Ocular adverse events following vaccination: overview and update

The Food and Drug Administration has licensed, approved, and expanded guidelines for dozens of vaccines since 2010. Although advancements in biotechnology have made vaccines more effective and safer, none are completely free from adverse effects. Many vaccines have been implicated in causing ocular adverse events based on the temporal association of exposure and putative complication. Determination of causality is difficult. We provide an overview of vaccine side effects and also examine the English literature and the Vaccine Adverse Events Reporting System (VAERS) from 2010 through 2020 for vaccine-implicated ocular adverse events. While reactions of eyelids and conjunctiva are commonly reported, the most frequently implicated serious adverse events are optic neuritis and various patterns of intraocular inflammation. Live attenuated vaccines have the potential to cause ocular infection from vaccine-strain organisms, particularly in those immunosuppressed. While postmarketing registries for suspect vaccination adverse events, such as VAERS, are unable to determine causal associations, they are a mainstay in signaling suspected trends that require investigation. The majority of probable and possible serious ocular adverse effects are distinctly uncommon.