Sex: F
Vaccine: COVID19
Symptoms: Anti-thyroid antibody, Blood thyroid stimulating hormone, Scan thyroid gland, Thyroid stimulating immunoglobulin, Thyroiditis
Clinical narrative: Thyroiditis following COVID 19(mRNA) vaccine administration; This is a literature report for the following literature source(s):  While cases of Thyroiditis after COVID mRNA vaccination are reported, the recovery duration is not yet determined. Therefore, the authors present the time course of two healthy middle-aged South Asian patients who developed symptomatic, biochemical, and radiological evidence of Thyroiditis following COVID 19(mRNA) vaccine administration. Despite being more than six months post-vaccination, both arestill hypothyroid, requiring levothyroxine replacement. A 41-year-old female presented after the second dose of Pfizer BioNTech vaccine four weeks prior. Initial workup confirmed biochemical hyperthyroidism (TSH0.019uIU/mL, Free T4 -2.52ng/dl, TotalT3-233ng/dl). During five-month follow-up, laboratory workup showed hypothyroidism with TSH -8.570uIU/mL, Free T4 0.98ng/dl, Total T3-111ng/dl, and still requiring Thyroid hormone replacement for the past six months. She was started on levothyroxine 25mcg daily increased to levothyroxine 25mcg nine pills/week to target TSH 0.5 to 5.0uIU/mL. At the time of diagnosis, both had TPO (Thyroid Peroxidase)-negative, TSI (Thyroid Stimulating immunoglobulin)-negative, and no autonomic nodules on thyroid ultrasound. The patient also had a Technetium-99m pertechnetate uptake scan, which showed decreased radiotracer uptake in both the lobes of thyroid gland. Thyroiditis is an inflammatory disorder diagnosed based on clinical and laboratory findings. While there have been cases reports of Subacute Thyroiditis following immunizations, such as the influenza vaccine, the mechanism of thyroiditis after the COVID mRNA vaccine remains unclear. Subacute Thyroiditis typically manifests as a triphasic clinical course of thyrotoxicosis, followed by hypothyroidism and a return to the euthyroid state; however, mRNA vaccine-induced Thyroiditis seems to have a different disease course. In the authours' observation of these case series, both patients remained in the hypothyroid state requiring Levothyroxine replacement eight-and twelve-months post-vaccination, respectively. Whether they developed permanent thyroid damage or are able to recover with prolonged recovery time is still unclear, which needs further follow-up in the future.; Sender's Comments: Based on the information available a possible contributory role of the suspect BNT162b2 cannot be excluded for the reported event-Thyroiditis. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-PV202200097378 Same article, drug and event different patient;US-PFIZER INC-202201282285 same article/patient, different drug/event;