The US Food and Drug Administration (FDA) issued an update June 12 on the Johnson and Johnson’s COVID-19 vaccine and a small potential increased risk of a rare neurological disorder called Guillain-Barre Syndrome (GBS). Learn more about Guillain-Barre Syndrome and whether you should get the COVID-19 vaccine.
Of the 12.5 million people vaccinated, only 100 people have been reported to develop symptoms consistent with GBS during the 42 days following vaccination with the J&J COVID-19 vaccine. The evidence suggests an association and is insufficient to determine a causal relationship. A similar association has not been reported with the Moderna or Pfizer COVID-19 vaccine. However, there are 7 case reports of a GBS variant occurring 10-20 days after receiving the AstraZeneca COVID-19 vaccine, which is not offered in the US.
What is Guillain-Barre Syndrome?
Guillain-Barre Syndrome (GBS) is caused by an acute inflammation of your nerves that can occur 2-4 weeks after a benign respiratory or gastrointestinal infection. Your immune system produces antibodies that damage your nerves.
Usual symptoms consist of numbness/tingling and weakness that start in the feet and spread up your legs, body, arms, and face over the course of hours to days. Weakness can lead to difficulty breathing, slurred speech, problems swallowing, and double vision. You should emergently seek medical attention if you have any of these symptoms.
GBS is diagnosed by clinical history. Blood tests are done to exclude other diagnoses. A lumbar puncture (spinal tap) and electromyography (EMG) can be helpful in making the diagnosis of GBS but should not delay treatment. However, an EMG can be completely normal in acute cases and does not rule out GBS.
Who Gets Guillain-Barre Syndrome?
In the United States, about 1-2 out of 100,000 or 2000-3000 people develop GBS each year, whether or not they received a vaccine.
Anybody can get GBS, but adults are more affected than children. Men are slightly more at risk than women. Race does not appear to affect your risk of developing GBS.
Two-thirds of GBS cases occur after a respiratory or gastrointestinal infection. Associated viral infections include campylobacter jejuni (C jejuni), cytomegalovirus (CMV), and even COVID-19 virus. Vaccines for influenza and shingles have been linked to GBS but no definite causal relationships have been established except for the rabies and swine flu vaccines.
How is Guillain-Barre Syndrome Treated?
Most benign GBS cases make a good recovery with 15-20% still having residual symptoms 6-12 months later.
Treatment consists of close monitoring in the intensive care unit. Plasma exchange and immunoglobulin (IVIG) infusion are effective in clearing the antibodies that cause damage to your nerves. Corticosteroids have not been shown to be effective for GBS.
Should You Get the COVID-19 Vaccine?
The decision to get the COVID-19 vaccine is a personal decision. You need to weigh the risks and benefits of getting the vaccine. Although rare cases of Guillain-Barre Syndrome have been reported with both the Johnson and Johnson’s and AstraZeneca COVID-19 vaccines, there is no clear causal relationship at this time.
What we do know is that the COVID-19 virus spreads easily and has resulted in many deaths globally. In the United States, the 3 vaccines (Pfizer, Moderna, J&J) are very effective against the COVID-19 virus and variants.