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. 2022 Apr 19;107(5):e1823-e1834.
doi: 10.1210/clinem/dgac049.

SARS-CoV-2 Vaccine-induced Thyroiditis: Safety of Revaccinations and Clinical Follow-up

Seda Hanife Oğuz  1 , Süleyman Nahit Şendur  1 , Burçin Gönül İremli  1 , Alper Gürlek  1 , Tomris Erbas  1 , Uğur Ünlütürk  1
Affiliations

SARS-CoV-2 Vaccine-induced Thyroiditis: Safety of Revaccinations and Clinical Follow-up

Seda Hanife Oğuz et al. J Clin Endocrinol Metab. .

Abstract

Context: The number of reported cases with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine-induced subacute thyroiditis (SAT) and Graves' disease (GD) is growing. However, active debate continues about managing such side effects and the safety of repeat or booster doses of the vaccines in such cases.

Objectives: This study aims to present long-term clinical follow-up of SARS-CoV-2 vaccine-induced SAT or GD cases and provide data regarding the safety of revaccinations.

Methods: Patients diagnosed with SARS-CoV-2 vaccine-induced SAT or GD were included. Data regarding the long-term clinical follow-up of SARS-CoV-2 vaccine-induced SAT and GD cases and outcomes of repeat or booster SARS-CoV-2 vaccinations were documented. The literature, including cases of SARS-CoV-2 vaccine-induced SAT or GD, was reviewed.

Results: Fifteen patients with SARS-CoV-2 vaccine-induced SAT and 4 with GD were included. Pfizer/BioNTech COVID-19 vaccine (BNT162b2) was associated with symptoms in a majority of cases with SAT and all with GD. Median time from vaccination to symptom onset was 7 and 11.5 days, respectively, while 7 and 2 patients required medical treatment in SAT and GD groups, respectively. Remission was documented in 10 SAT patients, with a median time to remission of 11.5 weeks. No exacerbation/recurrence of SAT occurred in 7 of 9 patients who received a repeat vaccination dose, while symptoms of SAT worsened following the second vaccination in 2 cases. None of the patients experienced severe side effects that could be associated with revaccinations.

Conclusions: Revaccinations appear to be safe in patients with SARS-CoV-2 vaccine-induced SAT cases, while more evidence is needed regarding SARS-CoV-2 vaccine-induced GD.

Keywords: COVID-19; Graves’ disease; SARS-CoV-2; revaccination; subacute thyroiditis; vaccine.

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Figures

Figure 1.
Figure 1.
SARS-CoV-2 vaccinations, as well as the onset and duration of disease in patients with SARS-CoV-2 vaccine–induced subacute thyroiditis (SAT) and Graves’ disease (GD), are illustrated in this timeline. SAT represents the onset of symptoms in patients with SAT, and GD represents the onset of symptoms in patients with GD. t0 illustrates the time of the administration of SARS-CoV-2 vaccination associated with thyroiditis. Mild gray indicates the time since remission or the follow-up period for patients who have not yet reached remission (*). Dark grey represents an exacerbation/recurrence in SAT. Repeat SARS-CoV-2 vaccinations that were received after SARS-CoV-2 vaccine–induced thyroiditis are circled. Abbreviations: B, BNT162b2; C, CoronaVac; Mo, month(s); w, week(s).
See this image and copyright information in PMC

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