{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:52:54Z","timestamp":1760147574597,"version":"build-2065373602"},"reference-count":97,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T00:00:00Z","timestamp":1676246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taoyuan Armed Forces General Hospital, Taiwan","award":["TYAFGH-D-111038"],"award-info":[{"award-number":["TYAFGH-D-111038"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), broke out in 2019 and became a pandemic in 2020. Since then, vaccines have been approved to prevent severe illness. However, vaccines are associated with the risk of neurological complications ranging from mild to severe. Severe complications such as vaccine-induced immune thrombotic thrombocytopenia (VITT) associated with acute ischaemic stroke have been reported as rare complications post-COVID-19 vaccination. During the pandemic era, VITT evaluation is needed in cases with a history of vaccination within the last month prior to the event. Cerebral venous sinus thrombosis (CVST) should be suspected in patients following immunization with persistent headaches who are unresponsive to analgesics. In this article, we investigated neurological complications after COVID-19 vaccination and provided more subsequent related clinical studies of accurate diagnosis, pathophysiological mechanisms, incidence, outcome, and management.<\/jats:p>","DOI":"10.3390\/vaccines11020425","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T04:07:19Z","timestamp":1676261239000},"page":"425","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Investigation of Neurological Complications after COVID-19 Vaccination: Report of the Clinical Scenarios and Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"given":"Wei-Ping","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Ta","family":"Shang","sequence":"additional","affiliation":[{"name":"Infectious Disease, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung-Hsi","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, National Central University, Taoyuan 320, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-An","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Pulmonary & Critical Care Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5192-6706","authenticated-orcid":false,"given":"Wen-Fang","family":"Chiang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenq-Shyong","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hann-Yeh","family":"Shyu","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4965-0285","authenticated-orcid":false,"given":"Po-Jen","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, National Central University, Taoyuan 320, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,13]]},"reference":[{"key":"ref_1","unstructured":"CDC (2022, November 28). Selected Adverse Events Reported after COVID-19 Vaccination, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/safety\/adverse-events.html."},{"key":"ref_2","unstructured":"FDA (2022, December 12). Available online: https:\/\/www.fda.gov.tw\/TC\/siteList.aspx?sid=1571."},{"key":"ref_3","unstructured":"Anil, K.L. (2020). Current Diagnosis & Amp; Treatment Otolaryngology\u2014Head and Neck Surgery, McGraw-Hill Education. [4th ed.]."},{"key":"ref_4","unstructured":"Maxine, A., Papadakis, M.A., McPhee, S.J., Rabow, M.W., and McQuaid, R. (2023). Current Medical Diagnosis & Treatment 2023, McGraw-Hill Education."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Transverse Myelitis Consortium Working Group (2002). Proposed Diagnostic Criteria and Nosology of Acute Transverse Myelitis. Neurology, 59, 499\u2013505.","DOI":"10.1212\/WNL.59.4.499"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1093\/cid\/cit458","article-title":"Case Definitions, Diagnostic Algorithms, and Priorities in Encephalitis: Consensus Statement of the International Encephalitis Consortium","volume":"57","author":"Venkatesan","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.antiviral.2006.04.002","article-title":"Herpes Simplex Encephalitis: Adolescents and Adults","volume":"71","author":"Whitley","year":"2006","journal-title":"Antivir. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1111\/ene.13381","article-title":"European Stroke Organization Guideline for the Diagnosis and Treatment of Cerebral Venous Thrombosis\u2013Endorsed by the European Academy of Neurology","volume":"24","author":"Ferro","year":"2017","journal-title":"Eur. J. