REPLY LETTER TO: IF SARS-COV-2 VACCINATION IS BLAMED FOR PARSONAGE–TURNER SYNDROME, NEUROSURGICAL NEUROLYSIS IS NOT INDICATED We would like to respond to the letter to the editor titled ‘If SARS-CoV-2 vaccination is blamed for Parsonage–Turner syndrome, neurosurgical neurolysis is not indicated’ addressed to our article titled ‘Parsonage–Turner syndrome: A case report of a rare side effect of COVID-19 booster vaccination’.1,2 We thank the author for raising several points worthy of discussion.

FEASIBILITY OF QUICK RESPONSE-BASED QUALITY IMPROVEMENT PROJECTS IN AN URBAN PRIMARY CARE SETTING: A CROSS-SECTIONAL SURVEY Introduction: Using quick response (QR) codes to disseminate information has become increasingly popular since the declaration of COVID-19 as a pandemic. We aimed to investigate the feasibility of implementing QR-based quality improvement projects in our clinic to improve patients’ medical knowledge, experience and access to care. Methods: We utilised systematic random sampling by recruiting every 25th patient registered in our clinic during data collection. Participants answered a self-administered printed questionnaire regarding their smartphone usage and familiarity with QR code scanning at the patients’ waiting area. Data were analysed using the Statistical Package for the Social Sciences version 26. Results: A total of 323 patients participated (response rate=100%). The participants’ median age was 57 years (interquartile range=41–67). Most participants were women (63.1%). Approximately 90.4% (n=282) used smartphones, with 83.7% (n=261) reporting average or good usage proficiency. More than half (58.0%) accessed medical information via their smartphones, and 67.0% were familiar with QR codes. Multiple logistic regression analyses revealed that familiarity with QR codes was linked to age of <65 years [adjusted odds ratio (AOR)=4.593, 95% confidence interval (CI)=2.351–8.976, P<0.001], tertiary education (AOR=2.385, 95% CI=1.170–4.863, P=0.017), smartphone proficiency (AOR=4.703, 95% CI=1.624–13.623, P=0.004) and prior smartphone usage to access medical information (AOR=5.472, 95% CI=2.790–10.732, P<0.001). Conclusion: Since smartphones were accessible to most primary care patients, and more than half of the patients were familiar with QR code scanning, QR code-based quality improvement projects can be used to improve services in our setting.

The mass vaccination against COVID-19 has saved millions of lives globally. The majority of people experience short-term mild side effects; however, in rare cases, some develop long-term severe adverse events. This case report illustrates the case of a middle-aged man with Parsonage–Turner syndrome, a rare adverse event following COVID-19 immunisation. The patient presented with pain and weakness of the right upper arm for 2 months, which developed 5 days after he received his mRNA COVID-19 booster vaccine. He sought medical attention after 9 weeks of experiencing weakness with obvious muscle wasting. He reported his condition only via a phone application, as he thought that his condition was self-limiting and will improve with time. Herein, we discuss the syndrome and highlight the importance of patient education and early recognition of serious adverse events related to vaccinations in the primary care setting.
COVID-19 Vaccines ; Brachial Plexus Neuritis ; Primary Health Care