Guillain-Barré syndrome (GBS) has been inconsistently associated to some Covid-19 vaccines. We aimed to quantify the risk of GBS according to the type of Covid-19 vaccine in a large population.
Using the French National Health Data System linked to the COVID-19 vaccine database, we analysed all individuals aged 12 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 to 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 time period and stratified by age group, gender, and for the presence of SARS-CoV-2 or common acute infections.
Of 58 530 770 people aged 12 years or older, 88.8% received at least one Covid-19 vaccine dose, and 2 229 were hospitalized for GBS during the study period. Patients had a median age of 57 years and were 60% males. The relative incidence of GBS between 1–42 days was 2.5 (95%CI, 1.8 to 3.6) for the first dose of ChAdOx1-S and 2.4 (95%CI, 1.2 to 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 12-49 years age group after the second dose of the mRNA-1273 vaccine (RI; 2.6 [95%CI, 1.2 to 5.5]), none of the relative incidence estimates were found significantly increased for the mRNA vaccines.
In summary, we found increased risks of Guillain-Barré syndrome following 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 risk of Guillain-Barré syndrome after the administration of mRNA vaccines. This is reassuring in the context of the ongoing and future use of mRNA-based booster vaccination.
Find the article on the website of Neurology