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/qjmed\/hcab335","article-title":"COVID-19 Vaccine-Induced Encephalitis and Status Epilepticus","volume":"115","author":"Fan","year":"2022","journal-title":"QJM"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.cca.2022.02.003","article-title":"The Role of Anti-Platelet Factor 4 Antibodies and Platelet Activation Tests in Patients with Vaccine-Induced Immune Thrombotic Thrombocytopenia: Brief Report on a Comparison of the Laboratory Diagnosis and Literature Review","volume":"529","author":"Hsiao","year":"2022","journal-title":"Clin. Chim. Acta"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1161\/CIRCRESAHA.121.318902","article-title":"SARS-CoV-2 Spike Protein Impairs Endothelial Function Via Downregulation of Ace 2","volume":"128","author":"Yuyang","year":"2021","journal-title":"Circ. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"151682","DOI":"10.1016\/j.anndiagpath.2020.151682","article-title":"Endothelial Cell Damage Is the Central Part of COVID-19 and a Mouse Model Induced by Injection of the S1 Subunit of the Spike Protein","volume":"51","author":"Nuovo","year":"2021","journal-title":"Ann. Diagn. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Michel, G., and Hermans, C. (2021). Thrombotic Thrombocytopenia Associated with COVID-19 Infection or Vaccination: Possible Paths to Platelet Factor 4 Autoimmunity. PLOS Med., 18.","DOI":"10.1371\/journal.pmed.1003648"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"117607","DOI":"10.1016\/j.jns.2021.117607","article-title":"Vaccine-Induced Immune Thrombotic Thrombocytopenia and Cerebral Venous Sinus Thrombosis Post COVID-19 Vaccination; a Systematic Review","volume":"428","author":"Bahmanyar","year":"2021","journal-title":"J. Neurol. Sci."},{"key":"ref_15","first-page":"130","article-title":"Thrombosis Patterns and Clinical Outcome of COVID-19 Vaccine-Induced Immune Thrombotic Thrombocytopenia: A Systematic Review and Meta-Analysis","volume":"119","author":"Kim","year":"2022","journal-title":"Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.thromres.2022.04.020","article-title":"Thrombotic Thrombocytopenic Purpura (Ttp) after COVID-19 Vaccination: A Systematic Review of Reported Cases","volume":"214","author":"Saluja","year":"2022","journal-title":"Thromb. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1159\/000524290","article-title":"Ischemic Stroke and Vaccine-Induced Immune Thrombotic Thrombocytopenia Following COVID-19 Vaccine: A Case Report with Systematic Review of the Literature","volume":"51","author":"Giussani","year":"2022","journal-title":"Cereb. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"104032","DOI":"10.1016\/j.msard.2022.104032","article-title":"Clinical Characteristics, Radiological Features and Prognostic Factors of Transverse Myelitis Following COVID-19 Vaccination: A Systematic Review","volume":"66","author":"Ostovan","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Takuva, S., Takalani, A., Seocharan, I., Yende-Zuma, N., Reddy, T., Engelbrecht, I., Faesen, M., Khuto, K., Whyte, C., and Bailey, V. (2022). Safety Evaluation of the Single-Dose Ad26.Cov2.S Vaccine among Healthcare Workers in the Sisonke Study in South Africa: A Phase 3b Implementation Trial. PLoS Med., 19.","DOI":"10.1101\/2021.12.20.21267967"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1016\/S0140-6736(20)32466-1","article-title":"Safety and Immunogenicity of Chadox1 Ncov-19 Vaccine Administered in a Prime-Boost Regimen in Young and Old Adults (Cov002): A Single-Blind, Randomised, Controlled, Phase 2\/3 Trial","volume":"396","author":"Ramasamy","year":"2021","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1288\/00005537-198901000-00006","article-title":"Histopathology of Bell\u2019s Palsy","volume":"99","author":"Liston","year":"1989","journal-title":"Laryngoscope"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1007\/s12070-018-1381-9","article-title":"Bell\u2019s Palsy-Tertiary Ischemia: An Etiological Factor in Residual Facial Palsy","volume":"70","author":"Grewal","year":"2018","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"27","DOI":"10.7326\/0003-4819-124-1_Part_1-199601010-00005","article-title":"Bell Palsy and Herpes Simplex Virus: Identification of Viral DNA in Endoneurial Fluid and Muscle","volume":"124","author":"Murakami","year":"1996","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"245","DOI":"10.12688\/f1000research.2-245.v1","article-title":"Bell\u2019s Palsy During Interferon Alpha 2a Treatment in a Case with Behcet Uveitis","volume":"2","author":"Yalcindag","year":"2013","journal-title":"F1000 Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2526","DOI":"10.1111\/ene.15371","article-title":"Surge of Bell\u2019s Palsy in the Era of COVID-19: Systematic Review","volume":"29","author":"Gupta","year":"2022","journal-title":"Eur. J. Neurol."