Download This PaperGuillain-Barré Syndrome Temporally Associated with COVID-19 Vaccines in Victoria, Australia
17 Pages Posted: 3 Jun 2022
Abstract
Guillain–Barré syndrome (GBS) is an adverse event of special interest (AESI) for surveillance systems monitoring adverse events following immunisation (AEFI) with COVID-19 vaccines. Emerging data support a temporal association between GBS and adenovirus-vector COVID-19 vaccines. We present a case series of GBS reports submitted between February and November 2021 to our enhanced spontaneous surveillance system (SAEFVIC) in Victoria, Australia, following vaccination with either the adenovirus-vector vaccine Vaxzevria ChadOx1-S (AstraZeneca) or an mRNA vaccine (Comirnaty BNT162b2 [Pfizer-BioNTech] or Spikevax mRNA-1273 [Moderna]). For each report, Brighton Collaboration case definitions were used to describe diagnostic certainty. Severity was graded using the GBS Disability Score. The incidence of GBS following immunisation against COVID-19 was compared to expected background hospitalisation rates. There were 41 total cases of GBS reported to SAEFVIC following Vaxzevria (n = 38), Comirnaty (n= 3), or Spikevax (n = 0) vaccines. The observed GBS incidence rate exceeded the expected background rate for Vaxzevria only, with 1.85 reports per 100,000 doses following dose 1, higher than the expected rate of 0.61 presentations per 100,000 within 42 days of vaccination. Of 38 GBS reports following Vaxzevria, the median age at vaccination was 66 years and median onset of symptoms was 14 days following immunisation. There was one death. Four cases initially categorised as GBS were later reclassified as acute-onset chronic inflammatory demyelinating polyneuropathy. Fatigue was the predominant persisting symptom reported at follow up (mean 252 days after initial presentation).
Note:
Funding Information: This research was not supported by any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of Interests: Declaration of Competing Interest Jim Buttery is a site investigator for non-COVID vaccine related clinical trials for both Pfizer and AstraZeneca. He does not receive compensation for this but his (former) employer Monash Health is compensated for his time. All other authors have no relevant financial or other conflicts of interest pertaining to this submission.
Ethical Approval: Ethics approval was not required for this study as the case review and follow-up was undertaken as part of routine public health AEFI management.
Keywords: COVID-19, Guillain-Barré syndrome, vaccination, Vaccine
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