Publication date: Sep 06, 2026
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.
| Concepts | Keywords |
|---|---|
| COVID-19 mRNA vaccines | |
| dysautonomia | |
| GLP-1 receptor agonists | |
| neuropathic pain | |
| semaglutide | |
| Vasovagal syncope |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | MESH | dysautonomia |
| disease | MESH | Vasovagal syncope |
| disease | MESH | postural orthostatic tachycardia syndrome |
| disease | MESH | syndromes |
| drug | DRUGBANK | Semaglutide |
| disease | MESH | Orthostatic Hypotension |
| disease | MESH | neuropathic pain |