy after vaccination against COVID-19: A systematic review and meta-analysis","volume":"169","author":"Gordon","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"104758","DOI":"10.1016\/j.amsu.2022.104758","article-title":"Development of facial palsy following COVID-19 vaccination: A systematic review","volume":"82","author":"Khurshid","year":"2022","journal-title":"Ann. Med. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"75","DOI":"10.5114\/ceji.2023.125309","article-title":"Trigeminal neuralgia occurring after the third dose of Pfizer BioNTech COVID-19 vaccine. complication or coincidence? an illustrative case report and literature review","volume":"48","author":"Chrostowski","year":"2023","journal-title":"Cent. Eur. J. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s13365-021-01030-7","article-title":"A case of trigeminal neuralgia developing after a COVID-19 vaccination","volume":"28","author":"Kaya","year":"2022","journal-title":"J. Neurovirol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.jclinepi.2004.03.012","article-title":"New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality","volume":"57","author":"Sundararajan","year":"2004","journal-title":"J. Clin. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1007\/s13760-023-02204-2","article-title":"Risk and characteristics of Bell\u2019s palsy in adults as an adverse event following COVID-19 vaccination: A retrospective study","volume":"123","author":"Kim","year":"2023","journal-title":"Acta Neurol. Belg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1001\/jamaoto.2021.1259","article-title":"Association of COVID-19 vaccination and facial nerve palsy: A case-control study","volume":"147","author":"Shemer","year":"2021","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3589","DOI":"10.1007\/s00415-021-10462-4","article-title":"Bell\u2019s palsy following COVID-19 vaccination","volume":"268","author":"Colella","year":"2021","journal-title":"J. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S1473-3099(21)00076-1","article-title":"Bell\u2019s palsy and SARS-CoV-2 vaccines","volume":"21","author":"Ozonoff","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100217","DOI":"10.1016\/j.bbih.2021.100217","article-title":"Bell\u2019s palsy after second dose of Pfizer COVID-19 vaccination in a patient with history of recurrent Bell\u2019s palsy","volume":"13","author":"Repajic","year":"2021","journal-title":"Brain Behav. Immun. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e253302","DOI":"10.1136\/bcr-2022-253302","article-title":"Concurrent facial and trigeminal nerve palsies in a child following COVID-19 vaccination with the Pfizer vaccine","volume":"16","author":"Moezinia","year":"2023","journal-title":"BMJ Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"CASE22101","DOI":"10.3171\/CASE22101","article-title":"Trigeminal neuropathy after tozinameran vaccination against COVID-19 in postmicrovascular decompression for trigeminal neuralgia: Illustrative case","volume":"3","author":"Onoda","year":"2022","journal-title":"J. Neurosurg. Case Lessons"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6041","DOI":"10.1016\/j.csbj.2022.10.022","article-title":"Molecular mimicry of SARS-CoV-2 spike protein in the nervous system: A bioinformatics approach","volume":"20","year":"2022","journal-title":"Comput. Struct. Biotechnol. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1196\/annals.1398.009","article-title":"Immune complex pathophysiology","volume":"1109","author":"Nydegger","year":"2007","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"F1000 Faculty Rev-368","DOI":"10.12688\/f1000research.17959.1","article-title":"The central role of nucleic acids in the pathogenesis of systemic lupus erythematosus","volume":"8","author":"Pisetsky","year":"2019","journal-title":"F1000Res"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/bs.acc.2019.11.001","article-title":"Revisiting immune complexes: Key to understanding immune-related diseases","volume":"96","author":"Aibara","year":"2020","journal-title":"Adv. Clin. Chem."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Mahemuti, N., Jing, X., Zhang, N., Liu, C., Li, C., Cui, Z., Liu, Y., and Chen, J. (2023). Association between systemic immunity-inflammation index and hyperlipidemia: A population-based study from the NHANES (2015\u20132020). Nutrients, 15.","DOI":"10.3390\/nu15051177"},{"key":"ref_24","first-page":"747","article-title":"Cellular and molecular links between autoimmunity and lipid metabolism","volume":"42","author":"Ryu","year":"2019","journal-title":"Mol Cells"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S0895-4356(03)00246-4","article-title":"Validation of diagnostic codes within medical services claims","volume":"57","author":"Wilchesky","year":"2004","journal-title":"J. Clin. Epidemiol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/7\/671\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:02:42Z","timestamp":1760108562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/7\/671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,21]]},"references-count":25,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jpm14070671"],"URL":"https:\/\/doi.org\/10.3390\/jpm14070671","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,21]]}}}