GBS|CIDP Foundation International Position on Flu Shots and Vaccinations
**This information is intended for general educational purposes only. Any decisions regarding vaccinations should be made in consultation with your primary doctor.**
Vaccines and Guillain-Barré Syndrome
Summary: Vaccines are usually safe for most people; their potential benefits usually outweigh their small risks. However there is a lack of data to guide the use of immunizations in former GBS pa
tients. The GBS|CIDP Foundation recommends avoiding immunizations that a GBS patient had received within six weeks of developing their initial symptoms. The decision to receive a vaccination is likely best made by conferring with the patient’s primary physician and following guidelines in the product literature.
History of Guillain-Barré Syndrome and Vaccines
GBS is a rare disorder caused by damage of the peripheral nerves. Major features are weakness, paralysis, and sometimes even breathing issues. Most patients recover but some are left with long term weakness. Infections commonly precede GBS and are thought to “trigger” GBS through a process called “molecular mimicry.” In this process, the body’s immune defense system attacks an infecting microbe and then inadvertently attacks peripheral nerves that “look” similar to that microbe.
The start of an American vaccination program against swine flu in the fall of 1976 was followed by more cases of GBS in vaccine recipients than would have been expected by chance. This experience raised concerns that future flu or other vaccines might also increase the risk of developing GBS.
However, a study of adverse events of flu shots given during the two flu seasons after 1976 showed no increased risk to developing GBS[i]. A recently published study looked carefully at vaccine recipients over the course of 11 years, 1995-2006, and found no increased risk of developing GBS from influenza or other vaccinations[ii]. Other studies suggest only a rare association with influenza vaccine citing an incidence of 1 or 2 excess cases of GBS over expected per million vaccinations[iii].
The risk of a former GBS patient developing GBS again from a vaccination is not known as the complication rate from vaccinations in recovered GBS patients has not been properly studied. Members of the GBS|CIDP Foundation Global Medical Advisory Board have deliberated on the safety of immunizations for former GBS patients and offer the following guidelines: For the rare person who developed GBS within four to six weeks of receiving an immunization, it seems prudent to avoid that vaccination in the future. For those whose GBS did not follow soon after a vaccination, there is no reliable data to indicate the risk of developing GBS after a vaccination.
Ultimately, former GBS patients should discuss the pros and cons of receiving a vaccination with their primary physician to evaluate its benefits and risks. Influenza is dangerous, accounting for 40,000 or so deaths each year in the US from complications, especially in the elderly and those with chronic illnesses (chronic lung disease, diabetes, etc.). The decision about a former GBS patient receiving or declining a flu shot or other immunization should be well thought out. Discussing this matter with the primary physician is likely the best means to assess a vaccine’s value.
[ii] Baxter R et al. Lack of Association of Guillain-Barre Syndrome with Vaccinations. CID 2013; 57: 197-204
[iii] Lasky T et al. The Guillain-Barre syndrome and the 1992-1993 and 1993-1994 Influenza Vaccines. N Engl J Med 1998; 339: 1797-1802