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Helping the Public Understand Adverse Events Associated With COVID-19 VaccinationsLessons Learned From Functional Neurological Disorder

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

By the end of January 2021, more than 97.3 million doses globally and 31.8 million doses in the United States have been administered of the COVID-19 vaccine.1 Although important postmarketing surveillance is ongoing, it is currently highly effective and safe, with adverse effects including transient symptoms such as fever/chills, headache, fatigue, myalgia/arthralgia, lymphadenopathy, nausea, or local effects of swelling, erythema, or pain.2 With the public being vaccinated, there have recently been videos circulating on social media about major neurologic adverse events after administration of the COVID-19 vaccine.3 A few of these videos have been viewed millions of times by the public.3 Some depict individuals with continuous movements of the trunk and limbs or walking difficulties. The spread of these videos has fueled vaccine hesitancy concerns and without effective communication by medical professionals to the public, this can lead to reduced vaccination rates and an unnecessary prolongation of the pandemic. It must be noted that these videos may be unsubstantiated, and it is not definitively known if the COVID-19 vaccine was administered in these cases. However, it was reported in the news that at least 1 patient was told by their physician that the diagnosis was conversion disorder,4 also known as functional neurological disorder (FND). Here, we provide context regarding potential associations between FND and COVID-19 vaccinations, as effective communication regarding this intersection is critically important.

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Article Information

Corresponding Author: David L. Perez, MD, MMSc, Departments of Neurology and Psychiatry, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 (dlperez@nmr.mgh.harvard.edu).

Published Online: April 9, 2021. doi:10.1001/jamaneurol.2021.1042

Conflict of Interest Disclosures: Dr Perez reports grants from the National Institute of Mental Health and Sidney R. Baer, Jr. Foundation and personal fees from Harvard Medical School outside the submitted work. No other disclosures were reported.

References
1.
Bloomberg News. More than 97.3 million shots given: Covid-19 tracker. Accessed January 31, 2021. https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/
2.
Polack  FP , Thomas  SJ , Kitchin  N ,  et al; C4591001 Clinical Trial Group.  Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine.   N Engl J Med. 2020;383(27):2603-2615. doi:10.1056/NEJMoa2034577PubMedGoogle ScholarCrossref
3.
Volpicelli  G . They claimed the Covid vaccine made them sick—and went viral. Wired UK. Published January 26, 2021. Accessed March 3, 2021. https://www.wired.com/story/they-claimed-the-covid-vaccine-made-them-sick-and-went-viral/
4.
Langhorne  T . CDC says vaccine side-effects 'tend to be mild' in response to Indiana woman's claims in viral video. Courier & Press. Updated January 12, 2021. Accessed March 3, 2021. https://www.courierpress.com/story/news/2021/01/12/covid-vaccine-moderna-side-effects-cdc-doctor-symptoms-shawn-skelton/6646047002/
5.
Espay  AJ , Aybek  S , Carson  A ,  et al.  Current concepts in diagnosis and treatment of functional neurological disorders.   JAMA Neurol. 2018;75(9):1132-1141. doi:10.1001/jamaneurol.2018.1264PubMedGoogle ScholarCrossref
6.
Functional Neurological Disorder Society. Press release from the Functional Neurological Disorder Society. Published January 19, 2021. Accessed February 19, 2021. https://www.fndsociety.org/UserFiles/file/FNDSSocietyPressReleaseCOVIDVaccines.pdf
7.
Popkirov  S , Nicholson  TR , Bloem  BR ,  et al.  Hiding in Plain sight: functional neurological disorders in the news.   J Neuropsychiatry Clin Neurosci. 2019;31(4):361-367. doi:10.1176/appi.neuropsych.19010025PubMedGoogle ScholarCrossref
8.
Stamelou  M , Edwards  MJ , Espay  AJ ,  et al.  Movement disorders on YouTube—caveat spectator.   N Engl J Med. 2011;365(12):1160-1161. doi:10.1056/NEJMc1107673PubMedGoogle ScholarCrossref
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Engel  GL .  The need for a new medical model: a challenge for biomedicine.   Science. 1977;196(4286):129-136. doi:10.1126/science.847460PubMedGoogle ScholarCrossref
10.
Edwards  MJ , Adams  RA , Brown  H , Pareés  I , Friston  KJ .  A bayesian account of ‘hysteria’.   Brain. 2012;135(pt 11):3495-3512. doi:10.1093/brain/aws129PubMedGoogle ScholarCrossref
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