Your risk of stroke after the COVID-19 vaccine doesn’t appear to be higher than the stroke risk in the general population. But, there does seem to be an elevated risk of stroke after having COVID-19, especially in the first 3 days after you become ill.

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The coronavirus disease 2019 (COVID-19) vaccine is important for preventing serious illness and death due to COVID-19. So far, 81.4% of people in the United States have received at least one dose of the COVID-19 vaccine.

But there have been questions about whether the COVID-19 vaccine increases your risk of stroke. This article will help to answer some of these questions.

Researchers have continued to study stroke risk after COVID-19 vaccination. So far, many have found that there’s no increase in the prevalence of stroke after getting the COVID-19 vaccine compared with stroke rates in the general population.

For example, a 2023 study looked at stroke risk after vaccination with mRNA COVID-19 vaccines in more than 4.1 million people. It didn’t find a higher rate of stroke in the 28 days after vaccination. This was true regardless of:

  • age
  • sex
  • the type or combination of mRNA vaccines received

Another 2022 review found that the prevalence of ischemic stroke after any COVID-19 vaccine was 4.7 per 100,000 doses. The researchers state that this is similar to the prevalence of stroke in the general population.

COVID-19 vaccines and thrombosis with thrombocytopenia syndrome

Thrombosis with thrombocytopenia syndrome (TTS) is a very rare, but serious, side effect that’s associated with the Johnson & Johnson (J&J) COVID-19 vaccine, a type of viral vector vaccine.

TTS causes low platelet counts and blood clots in your large blood vessels. These blood clots can potentially cause a stroke.

The Centers for Disease Control and Prevention (CDC) estimates that TTS happens with every four out of a million doses of the J&J vaccine.

Despite the rarity of TTS, a CDC advisory committee stated that other vaccines are preferred over the J&J vaccine due to their improved safety profile.

Bivalent COVID-19 vaccines and stroke risk

Earlier this year, the CDC and the Food and Drug Administration (FDA) announced an investigation into a safety signal for the Pfizer-BioNTech bivalent COVID-19 vaccine. Bivalent vaccines contain more than one strain of SARS-CoV-2, the virus that causes COVID-19.

This signal, triggered by the CDC’s Vaccine Safety Datalink, involved a potentially higher risk of ischemic stroke in adults ages 65 years old and older. A similar safety signal wasn’t seen with the Moderna bivalent COVID-19 vaccine.

The announcement goes on to say that no other safety systems or analyses have observed this signal:

  • Two studies that haven’t been published yet on bivalent vaccines using data from the Centers for Medicare and Medicaid Services database and Veterans Affairs database haven’t found an increased prevalence of ischemic stroke.
  • There hasn’t been an increase in reports of ischemic stroke in the Vaccine Adverse Event Reporting System after the introduction of the bivalent vaccine.
  • Pfizer-BioNTech’s safety database hasn’t identified a safety signal for ischemic stroke with their bivalent vaccine.
  • Other countries haven’t seen an increased rate of ischemic stroke with the bivalent vaccines yet.

Also, initial studies using data from health systems in France and the United States have found no association between the bivalent vaccine and an increased rate of ischemic stroke in older adults.

Currently, no change in vaccination practice is recommended by the CDC.

Some studies have found that the rate of ischemic stroke and serious blood clots is actually higher after having COVID-19 than after receiving a COVID-19 vaccine.

Although COVID-19-related strokes are generally uncommon, having COVID-19 may increase your risk of stroke. According to a 2021 study, the stroke rate among people hospitalized with COVID-19 was 1.3%.

The risk of stroke associated with COVID-19 is highest in the 3 days after you become ill. A higher risk of stroke can persist for months after recovery from COVID-19, even in people who didn’t need to be hospitalized.

A 2022 study revealed that some stroke survivors have concerns about COVID-19 vaccines. Many of these involve the risk of blood clots or a second stroke.

While few studies have assessed the risk of a second stroke after receiving the COVID-19 vaccine, a history of stroke increases your risk of severe COVID-19. As such, it’s a good idea for stroke survivors to get the COVID-19 vaccine to prevent serious illness.

Some research suggests that getting vaccinated against COVID-19 reduces your risk of major cardiovascular events like stroke if you do eventually develop COVID-19.

The American Heart Association also encourages all heart attack and stroke survivors as well as those with heart disease and other cardiovascular risk factors to get vaccinated against COVID-19.

What if I have stroke risk factors?

If you have stroke risk factors, it’s also important to get your COVID-19 vaccine, as many stroke risk factors are associated with a higher risk of serious COVID-19 illness. These risk factors include:

It’s not uncommon to have questions or concerns about any type of vaccine, medication, or medical procedure. If you have reservations about the safety of the COVID-19 vaccine, be sure to raise these with a doctor or healthcare professional.

A doctor is there to support you. They can help answer questions you have and address any concerns that you may have about the COVID-19 vaccine.

A doctor can also discuss the risk of various vaccine side effects as they relate to your individual situation. They may recommend that you receive a specific type of COVID-19 vaccine.

Compared with stroke rates in the general population, research shows that there isn’t a higher risk of stroke after COVID-19 vaccination. In fact, you may be more at a higher risk of stroke after developing COVID-19 than after getting vaccinated.

People with a history of stroke or who have certain stroke risk factors are at a higher risk of severe COVID-19 illness.

If you have questions or concerns about the COVID-19 vaccine, be sure to raise these with a doctor. They can help address any concerns you may have.