Sub-acute Onset of Guillain-Barré Syndrome Post-mRNA-1273 Vaccination: a Case Report

Abstract

Ever since the start of the pandemic, SARS-CoV-2 has taken the lives of millions of people around the globe. Several COVID-19 vaccines have been developed with rapidity to prevent acquiring COVID-19 infection, hospitalizations, and deaths. The routine side effects of these vaccines are commonly known and non-severe. Few serious side effects such as thrombosis with thrombocytopenia syndrome (TTS) and Guillain-Barré syndrome (GBS) are increasingly reported particularly after inoculation with ChAdOx1 nCoV-19 (Oxford/AstraZeneca) and Ad26.COV 2.S (Johnson & Johnson’s Janssen). Rare cases of GBS after BNT162b2 (Pfizer-BioNTech), an mRNA vaccine, are also reported. However, the true association of these cases to COVID-19 continues to be unclear and the safety of these vaccines continues to be great in preventing deaths from COVID-19 infection. We report a case of middle-aged female who had a gradual onset of lower extremity weakness with a nadir of symptoms reached 10 and 12 weeks after the onset. This protracted course (sub-acute) is atypical for a “classical” GBS. The presence of an antecedent event, autonomic symptoms such as hypotension, and the need for ventilator support favored the diagnosis of GBS than chronic inflammatory demyelinating polyneuropathy (CIDP). This is the first known case to be reported of sub-acute onset of Guillain-Barré syndrome after receiving the mRNA-1273 vaccine. Supplementary Information The online version contains supplementary material available at 10.1007/s42399-022-01124-1.

Inflammatory demyelinating polyneuropathy after the ChAdOx1 nCoV-19 vaccine may follow a chronic course

“…CSF albumino-cytological dissociation and EMG confirmed an inflammatory demyelinating polyneuropathy that responded to plasma exchange. The temporal course with evolution over >8 weeks suggests aCIDP, with a relatively severe course similar to our patients [ 37 ].…”

Profiling COVID-19 Vaccine Adverse Events by Statistical and Ontological Analysis of VAERS Case Reports

“…Caress et al reviewed 37 published cases of GBS associated with COVID-19 during the early pandemic and found a potentially small but statistically significant safety issue with GBS following Ad26.COV2.S vaccine (Caress et al, 2020). Nagalli and Kikkeri reported the first known case of subacute GBS onset following mRNA-1273 vaccination, in which a middle-aged woman gradually developed lower extremity weakness, symptoms peaked at 10 and 12 weeks after onset (Nagalli and Shankar Kikkeri, 2022). Roberto et al reported a case of GBS after receiving the second dose of Pfizer vaccine (Scendoni et al, 2021).…”

COVID-19 vaccine acceptance rates and predictors among the Egyptian general population and Healthcare workers, the intersectionality of age and other factors

“…Reluctance toward vaccination was associated with leading causes of refusal which had been delineated in previous studies, such as mistrust of vaccine safety due to ubiquity of negative and false information on vaccines on the internet, lack of information on different vaccines techniques, and possible side effects where reports of myocarditis and pericarditis were recorded in male adolescents and young adults after receiving Pfizer-BioNTech (BNT162b2) and Moderna mRNA-1273). In addition, reports of thrombosis and Guillain-Barré syndrome were recorded after Johnson & Johnson's Janssen and Oxford/AstraZeneca COVID-19 vaccine (AZD1222) 44,45…”