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Incidence of Guillain–Barré syndrome following SARS‐CoV ‐2 immunization: Analysis of a nationwide registry of recipients of 81 million doses of seven vaccines
Author(s) -
GarcíaGrimshaw Miguel,
GalnaresOlalde Javier Andrés,
BelloChavolla Omar Yaxmehen,
MichelChávez Anaclara,
CadenaFernández Arturo,
BriseñoGodínez María Eugenia,
AntonioVilla Neftali Eduardo,
Núñez Isaac,
GutiérrezRomero Alonso,
HernándezVanegas Laura,
Mar SanigerAlba María,
CarrilloMezo Roger,
CeballosLiceaga Santa Elizabeth,
CarbajalSandoval Guillermo,
FloresSilva Fernando Daniel,
DíazOrtega José Luis,
CortesAlcalá Ricardo,
PérezPadilla José Rogelio,
LópezGatell Hugo,
Chiquete Erwin,
ReyesTerán Gustavo,
Arauz Antonio,
ValdésFerrer Sergio Iván
Publication year - 2022
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.15504
Subject(s) - medicine , interquartile range , incidence (geometry) , vaccination , confidence interval , adverse effect , immunization , guillain barre syndrome , epidemiology , pediatrics , immunology , antibody , physics , optics
Background and purpose Information on Guillain–Barré syndrome (GBS) as an adverse event following immunization (AEFI) against SARS‐CoV‐2 remains scarce. We aimed to report GBS incidence as an AEFI among adult (≥18 years) recipients of 81,842,426 doses of seven anti‐SARS‐CoV‐2 vaccines between December 24, 2020, and October 29, 2021, in Mexico. Methods Cases were retrospectively collected through passive epidemiological surveillance. The overall observed incidence was calculated according to the total number of administered doses. Vaccines were analyzed individually and by vector as mRNA‐based (mRNA‐1273 and BNT162b2), adenovirus‐vectored (ChAdOx1 nCov‐19, rAd26‐rAd5, Ad5‐nCoV, and Ad26.COV2‐S), and inactivated whole‐virion‐vectored (CoronaVac) vaccines. Results We identified 97 patients (52 males [53.6%]; median [interquartile range] age 44 [33–60] years), for an overall observed incidence of 1.19/1,000,000 doses (95% confidence interval [CI] 0.97–1.45), with incidence higher among Ad26.COV2‐S (3.86/1,000,000 doses, 95% CI 1.50–9.93) and BNT162b2 recipients (1.92/1,00,000 doses, 95% CI 1.36–2.71). The interval (interquartile range) from vaccination to GBS symptom onset was 10 (3–17) days. Preceding diarrhea was reported in 21 patients (21.6%) and mild COVID‐19 in four more (4.1%). Only 18 patients were tested for Campylobacter jejuni (positive in 16 [88.9%]). Electrophysiological examinations were performed in 76 patients (78.4%; axonal in 46 [60.5%] and demyelinating in 25 [32.8%]); variants were similar across the platforms. On admission, 91.8% had a GBS disability score ≥3. Seventy‐five patients (77.3%) received intravenous immunoglobulin, received seven plasma exchange (7.2%), and 15 (15.5%) were treated conservatively. Ten patients (10.3%) died, and 79.1% of survivors were unable to walk independently. Conclusions Guillain–Barré syndrome was an extremely infrequent AEFI against SARS‐CoV‐2. The protection provided by these vaccines outweighs the risk of developing GBS.