PMID- 35135792
OWN - NLM
STAT- MEDLINE
DCOM- 20220210
LR  - 20220223
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 15
IP  - 2
DP  - 2022 Feb 8
TI  - Third cranial nerve palsy in an 88-year-old man after SARS-CoV-2 mRNA 
      vaccination: change of injection site and type of vaccine resulted in an 
      uneventful second dose with humoral immune response.
LID - 10.1136/bcr-2021-246485 [doi]
LID - e246485
AB  - Vaccines for SARS-CoV-2 currently authorised by the European Medicine Agency are 
      effective, safe and well tolerated in practice. Awareness of rare potential 
      vaccine-related adverse effects (AEs) is important to improve their recognition, 
      management and reporting. An 88-year-old man attended the emergency department 
      with incomplete palsy of the right third cranial nerve 3 days after the first 
      administration of Moderna mRNA-1273 SARS-CoV-2 vaccine. Imaging ruled out a 
      vascular accident and a vaccine AE was hypothesised. Two weeks of oral steroids 
      led to the patient's recovery, but without evidence of humoral immune response to 
      vaccine. Thus, full immunisation with a dose of Pfizer mRNA-BNT162b2 SARS-CoV-2 
      vaccine in a different site was attempted. This was uneventful and followed by a 
      robust antibody response. Empirical change of site and vaccine brand may 
      represent a tailored option to obtain full immune protection in selected 
      patients, after vaccine AEs.
CI  - (c) BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Cicalese, Maria Pia
AU  - Cicalese MP
AD  - San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Hospital, 
      Milan, Italy.
AD  - Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San 
      Raffaele Hospital, Milan, Italy.
FAU - Ferrua, Francesca
AU  - Ferrua F
AUID- ORCID: 0000-0002-5695-4490
AD  - San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Hospital, 
      Milan, Italy.
AD  - Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San 
      Raffaele Hospital, Milan, Italy.
FAU - Barzaghi, Federica
AU  - Barzaghi F
AD  - San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Hospital, 
      Milan, Italy.
AD  - Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San 
      Raffaele Hospital, Milan, Italy.
FAU - Cerri, Federica
AU  - Cerri F
AD  - Division of Neuroscience and Department of Neurology, IRCCS San Raffaele 
      Hospital, Milan, Italy.
FAU - Moro, Matteo
AU  - Moro M
AD  - Infection Control Committee, IRCCS San Raffaele Hospital, Milan, Italy.
FAU - Aiuti, Alessandro
AU  - Aiuti A
AD  - San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Hospital, 
      Milan, Italy aiuti.alessandro@hsr.it.
AD  - Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San 
      Raffaele Hospital, Milan, Italy.
AD  - Vita-Salute San Raffaele University, Milan, Italy.
FAU - Silvani, Paolo
AU  - Silvani P
AD  - Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Milan, 
      Italy.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20220208
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (Antibodies, Viral)
RN  - 0 (COVID-19 Vaccines)
RN  - 0 (RNA, Messenger)
RN  - N38TVC63NU (BNT162 Vaccine)
SB  - IM
MH  - Aged, 80 and over
MH  - Antibodies, Viral
MH  - BNT162 Vaccine
MH  - *COVID-19
MH  - *COVID-19 Vaccines
MH  - Humans
MH  - Immunity, Humoral
MH  - Male
MH  - Oculomotor Nerve
MH  - Paralysis
MH  - RNA, Messenger
MH  - SARS-CoV-2
MH  - Vaccination/adverse effects
PMC - PMC8830097
OTO - NOTNLM
OT  - COVID-19
OT  - cranial nerves
OT  - peripheral nerve disease
OT  - unwanted effects / adverse reactions
OT  - vaccination/immunisation
COIS- Competing interests: None declared.
EDAT- 2022/02/10 06:00
MHDA- 2022/02/11 06:00
PMCR- 2022/02/08
CRDT- 2022/02/09 05:41
PHST- 2022/02/09 05:41 [entrez]
PHST- 2022/02/10 06:00 [pubmed]
PHST- 2022/02/11 06:00 [medline]
PHST- 2022/02/08 00:00 [pmc-release]
AID - 15/2/e246485 [pii]
AID - bcr-2021-246485 [pii]
AID - 10.1136/bcr-2021-246485 [doi]
PST - epublish
SO  - BMJ Case Rep. 2022 Feb 8;15(2):e246485. doi: 10.1136/bcr-2021-246485.