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ABN Abstracts 2022
Parallel Session 4: COVID| Wed 18 May, 1445 – 1600|4
COVID-19 vaccination and Guillain-Barré syndrome: analyses using the National Immunoglobulin Database
  1. Ryan YS Keh1,2,
  2. Sophie Scanlon3,
  3. Katherine Donegan3,
  4. Sally Cavanagh4,
  5. Mark Foster5,
  6. David Skelland6,
  7. James Palmer4,
  8. Pedro M Machado1,7,
  9. Aisling S Carr1,7,
  10. Michael P Lunn1,7
  1. 1MRC Centre for Neuromuscular Diseases, NHNN
  2. 2Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust
  3. 3Medicines and Healthcare products Regulatory Agency
  4. 4NHS England and Improvement (NHSEI)
  5. 5Medical Data Solutions and Services (MDSAS) Ltd
  6. 6NHS Arden and Greater East Midlands (GEM) Commissioning Support Unit (CSU)
  7. 7Institute of Neurology, UCL

Abstract

Anti-viral vaccination has rarely been associated with Guillain-Barré syndrome(GBS). We performed a population-based study of NHS England data and a UK multicentre surveillance study to investigate the relationship between COVID-19 vaccination and GBS.

We linked GBS cases from England’s National Immunoglobulin Database(NID) with COVID-19 vaccina- tion data from December 2020–July 2021. GBS temporally associated within a 6-week risk window of any COVID-19 vaccine was identified.

We prospectively collected incident UK GBS cases January–November 2021 regardless of vaccine exposure.

The NID recorded 996 English GBS cases January–October 2021. A spike of cases above the 2016-2020 average occurred March–April 2021. 198 cases occurred within 6 weeks of first-dose COVID-19 vaccina- tion (0.618cases/100,000vaccinations: 176 ChAdOx1 nCoV-19, 21 tozinameran, 1 mRNA-1273). First-dose ChAdOx1 nCoV-19 accounted for the excess of 98-140 GBS cases with a peak 24 days post-vaccination. First-dose tozinameran and second-dose any vaccination showed no excess GBS risk. The UK multicen- tre surveillance dataset (121 patients) identified no phenotypic or demographic differences between vaccine-linked and unlinked cases.

First-dose ChAdOx1 nCoV-19 vaccination is associated with excess GBS risk 0.576 (95%CI 0.481-0.691) cases/100,000 doses. No specific features are associated with vaccination-related GBS cases. The mechanism of immunogenicity of ChAdOx1 nCoV-19- warrants further study.

https://doi.org/10.1136/jnnp-2022-abn2.23

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