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Can The Flu Shot Cause Guillain Barre Syndrome

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The Path To Recovery After A Guillain

Flu Vaccines and Guillain-Barré syndrome

Recovery generally begins two to four weeks after diagnosis and lasts from six months to three years. About 5% of cases relapse, though children tend to recover fully. Around 85% of patients who recover are free of lingering side effects. Immediate treatment is crucial after a diagnosis of Guillain-Barre syndrome for a chance of a meaningful recovery.

Two leading treatment methods dominate:

  • Plasma exchange
  • Intravenous Immunoglobulin when patients cannot walk ten meters unaided

A cure remains elusive, but treatments like these can reduce symptoms and mobilize patients.

Whats The Prognosis Like For Someone With Guillain

GBS can be a serious, life-threatening disease. Its more likely to be fatal in older people with severe disease that affects the heart or lungs. That said, its important to remember that GBS is rare. Of the few thousand people who get it each year in the U.S., most people will do well and recover in the first year.

Immune system treatments, like IVIG and plasma exchange, can speed up the recovery process. There are some people who may not respond to these treatments right away or who may respond at first and then have their symptoms get worse again.

Some people may have ongoing symptoms of pain, weakness, and fatigue for a number of years. Anxiety and depression can also be issues for people living with the long-term effects of GBS. Help and support are available through organizations, such as the GBS/CIDP Foundation International. You can find a local chapter here.

Influenza Vaccines And Adverse Effects

Influenza vaccines are commonly available for seasonal influenza and new versions of the vaccines are developed every year as the virus rapidly changes. Pandemic influenza vaccines are produced against certain strains of the influenza virus, such as the 2009 pH1N1 virus for rapid distribution during an influenza pandemic. Flu vaccines are available either as injectable inactivated vaccines or nasal spray flu vaccines . Some resources report that injectable trivalent and quadrivalent inactivated influenza vaccines are frequently used globally. Serious side effects to the flu vaccination are not very common. The most common adverse effects include pain at the injection site, muscle aches, fever, and malaise. Allergic reactions have also been rarely reported. GBS after influenza vaccination was first reported in 1976, which has become the origin of numerous studies on the association between this neurological disease and the vaccine. Before that, GBS was only associated with infectious diseases, but since 1976 an increase in the incidence of GBS after influenza vaccination has been noted with the same antigenic similarity in the role of vaccines, especially the influenza vaccine.

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The Typical Onset Of Guillain

Part of what makes the prognosis of Guillain-Barre syndrome difficult to measure is the wide variation in human immune responses to similar inputs. Scientists cannot agree on the cause of GBS or determine why some patients experience such a rapid onset of the symptoms.

The Journal of Neurology, Neurosurgery & Psychiatry reported that about two-thirds of patients report symptoms of infection in the four-week period preceding a diagnosis of Guillain-Barre syndrome. Another potential cause relates to vaccinations, as the body misinterprets the vaccine material and overcorrects its response.

Clients at Sadaka Associates Vaccine Injury Help or those these patients have left behind commonly express dismay at how little clarity there is about this disease. The centers legal team consults a wide array of knowledgeable sources while preparing the facts of each case while understanding these frustrations first-hand. If in doubt, schedule a consultation and discuss the options with one of the vaccine injury representatives.

How Do You Treat Guillain

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GBS can be a serious disease, but the good news is there is treatment for it. If you have GBS, you will most likely be treated in a hospital. While youre there, your breathing, blood pressure, heart rate, and neurological symptoms will be closely monitored. This is because GBS can get worse after the symptoms first start. Serious complications, like breathing problems and heart problems, need to be treated in the intensive care unit .

Most people with GBS have symptoms that get worse over 2 to 4 weeks before they start to improve. Treatment can lead to a quicker and better recovery. There are two treatments used for GBS that target the immune system:

  • Intravenous immune globulin : IVIG is given as an infusion each day for about 5 days. It contains antibodies from healthy, human plasma donors and is used to treat many illnesses, including GBS. The healthy antibodies in the IVIG counteract your immune system’s attack on the peripheral nerves, helping you recover faster.