},{"key":"ref_26","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_27","doi-asserted-by":"crossref","first-page":"102896","DOI":"10.1016\/j.jaut.2022.102896","article-title":"COVID-19 Mrna Vaccine Bnt162b2 Induces Autoantibodies against Type I Interferons in a Healthy Woman","volume":"132","author":"Ning","year":"2022","journal-title":"J. Autoimmun."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1016\/S1473-3099(21)00273-5","article-title":"Bell\u2019s Palsy and SARS-CoV-2 Vaccines-an Unfolding Story","volume":"21","author":"Cirillo","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lai, Y.H., Chen, H.Y., Chiu, H.H., Kang, Y.N., and Wong, S.B. (2022). Peripheral Nervous System Adverse Events after the Administration of Mrna Vaccines: A Systematic Review and Meta-Analysis of Large-Scale Studies. Vaccines, 10.","DOI":"10.3390\/vaccines10122174"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"n1435","DOI":"10.1136\/bmj.n1435","article-title":"Characterising the Background Incidence Rates of Adverse Events of Special Interest for COVID-19 Vaccines in Eight Countries: Multinational Network Cohort Study","volume":"373","author":"Li","year":"2021","journal-title":"BMJ"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4401","DOI":"10.1007\/s10072-021-05523-5","article-title":"Guillain-Barre Syndrome Following Bnt162b2 COVID-19 Vaccine","volume":"42","author":"Trimboli","year":"2021","journal-title":"Neurol. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e244125","DOI":"10.1136\/bcr-2021-244125","article-title":"Guillain-Barre Syndrome after COVID-19 Vaccination","volume":"14","author":"McKean","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e228879","DOI":"10.1001\/jamanetworkopen.2022.8879","article-title":"Incidence of Guillain-Barre Syndrome after COVID-19 Vaccination in the Vaccine Safety Datalink","volume":"5","author":"Hanson","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1126\/science.abb2507","article-title":"Cryo-Em Structure of the 2019-Ncov Spike in the Prefusion Conformation","volume":"367","author":"Wrapp","year":"2020","journal-title":"Science"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3988\/jcn.2014.10.2.94","article-title":"Prevalence of Anti-Ganglioside Antibodies and Their Clinical Correlates with Guillain-Barr\u00e9 Syndrome in Korea: A Nationwide Multicenter Study","volume":"10","author":"Kim","year":"2014","journal-title":"J. Clin. Neurol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s13760-021-01787-y","article-title":"SARS-CoV-2-Associated Guillain\u2013Barr\u00e9 Syndrome in Four Patients: What Do We Know About Pathophysiology?","volume":"122","author":"Guilmot","year":"2022","journal-title":"Acta Neurol. Belg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"102681","DOI":"10.1016\/j.autrev.2020.102681","article-title":"Guillain Barr\u00e9 syndrome and COVID-19: Possible role of the cytokine storm","volume":"19","author":"Hussain","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"120330","DOI":"10.1016\/j.jns.2022.120330","article-title":"COVID-19 Vaccine-Related Guillain-Barr\u00e9 Syndrome in the Liguria Region of Italy: A Multicenter Case Series","volume":"440","author":"Germano","year":"2022","journal-title":"J. Neurol. Sci."},{"key":"ref_39","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_40","doi-asserted-by":"crossref","first-page":"e242344","DOI":"10.1136\/bcr-2021-242344","article-title":"Trigeminal and Cervical Radiculitis after Tozinameran Vaccination against COVID-19","volume":"14","author":"Narasimhalu","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_41","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_42","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.autrev.2011.05.018","article-title":"Transverse Myelitis","volume":"11","author":"Borchers","year":"2012","journal-title":"Autoimmun. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e1912732","DOI":"10.1001\/jamanetworkopen.2019.12732","article-title":"Comparison of Clinical Outcomes of Transverse Myelitis among Adults with Myelin Oligodendrocyte Glycoprotein Antibody vs. Aquaporin-4 Antibody Disease","volume":"2","author":"Mariano","year":"2019","journal-title":"JAMA Netw Open"},{"key":"ref_44","first-page":"944","article-title":"Acute Disseminated Encephalomyelitis, Transverse Myelitis, and Neuromyelitis Optica","volume":"19","author":"Wingerchuk","year":"2013","journal-title":"Continuum"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"103960","DOI":"10.1016\/j.msard.2022.103960","article-title":"Watch out for neuromyelitis optica spectrum disorder onset or clinical relapse after COVID-19 vaccination: What neurologists need to know?","volume":"65","author":"Paybast","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1177\/13524585211057512","article-title":"Mog-Antibody-Associated Longitudinal Extensive Myelitis after Chadox1 Ncov-19 Vaccination","volume":"28","author":"Dams","year":"2022","journal-title":"Mult. Scler."