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Long Vax: Rare Link Between COVID Vaccination, POTS, and SFN

July 17, 2023

A recent article published by Science Insider discussed a new concern about COVID-19 vaccine side effects colloquially termed “Long Vax.” There have been rare reports of people developing symptoms of small fiber neuropathy (SFN) and/or postural orthostatic tachycardia syndrome (POTS) following vaccination for COVID-19. These conditions lead to persistent headaches, fatigue, and problems with heart rate and blood pressure, similar to those developed in cases of Long Covid. 

Relatively little is known about the potential connection between COVID-19 vaccines and POTS or SFN, though there have been case reports outlining incidences of either POTS or SFN developing after COVID-19 vaccines (1) (2) (3). A preprint of a small observational study on neuropathic symptoms caused some stir on the subject in January of 2022 but was never peer-reviewed or published. One peer-reviewed study found that POTS was diagnosed at a higher rate following vaccination, but that was still lower than the rate of POTS following COVID-19 infection. This suggests that the risk of developing POTS after vaccination is lower than the risk of developing POTS after a Covid-19 infection. Researchers from the Yale School of Medicine are currently working on a study of immune markers in patients’ blood with Long Covid and post-vaccination side effects. 

At this point, “Long Vax” seems to be incredibly rare. Researchers emphasize that the benefit of COVID-19 vaccines far outweighs the risk of side effects, and those who did not experience POTS or SFN after previous doses of the vaccine are extremely unlikely to do so after future doses.

Citations for report:

Abbott, M. G., Allawi, Z., Hofer, M., Ansorge, O., Brady, S., Fadic, R., Torres, G., Knight, R., Calvo, M., Bennett, D. L. H., & Themistocleous, A. C. (2022). Acute small fiber neuropathy after Oxford-AstraZeneca ChAdOx1-S vaccination: A report of three cases and review of the literature. Journal of the peripheral nervous system : JPNS, 27(4), 325–329. https://doi.org/10.1111/jns.12509

Hermel, M., Sweeney, M., Abud, E., Luskin, K., Criado, J. P., Bonakdar, R., Gray, J., & Ahern, T. (2022). COVID-19 Vaccination Might Induce Postural Orthostatic Tachycardia Syndrome: A Case Report. Vaccines, 10(7), 991. https://doi.org/10.3390/vaccines10070991

Potential POTS association with COVID-19 vaccination weaker than with COVID-19 infection. (2022). Nature cardiovascular research, 1(12), 1132–1133. https://doi.org/10.1038/s44161-022-00194-7

Reddy, S., Reddy, S., & Arora, M. (2021). A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine. Cureus, 13(5), e14837. https://doi.org/10.7759/cureus.14837

Safavi, F., Gustafson, L., Walitt, B., Lehky, T., Dehbashi, S., Wiebold, A., Mina, Y., Shin, S., Pan, B., Polydefkis, M., Oaklander, A. L., & Nath, A. (2022). Neuropathic symptoms with SARS-CoV-2 vaccination. medRxiv : the preprint server for health sciences, 2022.05.16.22274439. https://doi.org/10.1101/2022.05.16.22274439

Science. In rare cases, coronavirus vaccines may cause Long Covid–like symptoms

Science. Rare link between coronavirus vaccines and Long Covid–like illness starts to gain acceptance

Yale School of Medicine. The Yale LISTEN Study





Sources

  1. Article Sources and Footnotes

    1. Abbott, M. G., Allawi, Z., Hofer, M., Ansorge, O., Brady, S., Fadic, R., Torres, G., Knight, R., Calvo, M., Bennett, D. L. H., & Themistocleous, A. C. (2022). Acute small fiber neuropathy after Oxford-AstraZeneca ChAdOx1-S vaccination: A report of three cases and review of the literature. Journal of the peripheral nervous system : JPNS, 27(4), 325–329. https://doi.org/10.1111/jns.12509

    2. Hermel, M., Sweeney, M., Abud, E., Luskin, K., Criado, J. P., Bonakdar, R., Gray, J., & Ahern, T. (2022). COVID-19 Vaccination Might Induce Postural Orthostatic Tachycardia Syndrome: A Case Report. Vaccines, 10(7), 991. https://doi.org/10.3390/vaccines10070991

    3. Potential POTS association with COVID-19 vaccination weaker than with COVID-19 infection. (2022). Nature cardiovascular research, 1(12), 1132–1133. https://doi.org/10.1038/s44161-022-00194-7

    4. Reddy, S., Reddy, S., & Arora, M. (2021). A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine. Cureus, 13(5), e14837. https://doi.org/10.7759/cureus.14837

    5. Safavi, F., Gustafson, L., Walitt, B., Lehky, T., Dehbashi, S., Wiebold, A., Mina, Y., Shin, S., Pan, B., Polydefkis, M., Oaklander, A. L., & Nath, A. (2022). Neuropathic symptoms with SARS-CoV-2 vaccination. medRxiv : the preprint server for health sciences, 2022.05.16.22274439. https://doi.org/10.1101/2022.05.16.22274439

    6. Science. In rare cases, coronavirus vaccines may cause Long Covid–like symptoms

    7. Science. Rare link between coronavirus vaccines and Long Covid–like illness starts to gain acceptance

    8. Yale School of Medicine. The Yale LISTEN Study