U.S. study examines whether COVID-19 vaccines increase the risk of GBS

Vaccination has rarely been associated with Guillain-Barré syndrome (GBS). GBS is a rare, immune-mediated neurologic disorder of the peripheral nervous system. It is characterized by ascending weakness and paralysis. Using data from the U.S. Vaccine Adverse Events Reporting System (VAERS), investigators examined cases of verified GBS following vaccination with any of the three COVID-19 vaccines available to U.S. adults. The authors specifically investigated whether there was an association between use of the Janssen (Ad26.COV2.S), Pfizer-BioNTech (BNT162b2) or Moderna (mRNA-1273) COVID-19 vaccine and the development of GBS within 21 and 42 days after vaccination. Reporting rate ratios (RRRs) after receipt of the Janssen, Pfizer or Moderna vaccine within 21- and 42-day post-vaccination intervals were calculated. Observed-to-expected ratios were estimated using published GBS background rates. Results showed the following: 487,651,785 COVID-19 vaccine doses were included in the analysis—17,944,515 doses (3.7%) of the Janssen vaccine, 266,859,784 doses (54.7%) of the Pfizer vaccine, and 202,847,486 doses (41.6%) of the Moderna vaccine. 209 reports of GBS occurred within 21 days and 253 within 42 days of vaccination. Within 21 days of vaccination, GBS reporting rates per 1,000,000 doses were 3.29 for the Janssen vaccine, 0.29 for the Pfizer vaccine, and 0.35 for the Moderna vaccine. Within 42 days of vaccination, GBS reporting rates per 1,000,000 doses were 4.07 for the Janssen vaccine, 0.34 for the Pfizer vaccine, and 0.44 for the Moderna vaccine. GBS was more frequently reported within 21 days after the Janssen vaccine than after the Pfizer vaccine (RRR = 11.40; 95%CI, 8.11–15.99) or Moderna vaccine (RRR = 9.26; 95%CI, 6.57–13.07). Similar findings were observed within 42 days after vaccination. Observed-to-expected ratios were 3.79 (95%CI, 2.88–4.88) for 21-day and 2.34 (95%CI, 1.83–2.94) for 42-day intervals after the Janssen vaccine, and < 1 (not significant) after Pfizer or Moderna vaccination within both post-vaccination periods. These results suggest that the Janssen vaccine was associated with an increased risk for GBS. No association was observed between the use of either mRNA COVID-19 vaccine (Pfizer or Moderna) and risk of GBS. GBS reporting rates within 21 and 42 days of receiving the Janssen vaccine were nine to 12 times higher than after the Pfizer or Moderna vaccines. These results provide reassurance about no increased risk of GBS with mRNA COVID-19 vaccines and support their continued preferential use over the Janssen vaccine. Reference 1. Abara WE, Gee J, Marquez P, et al. Reports of Guillain-Barré syndrome after COVID-19 vaccination in the United States. JAMA Network Open 2023;6(2):e2253845. (accessed February 2, 2023).

U.S. study examines whether COVID-19 vaccines increase the risk of GBS

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