Adverse Events Following COVID-19Vaccination in Adolescents: Insights From Pharmacovigilance Study of VigiBase

Background@#During coronavirus disease 2019 (COVID-19) pandemic, several COVID-19 vaccines were licensed with fast-track procedures. Although these vaccines have demonstrated high immunogenicity, there has been concerns on the serious adverse events (AEs) following COVID-19 vaccination among adolescents. We aimed to analyze comparative safety of COVID-19 vaccination in adolescents. @*Methods@#In this pharmacovigilance study, we performed a disproportionality analysis using VigiBase, the World Health Organization’s global individual case safety report (ICSR) database. To compare serious AEs reported following COVID-19 vaccines vs. all other vaccines in adolescents aged 12–17 years, ICSRs following any vaccines on adolescents aged 12–17 years were included, defining cases as reports with the AEs of interest, with all other AEs as non-cases. The AEs of interest were myocarditis/pericarditis, multisystem inflammatory syndrome/Kawasaki disease (MIS/KD), anaphylaxis, Guillain-Barré syndrome (GBS), and immune thrombocytopenia (ITP). We conducted a disproportionality analysis to estimate reporting odds ratio (ROR) with 95% confidence interval (CI) for each AE of interest, adjusted for sex by using logistic regression. @*Results@#Of 99,735 AE reports after vaccination in adolescents, 80,018 reports were from COVID-19 vaccinated adolescents (52.9% females; 56.3% America). The AEs of interest were predominantly reported as serious AE (76.1%) with mRNA vaccines (99.4%). Generally, higher reporting odds for the AEs were identified following COVID-19 vaccination in adolescents;myocarditis/pericarditis (2,829 reports for the COVID-19 vaccine vs. 35 for all other vaccines, adjusted ROR [aROR], 19.61; 95% CI, 14.05–27.39), and MIS/KD (104 vs. 6, aROR, 4.33; 95% CI, 1.89–9.88). The reporting odds for anaphylaxis (515 vs. 165, aROR, 0.86; 95% CI, 0.72– 1.02), GBS (94 vs. 40, aROR, 0.64; 95% CI, 0.44–0.92) and ITP (52 vs. 12, aROR, 1.12; 95% CI, 0.59–2.09) were not significantly higher following COVID-19 vaccination. @*Conclusion@#In this study, there were disproportionate reporting of immune-related AEs following COVID-19 vaccination. While awaiting definitive evidence, there is a need to closely monitor for any signs of immune-related AEs following COVID-19 vaccination among adolescents.

The Effect of Motor Point Block with Alcohol on Hip Adductor Muscles in Spastic Cerebral Palsy

OBJECTIVE: To investigate the effectiveness of motor point blocking using 70% alcohol for the treatment of spasticity in patients with cerebral palsy. METHOD: 16 patients with spastic cerebral palsy were injected at both hip adductor muscles with 70% alcohol. The severity of spasticity was assessed with the modified Ashworth scale (MAS) of adductor muscles, and the passive range of motion (PROM) of hip abduction. MAS and PROM were measured before, immediately after, and 1 and 3 months after the motor point block. Satisfaction of caregivers was also checked 3 months after the procedure. RESULTS: The MAS prior to the motor point block and at 3 months after the procedure were 4.44+/-0.62 and 3.63+/-1.16. The PROM before motor point block and at 3 months after the procedure were 21.81+/-14.14d egrees and 32.81+/-12.37 egrees. 11 out of 16 (68.8%) caregivers reported high satisfaction. CONCLUSION: Motor point block with 70% alcohol to the hip adductor muscles could be a safe and cost-effective procedure for relieving the localized spasticity of hip adductor muscles in spastic cerebral palsy.

The Effect of Foot Orthosis on Spinal Curvature by Correction of Foot Pronation and Limb Length Discrepancy

OBJECTIVE: To investigate the effect of foot orthosis on spinal curvature, by correction of foot pronation and limb length discrepancy METHOD: 38 cases of foot-pronated children were investigated for changes in Cobb's angle before and after applying foot orthosis, and followed up after 6 months. RESULTS: There were 25 males and 13 females, and the average age was 10.28+/-0.45 years. There were no significant correlation among Cobb's angle, limb length discrepancy, and difference of pronation. Cobb's angles were improved in 26 cases after applying foot orthosis, by mean 5.84+/-2.47 degree. 16 cases were followed up after 6 months, and Cobb's angle were maintained or improved in 11 cases. Mean correctability was 47.93+/-26.47%. CONCLUSION: This study showed that foot orthosis could be one of the effective method to improve spinal curvature.

Juvenile Muscular Atrophy of the Upper Limb (Hirayama Disease): A case report

Hirayama disease is characterized by focal amyotrophy of the upper limb associated with unilateral or asymmetric bilateral muscle weakness. It occurs in young men in their late teens or early twenties. Repeated or sustained neck flexion is thought to be a cause of the disease. It is important to prevent the progression of the disease through early recognition and management. We reported a patient with Hirayama disease in order to review the typical clinical, electrodiagnostic and radiological findings of Hirayama disease.