  • Plasma exchange: To do plasma exchange, large IVs are inserted into your veins and plasma is removed from your blood and replaced with new plasma. Doing this removes unhealthy antibodies from your body that are causing the nerve damage. Multiple treatments are usually given over a few days. Plasma exchange can lower the level of disease-causing antibodies by up to 75%.

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What Treatments Are Available For Guillain

The autoimmune reaction in Guillain-Barré is directed against the myelin sheaths that surround the axons of peripheral nerves or the axons themselves. The greatest point of weakness or paralysis can occur days or weeks after the first symptoms occur.

Because the signs and symptoms of Guillain-Barré vary, it can be difficult to diagnose the condition in the early stages. A physical exam as well as an examination of the cerebrospinal fluid obtained from a spinal tap may help aid diagnosis.

Treatment of Guillain-Barré syndrome may include plasma exchange and high-dose immunoglobulin therapy. A respirator may be used if the patient requires assistance to breathe. Physical therapy can begin after the patient recovers limb control.

The recovery period after a bout of Guillain-Barré may be as little as a few weeks or as long as a few years. About 30% of those with Guillain-Barré may suffer from residual weakness after 3 years.

Study: Flu Vaccine Slightly Raises Guillain

Researchers from the University of Toronto, who published their findings in the Nov 13 issue of Archives of Internal Medicine, studied residents of Ontario, where everyone older than 6 months can receive a free annual flu shot under a program that began in 2000.

GBS, believed to be an autoimmune disorder, causes weakness or tingling that can worsen to paralysis. The syndrome affects roughly 1 in 100,000 people each year. Some previous studies have linked flu vaccination with a slightly increased risk of GBS, but uncertainty remains about the association.

The researchers performed two analyses. In the first, they identified all hospitalizations for GBS among Ontario residents aged 18 and older from April 1993 through March 2004. Then they identified which patients received flu shots and compared their risk for hospitalization for GBS for two time intervals: 2 to 7 weeks and 20 to 43 weeks after vaccination.

In a second analysis, the researchers examined the number of hospitalizations for GBS in Ontario between 1991 and 2004 and compared the number of cases before and after the universal flu immunization program began in 2000.

In the second analysis, the authors identified 2,173 hospitalizations for GBS between 1991 and 2004 and found no significant difference between hospitalization rates before and after the universal immunization program took effect.

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Symptoms Of Paralysis After The Flu Shot

While for some the flu shot causes paralysis, it usually starts as a numbness or tingling sensation. Many people may have a slight sensation at the injection site, which is usually not concerning, but for some, the tingling starts in their feet and legs. This tingling begins to spread, and numbness soon follows. As feeling is lost in areas, so is functional control, leaving victims with the inability to feel or move affected areas even as it keeps spreading. Eventually, this can create a host of complications requiring medical intervention:

Rapid Cycle Analysis In The Vaccine Safety Datalink

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The VSD conducted rapid cycle analysis to sequentially monitor, on a weekly basis, the risk of GBS and other selected adverse events among individuals ages 6 months vaccinated with any seasonal influenza vaccine from July 1, 2018 through April 3, 2019, using current-vs-historical and self-controlled risk interval designs . The methods we describe here focus on the investigation of GBS risk in days 142 after IIV3-HD administration among individuals ages 65 years.

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What Are The Symptoms Of Guillain

Guillain-Barre Syndrome can occur following the administration of a vaccine such as the flu shot.

The initial symptoms of GBS after receiving an influenza vaccination or another vaccine are typically weakness, tingling in your hands and feet, respiratory failure, and other side effects. These symptoms can quickly spread in an ascending fashion, meaning that it travels up the limbs from the fingers and toes towards the torso. In rare cases, as Guillain-Barre Syndrome progresses, muscle weakness can evolve into paralysis and sometimes death.

Guillain-Barre Syndrome Causes and Symptoms

If you have experienced Guillain-Barre Syndrome from a flu shot or Chronic Inflammatory Demyelinating Polyneuropathy from another vaccine, you may be entitled to compensation through a special federal trust fund called the Vaccine Injury Compensation Program.

