Guillain-Barré Syndrome (GBS) briefly came to public attention in the fall of 1976 when it developed in an unusually large number of people who had received 1976 swine flu shots. More recently, rare mild increases in GBS cases have been associated with influenza immunizations. These events have raised concerns among GBS patients about the safety of immunizations. Most recommendations about immunizations have been derived from experiences with the population at large. The general teaching has been that most former GBS patients who would otherwise be a candidate for an immunization should still likely receive it, with rare exceptions. But what about the actual experiences of GBS patients with immunizations? Through the efforts of our sister organization, the Guillain-Barré Syndrome Support Group of the United Kingdom, data was collected from a large body of patients, and reported by Drs. J. Pritchard, R. Mukhergjee, and R.A.C. Hughes of Guy's, of the King's and St. Thomas' School of Medicine, Dept. of Clinical Neurosciences, London (J Neurol Neurosurg Psychiatry 73:348-9, 2002). Of 311 GBS patients who, after recovering, received an immunization, only one got sick enough to prevent walking; ten other patients developed mild symptoms such as abnormal sensations, weakness or fatigue, but they did not require hospital care. Information about exactly what type of disorder these patients developed was not available. However, the low risk of substantial problems, in one patient out of 311, or 0.3%, suggests that most immunizations are safe for most recovered GBS patients.

The general approach to making a decision about the safety of immunizations is based on comparing the risks of developing an illness and its complications with the risks of developing complications from the immunization that is used to prevent it. By and large, the risk of complications from the flu are substantially greater than the small risk of side effects from the flu shot. Accordingly, the flu shot appears to be relatively safe for most candidates for it, including most former GBS patients.

If however, a patient's GBS followed shortly after receiving an immunization, within two weeks or so, it would likely be unwise to receive that immunization again.

Finally, it is likely best for a patient with GBS to wait at least a year after its onset to receive an immunization, in order to help assure that the immune system is now stable and in normal working order. Ultimately, the best approach to decision making about various immunizations is to discuss the pros and cons with the family physician who can take the patient's individual medical history into accounted help offer a recommendation.