Recovery from Myalgic Encephalomyelitis/Chronic Fatigue syndrome developed after [SARS-CoV-2] vaccination: A case report, 2025, Kurotori et al

[forestglip]

Recovery from Myalgic Encephalomyelitis/Chronic Fatigue syndrome developed after severe acute respiratory syndrome coronavirus 2 vaccination: A case report

Isaku Kurotori, Wataru Sasao, Masahiko Abe

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Background
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a neurological adverse effect after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations. However, clinicians do not recognize the condition well, and no case report has shown a full recovery.

Case Presentation
We present a 65-year-old Japanese female who experienced severe fatigue, postexertional malaise, orthostatic intolerance, and various symptoms after her third SARS-CoV-2 vaccination. Following thorough examinations and excluding other potential diagnoses, she met the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

The symptoms persisted for 30 months and improved ultimately with comprehensive treatment and a self-management strategy, including pacing management, pharmacological treatments, and psychiatric interventions to support those struggling with the despair over the devastating symptoms.

Conclusion
This case report describes ME/CFS following the SARS-CoV-2 vaccination and its full recovery. It illustrates the importance of considering the differential diagnosis of psychiatric disorders and addressing the condition through psychiatric interventions. Our findings provide new insights into treating ME/CFS and the vaccination-related adverse effects.

Link | PDF (Psychiatry and Clinical Neurosciences Reports) [Open Access]

 

[Utsikt]

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After excluding other potential diagnoses, she met the diagnostic criteria for ME/CFS.

While there is no evidenced-based radical treatment for ME/CFS and PEM, the most common treatment strategy aimed to relieve PEM, which balances energy and rests to reduce the frequency or severity of episodes of PEM, is called pacing.
Therefore, pacing with information about the diseases, education for self-management, and emotional support were incorporated. She was advised to engage in leisure activities and avoid overexerting herself with household chores or work.

She was encouraged not to dwell excessively on her symptoms, to take time for herself, and to find the path to recovery, under the clinician's guidance.

She was also required to report detailed daily activities every week for 2 months, while activity diaries were not introduced. Additionally, hochuekkito, a Japanese herbal (Kampo) medicine (7.5 g/day), and tandospirone (15 mg/day) were prescribed.

The classic paternalistic approach of telling the patients how to behave and think.

Twelve months after the third vaccination, she restarted taking walks around the neighborhood and vegetable gardening at home, which she had been unable to do for a year.

Her symptoms gradually improved, and she said, “I was feeling rushed. I can see a clear sky now”.

Although her symptoms occasionally appeared, she developed self-management skills and began working every other day.

Fourteen months after the third vaccination, the patient experienced a new-onset headache that persisted for a month, leading to increased anxiety. The headache was alleviated after advising her to pace herself, offering supportive psychotherapy, and encouraging a commitment to recovery.

Her symptoms gradually improved with the coping strategy, allowing her to return to work just as before the third vaccination.

Thirty months after the third vaccination, her taste dysfunction finally improved, and all symptoms were entirely resolved. By the time this report was written, 6months had passed since her full recovery, with no signs of relapse or recurrence.

If only I had not been committed to being sick, I would have already recovered!

Pacing is a physical therapy strategy that enables patients to increase or decrease their activity levels according to their daily condition, not to trigger PEM.25 Patients and clinicians collaboratively determine the activity limits that can be tolerated.2, 3

No, pacing is not a therapy strategy. And there is no collaboration!

It is important to discuss and determine patients' tolerable activity limits through a mutual decision-making process.2, 3, 30

Again, there is no mutual decision-making here. Stop trying to micro manage patients.

CONCLUSION
This case report highlights the occurrence of ME/CFS following the SARS-CoV-2 vaccination and details the patient's complete recovery. It emphasizes the importance of considering ME/CFS in the differential diagnosis among patients experiencing adverse effects of the SARS-CoV-2 vaccination. While the severity and conditions of each patient vary, our findings shed new light on the treatment of ME/CFS and the vaccination-related adverse effects. Psychiatrists can provide valuable interventions to help those struggling with devastating symptoms and the associated despair over the condition.

There is nothing new here.

This appears to be a fortunate case of natural recovery over 2-3 years where the therapist believes that their divine insight and intervention, and the patients focus on recovery, made the recovery happen.

 

[Snow Leopard]

Yes, this very much sounds like a natural remission. It remains to be seen whether it is a long-term remission.