Our vaccine injury law firm has represented hundreds of clients suffering from GBS after a flu shot and other vaccines across the United States. Our fees are paid through the VICP, not by our clients.

What’s The Potential Relationship Between Vaccines And Guillain

Some studies have shown similar, albeit rare , GBS links for certain flu vaccines. Generally speaking, contracting the flu itself carries a higher likelihood of resulting in GBS than getting the actual vaccine says Damania.

While the J& J and AstraZeneca vaccines are currently being investigated for this association, no risk has been assessed from Moderna, Pfizer, or other mRNA vaccines because they don’t use adenovirus technology.

While the Vaccine Adverse Event Reporting System , a mandatory reporting of any adverse side effects related to a vaccine, investigates the potential connection between the J& J vaccine and GBS, the FDA has issued a warning that there may be an association of GBS with getting the vaccine, but not implying that the vaccine causes GBS.

Bottom line: Does this mean you should hold off on getting the vaccine? Not at all, Damania says. The relatively minuscule number of cases100 in 13 million dosesis no reason the average person should be concerned. This condition primarily targets men who are 50 and oldera group that is also more susceptible to serious illness and death from COVID. The risk of not getting vaccinated significantly outweighs that of getting it. We’re not denying that GBS is a serious diseasebut chances are, most people aren’t at risk of getting it from a vaccine, according to Damania.

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Quadrivalent Vaccines For Seasonal Flu

A quadrivalent flu vaccine administered by nasal mist was approved by the FDA in March 2012. Fluarix Quadrivalent was approved by the FDA in December 2012.

In 2014, the Canadian National Advisory Committee on Immunization published a review of quadrivalent influenza vaccines.

Starting with the 2018-2019 influenza season most of the regular-dose egg-based flu shots and all the recombinant and cell-grown flu vaccines in the United States are quadrivalent. In the 2019â2020 influenza season all regular-dose flu shots and all recombinant influenza vaccine in the United States are quadrivalent.

In November 2019, the FDA approved Fluzone High-Dose Quadrivalent for use in the United States starting with the 2020-2021 influenza season.

In February 2020, the FDA approved Fluad Quadrivalent for use in the United States. In July 2020, the FDA approved both Fluad and Fluad Quadrivalent for use in the United States for the 2020â2021 influenza season.

Should I Still Get A Covid

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If the link between the vaccine and Guillain-Barré is real, it appears to be far outweighed by the risks of Covid-19, experts said. In the United States, almost all hospitalizations and deaths from Covid-19 are happening in those who are unvaccinated, the C.D.C. said in a statement. The agency recommends that everyone who is 12 or older be vaccinated.

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Learn More Aboutzostavax Lawsuits

Side effects of the shingles vaccine Zostavax may result in the development of a painful and persistent strain of shingles

Shingrix was the second vaccine approved in the U.S. for prevention of shingles among adults, which involves two doses for inoculation. GlaxoSmithKline introduced the Shingrix vaccine in October 2017, and it has largely replaced the earlier shingles vaccine approved by the FDA in 2006, Zostavax, which involved the use of a live virus that has been linked to reports of severe shingles outbreaks and auto-immune problems.

Although Shingrix has been marketed as a safer alternative, side effects have been linked to reports of injection site reactions and other less severe problems. However, the drug maker is now being required to add new information about the potential Guillain-Barre Syndrome risk with the Shingrix vaccine, which may cause the bodys immune system to attack the nerves.

The FDA indicates the Warnings and Precautions section of the Shingrix Prescribing Information will now contain the following statement:

In a postmarketing observational study, an increased risk of GBS was observed during the 42 days following vaccination with Shingrix.

The Diagnostic Criteria For Guillain

Medical professionals follow a straightforward process when diagnosing this condition, but there are times where patients exhibit abnormal characteristics. A lumbar puncture recommendation arises to prevent false diagnoses and eliminate the possibility of other causes for similar symptoms. The differential diagnosis covers infectious diseases and neuromuscular disorders.

