Do vaccines increase or decrease the risk of developing Guillain-Barre syndrome (GBS), and is there a risk with the Johnson & Johnson COVID-19 vaccine?

Updated: Jul 14, 2021
  • Author: Michael T Andary, MD, MS; Chief Editor: Milton J Klein, DO, MBA  more...
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Results from studies into the association between GBS and other vaccines include the following:

  • Data from a large-scale epidemiologic study reported a decreased GBS incidence following administration of tetanus toxoid containing vaccinations when compared with the baseline population [62]

  • An epidemiologic study failed to show any conclusive epidemiologic association between GBS and the hepatitis B vaccine [63]

  • A large Latin American study of more than 2000 children with GBS following a mass measles vaccination program in 1992-1993 failed to establish a statistically significant causal relationship between administration of the measles vaccine and GBS [67]

  • A report from the CDC suggests that recipients of the Menactra meningococcal conjugate vaccine may be at increased risk of GBS [68]

  • Case reports exist regarding group A streptococcal vaccines and the rabies vaccine; however, conclusive, statistically significant evidence is lacking

In July 2021, the US Food and Drug Administration (FDA) announced that the Janssen (Johnson & Johnson) COVID-19 vaccine may increase the risk of developing GBS, adding the warning to the vaccine’s label. This announcement arose from the approximately 100 preliminary reports of GBS in persons to whom the Johnson & Johnson vaccine had been administered that had been identified in the federal Vaccine Adverse Event Reporting System by mid-July 2021. This was out of the 12.8 million doses of the Johnson & Johnson vaccine that had been administered in the United States up to that point. The risk seems to be higher in men, particularly those aged 50 years or above. Despite the warning, however, the FDA stated that it has not yet determined whether the vaccine actually causes GBS and indicated that the benefits of the vaccine outweigh the GBS risk. The FDA announcement does not apply to the Pfizer/BioNTech and Moderna COVID-19 vaccines. [64, 65, 66]

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