25 May 2022
: Case report 
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 Hanif1ABEF, Sekar Satiti1ADE, Subagya Subagya1DE, Heni Retnowulan2DE, Yanri Wijayanti Subronto2DEF, Deshinta Putri Mulya2DEF, Mawaddah Ar Rochmah1ADEF*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? |