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1177\/0961203309345730","article-title":"Transverse Myelitis and Vaccines: A Multi-Analysis","volume":"18","author":"Kivity","year":"2009","journal-title":"Lupus"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"577606","DOI":"10.1016\/j.jneuroim.2021.577606","article-title":"A Case of Longitudinally Extensive Transverse Myelitis Following Vaccination against COVID-19","volume":"358","author":"Pagenkopf","year":"2021","journal-title":"J. Neuroimmunol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e238668","DOI":"10.1136\/bcr-2020-238668","article-title":"COVID-19-Associated Acute Transverse Myelitis: A Rare Entity","volume":"13","author":"Chakraborty","year":"2020","journal-title":"BMJ Case Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"577661","DOI":"10.1016\/j.jneuroim.2021.577661","article-title":"Hyperacute Reversible Encephalopathy Related to Cytokine Storm Following COVID-19 Vaccine","volume":"358","author":"Baldelli","year":"2021","journal-title":"J. Neuroimmunol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1002\/ana.26182","article-title":"Postvaccinal Encephalitis after Chadox1 Ncov-19","volume":"90","author":"Zuhorn","year":"2021","journal-title":"Ann. Neurol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.jiac.2022.02.009","article-title":"A Case of Encephalitis Following COVID-19 Vaccine","volume":"28","author":"Kobayashi","year":"2022","journal-title":"J. Infect. Chemother."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"4433","DOI":"10.1007\/s10072-021-05543-1","article-title":"Aseptic Meningitis after Vaccination of the Bnt162b2 Mrna COVID-19 Vaccine","volume":"42","author":"Saito","year":"2021","journal-title":"Neurol. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"108480","DOI":"10.1016\/j.clim.2020.108480","article-title":"Potential Antigenic Cross-Reactivity between SARS-CoV-2 and Human Tissue with a Possible Link to an Increase in Autoimmune Diseases","volume":"217","author":"Vojdani","year":"2020","journal-title":"Clin. Immunol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"617089","DOI":"10.3389\/fimmu.2020.617089","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","journal-title":"Front. Immunol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"895429","DOI":"10.3389\/fnmol.2022.895429","article-title":"Endothelial Beta-Catenin Deficiency Causes Blood-Brain Barrier Breakdown Via Enhancing the Paracellular and Transcellular Permeability","volume":"15","author":"Hussain","year":"2022","journal-title":"Front. Mol. Neurosci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1161\/CIRCULATIONAHA.115.015982","article-title":"Endothelial Beta-Catenin Signaling Is Required for Maintaining Adult Blood-Brain Barrier Integrity and Central Nervous System Homeostasis","volume":"133","author":"Tran","year":"2016","journal-title":"Circulation"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3491","DOI":"10.1111\/ene.14913","article-title":"Encephalitis as a Neurological Complication of COVID-19: A Systematic Review and Meta-Analysis of Incidence, Outcomes, and Predictors","volume":"28","author":"Siow","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3104","DOI":"10.1093\/brain\/awaa240","article-title":"The Emerging Spectrum of COVID-19 Neurology: Clinical, Radiological and Laboratory Findings","volume":"143","author":"Paterson","year":"2020","journal-title":"Brain"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1212\/WNL.0000000000012051","article-title":"SARS-CoV-2 Encephalitis Presenting as a Clinical Cerebellar Syndrome: A Case Report","volume":"97","author":"Oosthuizen","year":"2021","journal-title":"Neurology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s12348-021-00262-2","article-title":"Effect of SARS-CoV-2 Mrna Vaccination on Ocular Herpes Simplex and Varicella-Zoster Virus Reactivation: Should Preventive Antiviral Treatment Be Given in Known Herpes Patients","volume":"11","author":"Herbort","year":"2021","journal-title":"J. Ophthalmic Inflamm. Infect."