The American Neurological Association recently shared that a couple of studies published in the Annals of Neurology highlight small clusters of COVID-19 vaccine-related incidence of an unusual variant of Guillain-Barre syndrome. The studies, one from England and the other from India, reveal the first seven cases identified from a regional medical center in Kerala, India, the location of about 1.2 million COVID-19 inoculations with the AstraZeneca (Oxford) vaccine manufactured by Serum Institute of India, the busiest vaccine maker in the world as measured by volume. Another four cases were reported in Nottingham, England, a location where about 700,000 people received that same AstraZeneca vaccine. In all cases, those that are experiencing the health condition received the vaccine anywhere from 10 to 22 days earlier. Apparently, according to the American Neurological Association, the incidence of this condition in these locations deviates from the norm about 4-10 times greater than the expected baseline. What made the situation stand out most was “the unusually severe bilateral facial weakness and precise timing with respect to vaccination that made the occurrences stand out.”
What is Guillain-Barre Syndrome?
Guillain-Barre syndrome is an acute polyneuropathy often associated with infection or at times vaccination. A very rare condition (less than 200,000 cases per annum), it involves the immune system actually attacking the nerves. It can be triggered by acute bacterial or viral infection. Symptoms can range from weakness and tingling in the feet and legs to the condition spreading to the upper body. It can lead to paralysis. The treatment involves special blood therapy (plasma exchange and immunoglobulin therapy), which can relieve the symptoms. Physical therapy is used as well.
Apparently, similar cases were seen in Boston in a patient who received the vaccine produced by Johnson & Johnson according to the editors at Annals of Neurology. A tour of the CDC’s Vaccine Adverse Events Reporting System (VAERS) in America also found that “5 of 8 cases of GBS with bilateral facial weakness in the U.S. were reported in people who had received the Johnson & Johnson vaccine, which like the AstraZeneca vaccine, is adenovirus-based.” Of note, the U.S. FDA never accepted the AstraZeneca vaccine as there were some safety incidents that stopped the trial for a while. Apparently, only three similar cases were recorded among the much larger pool of vaccinations involving the two mRNA-based vaccines.
Rare but Take Note
The American Neurological Association suggests that Guillain-Barre syndrome with bilateral facial weakness is perhaps a rare but associated condition with both AstraZeneca and Johnson & Johnson. The condition should be promptly treated with a standard therapy (e.g. intravenous immunoglobulin).
A Common Theme—No Proof of Causation
As with all of the incidence of adverse events associated with COVID-19 vaccines, there seems to be a worldwide agreement to, by any means necessary, ensure that causality cannot be proven. For example, in Healio’s assessment, Dr. Dhanashri P. Miskin from Thomas Jefferson University Hospital shared that, in this case, these particular clusters of Guillain-Barre syndrome patients seemingly “temporally associated with vaccination” do not prove causation. And, of course, the doctor thereafter emphasizes that the “benefits of vaccination substantially outweigh the risk for this relatively rare outcome and robust post-vaccination surveillance programs remain essential to definitely establish causality.”
TrialSite, a pro-vaccination, pro-research platform, does seek to support transparency and engagement, and our contributors have called attention to some challenges with the data in VAERS, for example. Note that on TrialSite, it’s also been suggested that at least with one mRNA-based vaccine, the dosage could be too high.