RT Journal Article
SR Electronic
T1 Guillain-Barré syndrome following SARS-CoV-2 vaccination in the UK: a prospective surveillance study
JF BMJ Neurology Open
JO BMJ Neurol Open
FD BMJ Publishing Group Ltd
SP e000309
DO 10.1136/bmjno-2022-000309
VO 4
IS 2
A1 Arina A Tamborska
A1 Bhagteshwar Singh
A1 Sonja E Leonhard
A1 Eva Maria Hodel
A1 Julia Stowe
A1 Taylor Watson-Fargie
A1 Peter M Fernandes
A1 Andreas C Themistocleous
A1 Jacob Roelofs
A1 Kathryn Brennan
A1 Caroline Morrice
A1 Benedict D Michael
A1 Bart C Jacobs
A1 Helen McDonald
A1 Tom Solomon
A1 ,
YR 2022
UL http://neurologyopen.bmj.com/content/4/2/e000309.abstract
AB Objective To investigate features of Guillain-Barré syndrome (GBS) following SARS-CoV-2 vaccines and evaluate for a causal link between the two.Methods We captured cases of GBS after SARS-CoV-2 vaccination through a national, open-access, online surveillance system. For each case, the certainty of GBS was graded using the Brighton criteria, and the relationship to the vaccine was examined using modified WHO Causality Assessment criteria. We compared age distribution of cases with that of prepandemic GBS cases and clinical features with the International GBS Outcome Study (IGOS).Results Between 1 January and 30 June 2021, we received 67 reports of GBS following the ChAdOx1 vaccine (65 first doses) and three reports following the BNT162b2 vaccine (all first doses). The causal association with the vaccine was classified as probable for 56 (80%, all ChAdOx1), possible for 12 (17%, 10 ChAdOx1) and unlikely for two (3%, 1 ChAdOx1). A greater proportion of cases occurred in the 50–59 age group in comparison with prepandemic GBS. Most common clinical variants were sensorimotor GBS (n=55; 79%) and facial diplegia with paraesthesias (n=10; 14%). 10% (n=7/69) of patients reported an antecedent infection, compared with 77% (n=502/652) of the IGOS cohort (p<0.00001). Facial weakness (63% (n=44/70) vs 36% (n=220/620); p<0.00001) and sensory dysfunction (93% (n=63/68) vs 69% (n=408/588); p=0.00005) were more common but disease severity and outcomes were similar to the IGOS study.Interpretation Most reports of GBS followed the first dose of ChAdOx1 vaccine. While our study cannot confirm or refute causation, this observation, together with the absence of alternative aetiologies, different than expected age distribution and the presence of unusual clinical features support a causal link. Clinicians and surveillance bodies should remain vigilant to the possibility of this very rare adverse event and its atypical variants.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Anonymised cumulative data can be made available for surveillance purposes on request to the corresponding author.