Risk of Guillain-Barré Syndrome Following COVID-19 Vaccines
A Nationwide Self-Controlled Case Series Study
Abstract
Background and Objectives
Guillain-Barré syndrome (GBS) has been inconsistently associated with some coronavirus disease 2019 (COVID-19) vaccines. We aimed to quantify the risk of GBS according to the type of COVID-19 vaccine in a large population.
Methods
Using the French National Health Data System linked to the COVID-19 vaccine database, we analyzed all individuals aged 12 years or older admitted for GBS from December 27, 2020, to May 20, 2022. We estimated the relative incidence (RI) of GBS within 1–42 days after vaccination up to the first booster dose compared with baseline periods using a self-controlled case series design. We then derived the number of cases attributable to the vaccination. Analyses were adjusted for the period and stratified by age group, sex, and for the presence of severe acute respiratory syndrome coronavirus 2 or common acute infections.
Results
Of 58,530,770 people aged 12 years or older, 88.8% received at least 1 COVID-19 vaccine dose and 2,229 were hospitalized for GBS during the study period. Patients had a median age of 57 years, and 60% were male patients. The RI of GBS between 1–42 days was 2.5 (95% CI 1.8–3.6) for the first dose of ChAdOx1-S and 2.4 (95% CI 1.2–5.0) for the unique dose of Ad26.COV2.S vaccine. We estimated 6.5 attributable GBS cases per million persons having received a first dose of ChAdOx1-S and 5.7 cases per million for the Ad26.COV2.S vaccine. Except for the age group of 12–49 years after the second dose of the messenger RNA (mRNA)-1273 vaccine (RI 2.6, 95% CI 1.2–5.5), none of the RI estimates were found significantly increased for the mRNA vaccines.
Discussion
In summary, we found increased risks of GBS after the first administration of ChAdOx1-S and Ad26.COV2.S vaccines. In this comprehensive assessment at the French population level, there was no statistically significant increase in the risk of GBS after the administration of mRNA vaccines. This is reassuring in the context of the ongoing and future use of mRNA-based booster vaccination.
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© 2023 American Academy of Neurology.
Publication History
Received: April 7, 2023
Accepted: August 3, 2023
Published online: October 3, 2023
Published in print: November 21, 2023
Disclosure
The authors report no relevant disclosures. Go to Neurology.org/N for full disclosures.
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Cited By
- A nationwide Guillain–Barré syndrome epidemiological study in Spain during the COVID ‐19 years , European Journal of Neurology, 31, 12, (2024).https://doi.org/10.1111/ene.16439
- Exploring the adverse events of Oxford–AstraZeneca, Pfizer-BioNTech, Moderna, and Johnson and Johnson COVID-19 vaccination on Guillain–Barré Syndrome, Scientific Reports, 14, 1, (2024).https://doi.org/10.1038/s41598-024-66999-7
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- SARS-CoV-2 Vaccination and Neuroimmunological Disease, JAMA Neurology, 81, 2, (179), (2024).https://doi.org/10.1001/jamaneurol.2023.5208
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