Vaccination prior to SARS-CoV-2 infection does not affect the neurologic manifestations of long COVID, 2024, Mukherjee et al.

Vaccination prior to SARS-CoV-2 infection does not affect the neurologic manifestations of long COVID
Mukherjee, Shreya; Singer, Tracey; Venkatesh, Aditi; Choudhury, Natasha A; Perez Giraldo, Gina S; Jimenez, Millenia; Miller, Janet; Lopez, Melissa; Hanson, Barbara A; Bawa, Aasheeta P; Batra, Ayush; Liotta, Eric M; Koralnik, Igor J

Persistent symptoms after COVID-19 constitute the long COVID syndrome, also called post-acute sequelae of SARS-CoV-2 infection (PASC). COVID-19 vaccines reduce the gravity of ensuing SARS-CoV-2 infections. However, whether vaccines also have an impact on PASC remain unknown.

We investigated whether vaccination prior to infection alters the subsequent neurologic post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC). We studied prospectively the first consecutive 200 post-hospitalization Neuro-PASC (PNP) and 1100 non-hospitalized Neuro-PASC (NNP) patients evaluated at our Neuro-COVID-19 clinic between May 2020 and January 2023.

Among PNP patients, 87% had a pre-vaccination infection and 13% had a breakthrough infection post-vaccination. Among the NNP patients, 70.7% had a pre-vaccination infection and 29.3% had a breakthrough infection. Both PNP and NNP breakthrough infection patients had more frequent pre-existing depression/anxiety than their respective pre-vaccination infection groups, and NNP breakthrough infection patients also had more frequent comorbidities of headache, lung and gastrointestinal diseases than the NNP pre-vaccination infection group.

An average of 10 months after symptom onset, the three most common neurological symptoms for PNP patients were brain fog (86.5%), numbness/tingling (56.5%), and headache (56.5%). Of all Neuro-PASC symptoms, PNP breakthrough infection more frequently reported anosmia compared to PNP pre-vaccination infection patients (69.2% vs. 37.9 %, p = 0.005). For NNP patients, the three most common neurological symptoms were brain fog (83.9%), headache (70.9%), and dizziness (53.8%). NNP pre-vaccination infection reported anosmia (56.6% vs. 39.1%, p < 0.0001) and dysgeusia (53.3% vs. 37.3%, p < 0.0001) more frequently than breakthrough infection patients. NNP breakthrough infection more frequently reported dizziness compared to NNP pre-vaccination infection patients (61.5% vs. 50.6%, p = 0.001).

Both PNP and NNP patients had impaired quality of life in cognitive, fatigue, sleep, anxiety, and depression domains with no differences between pre-vaccination infection and breakthrough infection groups. PNP patients performed worse on NIH Toolbox tests of processing speed, attention, executive function, and working memory than a US normative population whereas NNP patients had lower results in processing, speed, attention and working memory, without differences between pre-vaccination infection and breakthrough infection groups.

These results indicate that vaccination prior to SARS-CoV-2 infection does not affect the neurologic manifestations of long COVID in either PNP or NNP patients. Minor differences in neurologic symptoms between pre-vaccination infection and breakthrough infection groups may be caused by SARS-CoV-2 strains evolution. Patients developing Neuro-PASC after breakthrough infection have a higher burden of comorbidities, highlighting different risk factors warranting targeted management.

Link | PDF (Brain Communications) [Open Access]

 

I think this study doesn't provide proof for the assertion of the title.

We can't tell to what extent persistent neurological manifestations are prevented by vaccination by looking at the people who make it to this clinic, apart from being able to say 'vaccination does not completely prevent persistent neurological manifestations'.

• Vaccination may decrease transmission, reducing the number of people who get Covid-19, which is the one sure way to reduce Long Covid.
• Vaccination is almost certainly reducing the incidence of severe Covid-19, and that will reduce some persistent neurological manifestations, probably not of ME/CFS, but e.g. manifestations caused by oxygen deprivation.
• Vaccination may be reducing the percentage of people who get a range of post-Covid-19 symptoms from even mild infections, it may be reducing the incidence of ME/CFS as percentage of infections. I'm not at all convinced about that yet, but this study doesn't make me think it is less possible.

(Of course, differences in the symptoms recorded as being reported by people attending the clinic who were vaccinated or not vaccinated when they got Covid-19 may due to different viral strains and different knowledge or beliefs of the clinicians and patients over time.)

(I actually have brain fog right now, and can't quite think well enough to be sure of anything I have written here. But, it feels as though the logic is off in this abstract.)

 

Yes, but it's based only in the people who come to the clinic. It's possible that vaccination is changing the percentage of people who have neurological problems, or severe enough neurological problems that the people go to the effort of getting to this clinic, out of the total who are infected. I think it is unlikely, but it is possible.