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Volume 28, Number 5—May 2022

Guillain-Barré Syndrome Associated with COVID-19 Vaccination

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To the Editor: With interest we read the article by Shao et al. (1) about the frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination–associated Guillain-​Barré syndrome (SCoVaG) among 18,269 healthcare workers in Taiwan who had received the AstraZeneca vaccine (AZV; Only 1 vaccinee experienced SCoVaG during the study period (1). The study is appealing but raises concerns.

Recently, our review of 19 SCoVaG patients, for whom data were collected through June 2021, was published (2). The 9 men and 10 women in the study were 20–86 years of age. All patients experienced SCoVaG after the first vaccine dose. AZV was given to 14 patients, the Pfizer-BioNTech ( vaccine to 4 patients, and the Johnson & Johnson ( vaccine to 1 patient. Latency between vaccination and SCoVaG onset ranged from 3 hours to 39 days. Patients received intravenous immune globulin (n = 13), steroids (n = 3), or no therapy (n = 3). Six patients required mechanical ventilation. One patient recovered completely; 9 achieved partial recovery (2). Only 1 of the studies included in our review mentioned the total number of vaccinated persons (3); in that study, 7 persons among 1.2 million vaccinated persons were found to have SCoVaG (3).

In addition, data on 389 patients with SCoVaG were collected in a recent review about the neurologic adverse events of SARS-CoV-2 vaccination (4). However, no individual data were provided for 337 of these patients (4). Among the 53 patients for whom individual data were available, AZV was given to 39 patients, Pfizer-BioNTech vaccine to 9 patients, and Johnson & Johnson vaccine to 2 patients.

For the Shao et al. report (1), we wondered why the oldest healthcare worker was 86 years of age. Also missing were the specific treatment and outcome of the patient with SCoVaG.

Available data suggest that SCoVaG is a rare complication of SARS-CoV-2 vaccination, irrespective of the vaccine brand used. SCoVaG should be diagnosed early so treatment can be initiated promptly. Whether the beneficial effect of SARS-CoV-2 vaccination outweighs the risk for adverse events (e.g., Guillain-​Barré syndrome) remains a matter of discussion (5).


Josef FinstererComments to Author , Fulvio A. Scorza, and Carla A. Scorza
Author affiliations: Neurology and Neurophysiology Center, Vienna, Austria (J. Finsterer); Disciplina de Neurociência. Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil (J. Finsterer, F.A. Scorza, C.A. Scorza)



  1. Shao  SC, Wang  CH, Chang  KC, Hung  MJ, Chen  HY, Liao  SC. Guillain-Barré syndrome associated with COVID-19 vaccination. Emerg Infect Dis. 2021;27:31758. DOIPubMedGoogle Scholar
  2. Finsterer  J, Scorza  FA, Scorza  CA. Post SARS-CoV-2 vaccination Guillain-Barre syndrome in 19 patients. Clinics (São Paulo). 2021;76:e3286. DOIPubMedGoogle Scholar
  3. Maramattom  BV, Krishnan  P, Paul  R, Padmanabhan  S, Cherukudal Vishnu Nampoothiri  S, Syed  AA, et al. Guillain-Barré syndrome following ChAdOx1-S/nCoV-19 vaccine. Ann Neurol. 2021;90:3124. DOIPubMedGoogle Scholar
  4. Finsterer  J. Neurological side effects of SARS-CoV-2 vaccinations. Acta Neurol Scand. 2021. DOIPubMedGoogle Scholar
  5. Koike  H, Chiba  A, Katsuno  M. Emerging infection, vaccination, and Guillain-Barré syndrome: a review. Neurol Ther. 2021;10:52337. DOIPubMedGoogle Scholar


Cite This Article

DOI: 10.3201/eid2805.212145

Original Publication Date: April 11, 2022

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Josef Finsterer, Neurology and Neurophysiology Center Vienna, Postfach 20, 1180 Vienna, Austria

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Page created: March 11, 2022
Page updated: April 19, 2022
Page reviewed: April 19, 2022
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