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.annder.2021.07.009","article-title":"Herpes Simplex, Herpes Zoster and Periorbital Erythema Flares after SARS-CoV-2 Vaccination: 4 Cases","volume":"149","author":"Kluger","year":"2022","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ijid.2021.08.048","article-title":"Herpes Zoster after COVID Vaccination","volume":"111","author":"Lede","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1111\/jocd.14035","article-title":"Herpes Zoster Following Inactivated COVID-19 Vaccine: A Coexistence or Coincidence?","volume":"20","author":"Bostan","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"SI90","DOI":"10.1093\/rheumatology\/keab345","article-title":"Herpes Zoster Following Bnt162b2 Mrna COVID-19 Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases: A Case Series","volume":"60","author":"Furer","year":"2021","journal-title":"Rheumatology"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e620","DOI":"10.1111\/jdv.17422","article-title":"Ipsilateral Herpes Zoster after the First Dose of Bnt162b2 Mrna COVID-19 Vaccine","volume":"35","author":"Tessas","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"5231","DOI":"10.1002\/jmv.27036","article-title":"Herpes Zoster Emergence Following Mrna COVID-19 Vaccine","volume":"93","author":"Eid","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s13256-022-03350-6","article-title":"Herpetic Anterior Uveitis Following Pfizer-Biontech Coronavirus Disease 2019 Vaccine: Two Case Reports","volume":"16","author":"Sanchez","year":"2022","journal-title":"J. Med. Case Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3389","DOI":"10.1111\/jocd.14268","article-title":"Herpes Zoster after Inactivated COVID-19 Vaccine: A Cutaneous Adverse Effect of the Vaccine","volume":"20","author":"Arora","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Moslemi, M., Ardalan, M., Haramshahi, M., Mirzaei, H., Sani, S.K., Dastgir, R., and Dastgir, N. (2022). Herpes Simplex Encephalitis Following Chadox1 Ncov-19 Vaccination: A Case Report and Review of the Literature. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07186-9"},{"key":"ref_71","first-page":"e56","article-title":"Herpes Simplex Encephalitis after Receiving COVID-19 Vaccine; a Case Report","volume":"6","author":"Ebadi","year":"2022","journal-title":"Front. Emerg. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1038\/s41586-020-2639-4","article-title":"Phase I\/Ii Study of COVID-19 Rna Vaccine Bnt162b1 in Adults","volume":"586","author":"Mulligan","year":"2020","journal-title":"Nature"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.4049\/jimmunol.162.5.2895","article-title":"Macrophage Control of Herpes Simplex Virus Type 1 Replication in the Peripheral Nervous System","volume":"162","author":"Kodukula","year":"1999","journal-title":"J. Immunol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1128\/jvi.70.1.264-271.1996","article-title":"Inflammatory Infiltration of the Trigeminal Ganglion after Herpes Simplex Virus Type 1 Corneal Infection","volume":"70","author":"Liu","year":"1996","journal-title":"J. Virol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"644664","DOI":"10.3389\/fimmu.2021.644664","article-title":"Herpes Simplex Virus 1 Infection of Neuronal and Non-Neuronal Cells Elicits Specific Innate Immune Responses and Immune Evasion Mechanisms","volume":"12","author":"Verzosa","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.msard.2018.09.009","article-title":"Herpes Simplex Virus Encephalitis Temporally Associated with Dimethyl Fumarate-Induced Lymphopenia in a Multiple Sclerosis Patient","volume":"26","author":"Perini","year":"2018","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1159\/000515413","article-title":"Herpes Simplex Virus Esophagitis in the Setting of Acute Use of Corticosteroids for Copd Exacerbation in an Immunocompetent Middle-Aged Woman","volume":"15","author":"Haider","year":"2021","journal-title":"Case Rep. Gastroenterol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S0140-6736(99)00623-6","article-title":"Reactivation of Herpesvirus Infections after Vaccinations?","volume":"353","author":"Walter","year":"1999","journal-title":"Lancet"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.chom.2020.04.009","article-title":"Complex Immune Dysregulation in COVID-19 Patients with Severe Respiratory Failure","volume":"27","author":"Netea","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa2104840","article-title":"Thrombotic Thrombocytopenia after Chadox1 Ncov-19 Vaccination","volume":"384","author":"Greinacher","year":"2021","journal-title":"New Engl. J. Med."