When patients exhibit a higher cell count in cerebrospinal fluid , doctors weigh HIV, Lyme disease, and similar infectious diseases as viable possibilities. Lab-based investigations can also determine the origin of the GBS symptoms with more accuracy.

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Northern Hemisphere Influenza Season

The composition of trivalent virus vaccines for use in the 2017â2018 Northern Hemisphere influenza season recommended by the Advisory Committee on Immunization Practices on August 25, 2017, was:

  • an A/Michigan/45/2015 pdm09âlike virus
  • an A/Hong Kong/4801/2014 -like virus
  • a B/Brisbane/60/2008âlike virus

In addition to these components, quadrivalent vaccines will also include a B/Phuket/3073/2013âlike virus .

In California, some emergency systems were strained by a spike in H3N2 flu cases. In addition, some areas experienced local shortages of oseltamivir. The severity of the flu season seemed somewhat comparable to the 2009â10 swine flu outbreak. A February 2018 CDC interim report estimated the vaccine effectiveness to be 25% against H3N2, 67% against H1N1, and 42% against influenza B.

What Are My Risks If I Get The Flu Shot

Dr. Ellison explains why the flu causes a higher risk for Guillain-Barre syndrome than the flu shot

The governments official response is that the flu vaccination causes two cases of Guillain-Barre Syndrome per one million doses. Thats a very small number , but its difficult to be certain if the governments calculation is correct. Interestingly, the actual flu vaccine manufacturers packet insert lists the numbers at one case out of a million. But one thing is for sure, adult influenza vaccine injury claims are now the leading injury claim in the Vaccine Injury Compensation Program.

According the CDC, There is a small possibility that influenza vaccine could be associated with Guillain-Barré syndrome, no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.

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What If You Think You Have Symptoms Of Guillain

GBS usually starts with sensations of weakness or tingling in both legs, which sometimes spread to the upper body. This feeling can increase until some muscles cant be used at allin the most severe cases, the syndrome can lead to paralysis.

While the chance of developing GBS after a Johnson & Johnson vaccination is considered low, the FDA recommends seeking medical attention right away if you notice any of the following symptoms after getting the vaccine:

  • Weakness or tingling sensations, especially in the legs or arms, thats worsening and spreading to other parts of the body
  • Difficulty walking

How Common Is Gbs How Common Is It Among People Who Have Been Vaccinated Against Flu

The background rate for GBS in the Unites States is about 80 to 160 cases of GBS each week, regardless of vaccination. The data on the association between GBS and seasonal flu vaccination are variable and inconsistent across flu seasons. If there is an increased risk of GBS following flu vaccination it is small, on the order of one to two additional GBS cases per million doses of flu vaccine administered.

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Lighting Strikes Twice: Recurrent Guillainbarr Syndrome After Influenza Vaccination

Christopher R. Newey

1Cleveland Clinic Akron General, Neurological Institute, Akron General Avenue, Akron, OH 44307, USA

2AT Still University-Missouri Campus, Neurobehavioral Sciences, 800 West Jefferson Avenue, Kirksville, MO 63501, USA

3Cleveland Clinic, Neurological Institute, 9500 Euclid Avenue, Cleveland, OH 44195, USA


GuillainBarré syndrome is a rare acute demyelinating syndrome of the peripheral nervous system that is commonly preceded by infection. Vaccinations have also been associated with an increased incidence of GBS, though the risk is low. Caution with revaccination is recommended in patients with a history of GBS. Risks of revaccination compared with the risks of influenza complications should be considered. Patients who experience GBS after vaccination have not been shown to have an increased incidence of recurrent GBS after the influenza vaccine, though evidence is limited. We report a case of recurrent GBS in a patient following the influenza vaccine.

1. Introduction

We present a case of recurrent GBS in a patient who received the influenza vaccination with a prior history of GBS following influenza vaccination five years prior.

2. Case

3. Discussion

4. Conclusion

Data Availability

The data analyzed during the current case report are available from the corresponding author upon request.

Conflicts of Interest

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