Loss of memory may be due to stress

Dear Dr. Roach: I am a 67-year-old woman in good health. I received two doses of the Moderna vaccine. Within 16 hours of receiving the second dose I developed transient global amnesia. My family all say I shouldn’t get a booster. I want to stay as safe as possible from COVID but certainly don’t want to get trapped in a mental state where I can’t function. I would appreciate your thoughts on whether or not I should get a booster.

F.D.

Answer: Transient global amnesia is a terrifying experience for a person and for those around them. It begins with an abrupt onset of memory loss and disorientation, with the person often repeatedly asking questions about when and where they are; this is sometimes called “broken record” phenomenon. People are often concerned that it is a stroke. During this time, people are unable to make new memories. It most commonly lasts about six hours, and seldom, if ever, more than 12. It’s most common in middle aged and older adults. Prompt evaluation is indicated to be sure this isn’t anything more serious.

TGA is not a risk factor for stroke, unlike a transient ischemia attack. Once a person recovers, there is usually permanent memory lapse for the event and shortly before it, but otherwise people recover fully over time.

Numerous triggers have been identified for TGA, especially stress, physical exertion and contact with hot or cold water. A recent paper did note the increase in TGA during the COVID epidemic, but NOT due to COVID-19 infection. The authors felt the increase in stress in the community caused by social distancing and fear of the infection was the likely reason. You might well have been stressed when getting the vaccine — it is a perfectly understandable reaction. I don’t think there was anything in the vaccine that caused the TGA, but the stress itself seems the most likely cause.

People can have recurrences of TGA. The inscreased risk is between 2% and 5% per year. In my opinion, the low risk of recurrence is outweighed by the benefit of additional protection from the vaccine against the COVID-19 pandemic that continues to cause immense disease and death.