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Myasthenia Gravis Exacerbation Following Second Dose of mRNA-1273 Vaccine

Introduction A wide spectrum of central and peripheral neurological manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in the literature. Neuromuscular complications of SARS-CoV-2 infection resulting in coronavirus disease 2019 (Covid-19) range from the emergence of new findings to the exacerbation of existing neuromuscular disorders like myasthenia gravis. [1, 2] Interim analysis by a physicianreported registry, COVID-19 Associated Risks and Effects in Myasthenia Gravis (CARE-MG), demonstrated that, of reported myasthenia gravis patients with COVID-19, 40% of patients relapsed or experienced crisis requiring rescue therapy and 24% died due to COVID-19. [3] To the best of our knowledge, however, exacerbation of myasthenia gravis has not been reported following currently available COVID-19 vaccinations. Here we report a case of myasthenia gravis exacerbation requiring hospitalization and rescue therapy following a second dose of the mRNA1273 vaccination.