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Isolated cases of subacute thyroiditis exist in the early period of COVID‐19 vaccination, largely after mRNA vaccines. Here we report late onset thyroid disturbances and persistent health issues in patients of thyroid disorders after COVID‐19 vaccination. Seventy‐five patients with post COVID‐19 vaccination thyroid disturbances were identified. Among these, 41 had flare of underlying thyroid illness, majority occurring at a median time lag of 28.4 weeks since 2nd dose. Thirty‐one cases of new onset hypothyroidism and three of new onset hyperthyroidism were reported, with a median time lag respectively of 17.2 and 22.6 weeks since 2nd dose. Most cases occurred after ChAdOx1‐nCoV‐19, which was the commonest vaccine employed in mass roll out in India. Significant improvement was observed in majority, after a median follow up of 22–26 weeks. New onset health issues persisting for ≥4 weeks were reported in 37.3% and were common in individuals with history of COVID‐19 before vaccine. New onset metabolic, musculoskeletal, and reproductive disorders were the common health complaints. Active monitoring is warranted for late onset adverse events after COVID‐19 vaccines of all types. Larger studies with involvement of unvaccinated individuals are required to understand the incidence and causality of late onset thyroid disturbances after COVID‐19 vaccines. [ABSTRACT FROM AUTHOR]

Background: Older people are vulnerable to drug related problems (DRPs) such as adverse drug reactions (ADRs). Neurological system is one of the commonly affected systems by ADRs in the old. However, the epidemiological details of neurological ADRs have been scarcely evaluated. The main aim of this study was to predict the incidence, patterns, outcomes, and risk factors of drug-related neurological issues in older outpatients. Methodology: This was a subgroup analysis of a six year (2015 -2021) long prospective study conducted in the geriatric outpatient department of a tertiary care hospital in North India. Individuals of = 50 years developing any DRP were enrolled. Specifically, the nervous system ADRs were identified. Outcomes in the form of hospitalization and final improvement were recorded. Patients at risk of drug induced movement disorders (DIMDs) were identified. Results: In 10400 patient registrations, 187 neurological DRPs were reported (1.8%), next only to drug-induced metabolic disturbances (n=206). Sedation (27.8%), tremor (14.2%), and vertigo (11.8%) were the three most common neurological ADRs. 36 neurological DRPs (19.2%) required hospitalization. DIMDs were observed in 47 cases (27.8% of neurological ADRs) and calcium channel blockers (CCBs) such as valproate, cinnarizine, amlodipine etc. were the common culprits. Levosulpiride was involved in 41.6% of cases of drug induced extrapyramidal symptoms. Older adults of =65 years, and patients with dementia and lung disease were respectively at 3.45, 5.76- and 3.1 times higher risk of DIMDs. Conclusion: Neurological ADRs were the second most common ADRs in older outpatients and required hospitalization in every fifth case. DIMDs were the commonest neurological ADRs and CCBs might be a common culprit. Apart from antipsychotics and valproate, vigilance is warranted for antiemetic, levosulpiride, and cardiac drugs such as amlodipine. The ethnicity-related differences among older patients towards neurological ADRs should be investigated. [ABSTRACT FROM AUTHOR]