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Kowarz, E., Krutzke, L., K\u00fclp, M., Streb, P., Larghero, P., Reis, J., Bracharz, S., Engler, T., Kochanek, S., and Marschalek, R. (2022). Vaccine-Induced COVID-19 Mimicry Syndrome. Elife, 11.","DOI":"10.7554\/eLife.74974"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"598444","DOI":"10.3389\/fimmu.2020.598444","article-title":"Nf-\u039ab Pathway as a Potential Target for Treatment of Critical Stage COVID-19 Patients","volume":"11","author":"Kircheis","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Kircheis, R. (2021). Coagulopathies after Vaccination against SARS-CoV-2 May Be Derived from a Combined Effect of SARS-CoV-2 Spike Protein and Adenovirus Vector-Triggered Signaling Pathways. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms221910791"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"e68563","DOI":"10.7554\/eLife.68563","article-title":"SARS-CoV-2 spike protein induces inflammation via TLR2-dependent activation of the NF-\u03baB pathway","volume":"10","author":"Khan","year":"2021","journal-title":"Elife"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1161\/CIRCRESAHA.120.317015","article-title":"Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of Ace2","volume":"126","author":"Gheblawi","year":"2020","journal-title":"Circ. Res."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"7673","DOI":"10.12659\/MSM.909641","article-title":"Arterial Thrombosis Is Accompanied by Elevated Mitogen-Activated Protein Kinase (Mapk) and Cyclooxygenase-2 (Cox-2) Expression Via Toll-Like Receptor 4 (Tlr-4) Activation by S100a8\/A9","volume":"24","author":"Chen","year":"2018","journal-title":"Med. Sci. Monit."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1042\/CS20200904","article-title":"Unpuzzling COVID-19: Tissue-Related Signaling Pathways Associated with SARS-CoV-2 Infection and Transmission","volume":"134","author":"Battagello","year":"2020","journal-title":"Clin. Sci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"85","DOI":"10.3389\/fimmu.2019.00085","article-title":"Cell Type-Specific Roles of Nf-\u039ab Linking Inflammation and Thrombosis","volume":"10","author":"Mussbacher","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"106440","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106440","article-title":"Stroke Associated with COVID-19 Vaccines","volume":"31","author":"Kakovan","year":"2022","journal-title":"J. Stroke Cereb. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1056\/NEJMoa2104882","article-title":"Thrombosis and Thrombocytopenia after Chadox1 Ncov-19 Vaccination","volume":"384","author":"Schultz","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/ane.13505","article-title":"Large Hemorrhagic Stroke after Chadox1 Ncov-19 Vaccination: A Case Report","volume":"144","author":"Lopes","year":"2021","journal-title":"Acta Neurol. Scand."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1161\/STROKEAHA.108.543884","article-title":"Cerebral Venous and Sinus Thrombosis in Women","volume":"40","author":"Coutinho","year":"2009","journal-title":"Stroke"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"3656","DOI":"10.1111\/ene.15029","article-title":"Post-SARS-CoV-2-Vaccination Cerebral Venous Sinus Thrombosis: An Analysis of Cases Notified to the European Medicines Agency","volume":"28","author":"Krzywicka","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1001\/jamainternmed.2021.6352","article-title":"Age- and Sex-Specific Incidence of Cerebral Venous Sinus Thrombosis Associated with Ad26.Cov2.S COVID-19 Vaccination","volume":"182","author":"Ashrani","year":"2022","journal-title":"JAMA Intern. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1002\/ana.26172","article-title":"COVID-19 Vaccine-Associated Cerebral Venous Thrombosis in Germany","volume":"90","author":"Schulz","year":"2021","journal-title":"Ann. Neurol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1001\/jamaneurol.2021.3619","article-title":"Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine\u2013Induced Immune Thrombotic Thrombocytopenia","volume":"78","author":"Poli","year":"2021","journal-title":"JAMA Neurol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1053\/j.seminhematol.2022.03.002","article-title":"Treatment of Vaccine-Induced Immune Thrombotic Thrombocytopenia (Vitt)","volume":"59","author":"Gabarin","year":"2022","journal-title":"Semin. Hematol."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/2\/425\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:32:56Z","timestamp":1760121176000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/2\/425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,13]]},"references-count":97,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["vaccines11020425"],"URL":"https:\/\/doi.org\/10.3390\/vaccines11020425","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2023,2,13]]}}}