Interpretation of vaccine associated neurological adverse events: a methodological and historical review

Marija Cauchi*, Harriet A Ball, Yoav Ben-Shlomo, Neil Robertson

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

7 Citations (Scopus)
93 Downloads (Pure)


As a result of significant recent scientific investment, the range of vaccines available for COVID-19 prevention continues to expand and uptake is increasing globally. Although initial trial safety data has been generally reassuring, a number of adverse events, including vaccine induced thrombosis and thrombocytopenia (VITT), have come to light which have the potential to undermine the success of the vaccination program. However, it can be difficult to interpret available data and put these into context and to communicate this effectively. In this review, we discuss contemporary methodologies employed to investigate possible associations between vaccination and adverse neurological outcomes and why determining causality can be challenging. We demonstrate these issues by discussing relevant historical exemplars and explore the relevance for the current pandemic and vaccination program. We also discuss challenges in understanding and communicating such risks to clinicians and the general population within the context of the ‘infodemic’ facilitated by the internet and other media.
Original languageEnglish
Pages (from-to)493-503
Number of pages11
JournalJournal of Neurology
Issue number1
Early online date16 Aug 2021
Publication statusPublished - Jan 2022

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).


  • Vaccination
  • COVID-19
  • Thrombosis with thrombocytopenia syndrome
  • Vaccine-induced thrombocytosis with thrombocytopenia


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