Guillan-Barre Syndrome Following COVID-19 Vaccines: Analysis of the Vaccine Adverse Event Reporting System (VAERS) Database

ABSTRACT

Introduction: As part of post-authorization safety surveillance, the European Medicines Agency (EMA) has identified a potential safety concern for Guillain-Barre syndrome (GBS) following COronaVIrusDisease 2019 (COVID-19) vaccines [1,2]. Objective(s) To assess reports of GBS reported in the Vaccine Adverse Event Reporting System (VAERS) following COVID-19 vaccination and to evaluate if a COVID-19 vaccine has a lower/higher probability of reporting Individual Case Safety Reports (ICSRs) with GBS in a direct comparison with all other COVID-19 vaccines. Method(s) After selecting all ICRSs of GBS following vaccination reported in VAERS from 1 January 2021 to 31 December 2021, we assessed them through the case definition and classification of the Brighton Collaboration (BC). We performed a descriptive analysis. Finally, we used the Reporting Odds Ratio with a 95% of Confidence Interval to investigate disproportional reporting of GBS among the vaccines included in the analysis. Result(s) 774 ICSRs of GBS have been reported in VAERS, and 279 of them met the BC Case Definition 30 (10.7%) have been evaluated as Definitive, 56 (20.0%) as Probable, and 193 (69.3%) as Possible. COVID-19 Vaccine Pfizer-BioNTech was the most commonly vaccine reported (N = 118;42.3%) followed by COVID-19 Vaccine Moderna (N = 82;29.4%) and COVID-19 Vaccine Janssen (N = 79;28.3%). GBS was more commonly reported for male subjects (N = 143;51.3%) aged between 12 and 20 years (N = 59;21.1%). GBS mainly occurred between the 1st and 12th day following the first dose administration of mRNA vaccines and between the 4th and the 15th day following COVID-19 Vaccine Janssen. COVID-19 Vaccine Janssen was significantly associated with increased risks for Guillan- Barre syndrome (ROR 3.47, CI 95% = 2.58-4.65) compared to COVID-19 Vaccine Pfizer-BioNTech and COVID-19 Vaccine Moderna. Conclusion(s) GBS is an adverse event of special interest for all COVID-19 vaccines requiring specific safety monitoring. GBS is very rare, and the benefit-risk balance of the vaccine remains unchanged.