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25 May 2022: Articles

Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality

Unusual clinical course, Rare coexistence of disease or pathology

Faishal Hanif A , Sekar Satiti A , Subagya Subagya D , Heni Retnowulan D , Yanri Wijayanti Subronto D , Deshinta Putri Mulya D , Mawaddah Ar Rochmah A*

DOI: 10.12659/AJCR.936257

Am J Case Rep 2022; 23:e936257

Patient 2Step 1. Background.Data availability: YesDoes the diagnosis meet the case definition? YesStep 2. Questions of Adverse Events Following Immunization.

I. Is there strong evidence of other causes?
Do clinical or laboratory tests in this patient confirm other causes?
II. Is there any known causal relationship with the vaccination?
Is there any previous evidence that the vaccine may cause adverse events? Following Immunization even if it is appropriately given?
Is there a specific test showing the causal role of the vaccine or its composition?
Was there any error in prescribing or of the vaccine’s recommendation use? (Example: expired date, inappropriate recipient, etc)
Was the vaccine (or its composition) given in sterile procedure?
Was there any abnormality in the vaccine’s physical condition (example: color change, increased turbidity, foreign material, etc) during immunization?
Was there any error on the vaccine’s preparation (example: inappropriate product, inappropriate diluent, inappropriate syringe preparation, etc)?
Was there any error in the vaccine’s handling (example: cold chain failure on delivery, storage, or immunization)?
Was the vaccine given inappropriately? (example: inappropriate dose, inappropriate application, inappropriate syringe, etc)
Can the adverse events following immunization be caused by anxiety due to immunization? (example: vasovagal reflex, hyperventilation, or stress)
Did the adverse event occur within the time window after immunization?
III. Is there any strong evidence to deny the causal relationship?
Is there any strong evidence to deny the causal relationship?
IV. Other qualification factors for classification
Can the adverse event occur independently without vaccination (background rate)?
Can the adverse event occur as a manifestation from other health condition?
Did the adverse event occur after a similar vaccine’s dose as previously given?
Was there any exposure to other toxins or potential risk factors?
Was there any acute disease before the adverse event occurred?
Was there any previous adverse event that was not related to the vaccine?
Did the patient use any medications before the adverse events occurred?
Are there any logic biological causes explaining the vaccine adverse events?

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923