Immunopharmacology and immunotoxicologySep 7, 2026

Improvement of post-COVID-19 vaccination nerve system imbalance with GLP-1 receptor activator

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Sep 8, 2026

Abstract

A 42-year-old woman with post-vaccination vasovagal syncope showed a 44% reduction in her COMPASS-31 score after treatment with semaglutide.

Post-vaccination dysautonomia, including vasovagal syncope and postural orthostatic tachycardia syndrome, has been documented following COVID-19 vaccination.
Significant improvements were observed in autonomic symptom burden following semaglutide treatment, with a 59% decrease in the Orthostatic Hypotension Questionnaire score.
The average 24-hour heart rate decreased from 97 beats per minute to 80 beats per minute after treatment.
Post-vaccination neuropathic pain in the patient's feet completely resolved with semaglutide treatment.
GLP-1 receptor agonists may be considered for further investigation in treating recurrent vasovagal syncope and other post-vaccination syndromes.

Simplified

Vasovagal syncope (VVS) is the most common form of cardiovascular dysautonomia that has multiple etiologies. Post-vaccination dysautonomia, in the form of VVS and postural orthostatic tachycardia syndrome, has been reported in the literature after various vaccines, including COVID-19 mRNA vaccination. Treatment of post-vaccination syndromes has not been explored leaving patients with post-vaccination dysautonomia with limited therapeutic options. We report a 42-year-old woman who developed post-vaccination VVS after COVID-19 mRNA vaccine and improved significantly with semaglutide treatment. Her COMPASS-31 score decreased by 44% post-treatment, Orthostatic Hypotension Questionnaire score decreased by 59%, and an average 24-hr heart rate decreased from 97 bpm to 80 bpm, indicating significant reduction in the autonomic symptom burden. In addition, her post-vaccination neuropathic pain in the feet completely resolved after treatment with semaglutide. This case report suggests that GLP-1 receptor agonists might be beneficial for treatment of recurrent VVS, other forms of cardiovascular dysautonomia and post-vaccination syndromes with neuropathic pain, and need to be considered as candidates for randomized placebo-controlled trials in this patient population.

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Improvement of post-COVID-19 vaccination nerve system imbalance with GLP-1 receptor activator

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