Background

Guillain-Barre Syndrome (GBS) is an autoimmune condition whereby the body’s own immune system can attack the nerves, damaging the myelin (insulating layer) and sometimes the axon (nerve fiber). This damage can result in symptoms of muscle weakness, altered sensation, numbness and paralysis.

The rate of GBS is approximately 2 in every 100,000 people per year. The syndrome is often triggered following a viral or bacterial illness usually occurring 1-3 weeks prior to symptoms developing. As an example, ‘wild-type’ influenza and campylobacter are infections known to be associated with GBS.

Symptoms usually start in the lower extremities and progress up the body over a few days or weeks. There is no known cure but therapies include intravenous immunoglobulin. Most cases spontaneously recover although this may take from 6 months to 2 years. Approximately 10-15 percent of GBS cases can result in permanent disability.

GBS and influenza vaccines

Influenza vaccination has been identified as a possible cause following H1N1 containing vaccines, but the evidence is variable and at a very low rate, definitely lower than the rate of GBS caused by ‘wild type’ influenza. As per the AusVaxSafety clinical resources flow chart  [see resources], influenza immunisation is generally not recommended for people with a history of GBS occurring within 6 weeks of receiving a previous influenza vaccine. However specialist immunisation advice should be sought to discuss the potential benefit of vaccination and the risk for GBS recurrence post vaccination or GBS recurrence post influenza disease. There are no concerns administering influenza vaccines to patients who have a history of developing GBS more than 6 weeks following an influenza vaccine.

GBS and meningococcal vaccines

There is no increased risk of developing GBS after receiving meningococcal vaccinations. People with a history of GBS can safely receive meningococcal vaccines. It is also safe for them to receive all of the other routine National Immunisation Program (NIP) and travel vaccines as required.

GBS and COVID-19 vaccines

GBS has been reported to occur in individuals following both COVID-19 infection and COVID-19 vaccination. Intensive post-licensure surveillance and investigations by the TGA and other international vaccine regulators, has shown a growing body of evidence of a possible link between GBS and Vaxzevria (AstraZeneca). In response to this, GBS has been listed as a precaution for those receiving Vaxzevria.

Individuals who have previously been diagnosed with GBS can receive COVID-19 vaccines. Specialist advice from a treating neurologist or immunisation specialist may be considered to discuss the benefits and risks of vaccination.

GBS and Shingrix®

Preliminary data from the US suggests that there is a very rare risk of GBS ocurring in individuals who have received the shingles (herpes zoster) vaccine, Shingrix® (an additional 3-6 cases of GBS per million doses of vaccine administered). GBS has also been reported following shingles disease. The benefits of vaccination outweigh the risk of GBS.

Resources

Authors: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute)

Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)

Date: November 29, 2022

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.