Recently Elon Musk, owner of Twitter, has boosted videos of people alleging neurological side effects shortly after receiving one of the COVID vaccines. These videos started appearing after the vaccines were first rolled out, but often news stories have a second or third life on social media. It’s a good opportunity to look back at the data we have so far regarding the side effect profiles of the various COVID vaccines, and also give some much-needed perspective on these viral videos.
According to the CDC: “More than 667 million doses of COVID-19 vaccine have been given in the United States from December 14, 2020, through January 18, 2023.” That is a huge set of data, and side effects have been carefully tracked through various monitoring mechanisms. In order to establish that a symptom or disease is actually a side effect of a vaccine we need more than the simply fact that they occurred sometime after a vaccine dose. With so many doses given, people will continue to get all the ailments of life at the usual rate, and by coincidence along many people will get sick after getting the vaccine.
Monitoring systems generally report anything adverse that happens after receiving a vaccine as a side effect. They then leave it to epidemiologists to do statistical analysis, to see if the risk of any particular negative outcome is more likely after receiving a dose of a particular vaccine than the background rate. They can also compare negative outcomes among the various vaccines. So far there have been only four serious adverse event types where it seems likely the risk is higher after receiving a COVID-19 vaccine. These are:
- Anaphylaxis (a potentially life-threatening allergic reaction)
- Thrombosis with thrombocytopenia syndrome (TTS)
- Myocarditis/pericarditis
- Guillain-Barré Syndrome (GBS)
All of these adverse events are extremely rare, but they do seem to have occurred at higher rates than the background rate (matched for demographic features). Of note, however, GBS only occurred after the J&J/Janssen vaccine, not after either mRNA vaccine (Pfizer or Moderna). Also TTS was only caused by the adenovirus vaccines (J&J and AstraZeneca), not the mRNA vaccines.
All of these adverse events have something in common – they are caused by immune activation. This is the kind of side effect one would expect after a vaccine, which triggers immune activity. TTS can cause blood clots in the brain, and GBS attacks the nerves, so they are included as neurological complications. Otherwise there have been no major neurological complications of the COVID-19 vaccines established epidemiologically. Specifically, there is no link to seizures or any movement disorder.
One potential neurological side effect remains controversial – Bell’s palsy, a form of facial paralysis. There may be a small increased risk with viral vaccines (but no more than other vaccines), but probably not with the mRNA vaccines. If there is an increased risk, it must be tiny as the data cannot clearly establish a link. Further, there is a strong signal that COVID itself can cause Bell’s palsy, so getting vaccinated is likely protective overall.
With that update on the data for side effects, what do we make of the viral videos showing alleged neurological side effects? Before I comment I want to point out that I generally do not agree with making remote medical assessments of public figures. Sometimes I will comment on the commenting, but otherwise I think such information should come from medical professionals who have done a proper assessment and have the permission of their patient to make certain details public. I also think it’s reasonable to legally require people seeking certain public offices, such as the Presidency, to disclose basic health information through an objective source. Otherwise, people publicly speculating (without objective information or even a medical background) about medical diagnoses is inappropriate, of little value, and should not be magnified.
I make two exceptions to this rule. The first is when people post their own medical information online in order to promote a point of view, either to promote a treatment, warn about a risk, or impact the conversation on a public health issue. In such cases they chose to put their own medical information into the public square and a response is fair game. Still, I aim to be respectful and not overstep what is necessary to counter dangerous misinformation. Second, I tend to limit my comments to those cases where there is enough public information to have an opinion (otherwise I just point out the lack of such information). I also tend to stick with neurological issues, since I am a neurologist. In particular, videos of claimed movement disorders are amendable to analysis because the diagnosis is mostly in just looking at how subjects move. Yes, a direct exam provides more information, but sometimes the movement itself is the key, and a video is adequate.
With all that in mind, let’s take a look at three videos of alleged COVID vaccine neurological side effects. None of them provide objective medical information. They are simply anecdotes, of limited clinical utility and unable, by themselves, to establish cause and effect. There is also good reason to conclude, just from watching the videos themselves, that they are not vaccine side effects.
The first is of Angelia Desselle (one of the videos promoted by Musk). The video certainly looks dramatic, but to a neurologist’s eye this does not conform to any known movement disorder. There are only so many ways in which the parts of the brain that control movement can be damaged or function abnormally. The most likely diagnosis in this case is what is known as a functional movement disorder (a specific type of functional neurological disorder). These are real neurological disorders, but they are not caused by pathology or anything biological with the nervous system. They are complex disorders thought to be mainly a manifestation of psychological stress. The patients are generally not “faking it”. That tends to be the most common public comment by non-experts, and it is almost certainly incorrect. Again, these patients have a real and serious disorder that requires complex treatment, but it is not the kind of thing that can be directly caused by a vaccine.
The second video of Shawn Skelton is also typical for a functional movement disorder. These are definitely not seizures. They are not typical for any other known movement disorder. The third video is also of Shawn Skelton. This is less-specific shaking. From this video alone it would not be possible to completely rule out (or in) seizures, but in the context of the other video it is more likely functional. The third video is titled: “Does the moderna cause seizures???? Yes it does!!!”
By all available evidence, no, it doesn’t. Seizures have not been established as a side effect for any COVID-19 vaccine, including Moderna. Even if she were having seizures, that would not establish that they were caused by the vaccine. And the provided video evidence does not establish she is having seizures, but rather is more likely to be a functional neurological disorder.
However, since the video was released, Skelton has been treated and released from Deaconess Orthopedic Neuroscience hospital, according to the Evansville Courier & Press newspaper. Skelton says MRIs, CT scans and blood cultures came back no results, and doctors told her her problem is probably stress-related.
Translation: Functional neurological disorder.
I think the best response to such videos is for experts to set the record straight, and then for the public to subsequently ignore them. Of course, that’s not the culture of social media, but that’s my advice. There is nothing to be gained from confrontation. Such people deserve our sympathy, and their privacy should be respected as much as possible – even though they forfeited their own privacy by posting videos of themselves online. The goal is to mitigate the spread of misinformation as much as possible, while minimizing personal backlash.
Either way – these videos are not reliable medical evidence. They are anecdotes and very likely do not represent true vaccine side effects. It is unfortunate that some have chosen to exploit them to promote dangerous antivaccine misinformation. Meanwhile, after billions of doses given, the COVID-19 vaccines have proven extremely safe and effective.
