Neurological Conditions Following COVID-19 Vaccinations: Chance or Association?

Coronavirus disease 2019 (COVID-19) has been labeled a global pandemic with the first reported case of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurring in Wuhan, China in December 2019. To combat the alarming, increasing rate of those affected by the virus, vaccine development ensued. As mass vaccination initiatives against COVID-19 ensued, adverse reactions began emerging. This non-consecutive, population-based case series focuses on four vaccine-associated neurological adverse events across the central and peripheral nervous system detailing the diagnosis, treatment and subsequent follow-up management. These four patients presented to public and private hospitals in Trinidad and Tobago with new-onset neurological diseases soon after their first doses of a COVID-19 vaccine: two after the Pfizer-BioNTech vaccine (one case of new-onset seizures and one case of longitudinally extensive transverse myelitis) and two after the ChAdOx1 nCoV-19 vaccine (one case of Guillain-Barre syndrome and one case of meningitis-retention syndrome). The background incidence rates of neurological conditions in the population and the large numbers of persons being vaccinated means that some of these conditions will appear in the post-vaccination window by chance. Hence, establishing causal links is difficult. The close temporal relationship between vaccination and the presenting symptoms, the biological plausibility, and the extensive diagnostic workup to exclude other causes fulfill criteria provided by the World Health Organization for causality assessment of an adverse event following immunization on an individual level. On this basis, it was determined that these adverse events were likely due to the vaccines. However, establishing causal links on a population level requires large epidemiological studies and cannot be done on individual case reports alone. While physicians should be cognizant of even these rare adverse events of vaccines, it should be reiterated that the overall safety profile of vaccines is well established.

An Assessment of the Risk Factors and Concerns of Postpartum Depression among Mothers Seeking Health Care in North Central Trinidad.

BACKGROUND: Postpartum depression (PPD) is a debilitating mental disorder which affects mainly females usually after giving birth. OBJECTIVES: We aimed to study the risk factors and concerns of PPD among mothers seeking health care at regional health authority hospitals in Trinidad. MATERIALS AND METHODS: The cross-sectional study consisted of 360 mothers from the postnatal and neonatal clinics of the North Central Regional Health Authority, Trinidad. Data were collected via a questionnaire using convenience sampling to study the risk factors and concerns of PPD among mothers. Participants were asked to sign a consent form before filling out the questionnaire. The questions were geared toward obtaining mother's perspective on predisposing factors of PPD, identifying if they are at risk for perinatal depression, the outcomes of having PPD, and determining if they were screened and treated for it. RESULTS: This study comprised 360 postnatal women among which 4.7% were diagnosed with postpartum while 40% scored ≥10 in the Edinburgh Postnatal Depression Scale which indicated a risk for PPD. This research revealed seven significant predictors of PPD: family history of mental illness, baby blues, mood swings during period, use of oral contraceptives, emotional support, life stress, and being diagnosed with depression (P < 0.05). Other characteristics like sociodemographics were not remarkably correlated but marginally indicative of depressive signs. CONCLUSION: The study shows that many risk factors of PPD exist, and screening and treatment should be used to avoid the consequences of PPD.

An Assessment of the Risk Factors and Concerns of Postpartum Depression amongst Mothers Seeking Healthcare in North Central Trinidad

• Postpartum depression (PPD) is a debilitating mental disorder which affects 13% of females, usually after giving birth. • Predisposing factors increase the possibility of mothers acquiring PPD, some of which include lack of support, prior PPD, a history of mood changes with menstrual cycles or oral contraceptives, a family history and mental illness. • This illness can have long-term effects on a child causing the behavioural, cognitive and academic development to be impaired. • Currently, there are no screening techniques at the hospitals in Trinidad. Therefore, we have designed this study to assess the risk factors and concerns of PPD and to increase public awareness of PPD.