The Johnson & Johnson coronavirus vaccine now comes with a warning on its label about an increased risk of nerve damage known as Guillain-Barré syndrome (GBS). It has primarily been seen in men ages 50 and older, and appears roughly two weeks after vaccination. When about 13 million adults have received this vaccine, and we’re just beginning to hear about this potential side effect, it begs the question: Should you be worried? Hospitalist and clinical associate professor of medicine at UNLV School of Medicine, Zubin Damania, MD (better known as ZDoggMD) shared his take on why you likely have nothing to fear about GBS.
What is Guillain Barré Syndrome?
Damania explains that Guillain-Barré Syndrome is an autoimmune condition where your brain attacks your peripheral nerves, which causes anything from mild weakness in your body to full-on paralysis. The condition itself in the general population is very rare, affecting roughly 6,000 Americans per year, he says.
So far, there have only been about 100 cases among the millions of people who have been vaccinated with the J&J vaccine. The FDA states that “although the available evidence suggests an association between the Janssen vaccine and increased risk of GBS, it is insufficient to establish a causal relationship.” Still, the news can be disturbing, and Damania spells out more about what GBS is and isn’t, and what we know about the relationship and what we don’t.
“[GBS] can be mild, it can be nothing, and it can happen in all ages,” Damania says. “Or it can be really bad ascending paralysis,” he adds. That means it starts in the legs and feet and eventually affects the respiratory system so you need a ventilator to breathe. Even muscles of your face and your heart rate can be affected.
Damania, who has cared for GBS patients, states that the disease itself can get better on its own, but that can take weeks to even months because the nerves have to regrow or regenerate themselves. Despite the wide range of potential symptoms and pathways, the illness is treatable, and that treatment can help patients recover those damaged nerves a lot quicker than without treatment. Treatments can include immunoglobulin IVs, supportive care, and plasmapheresis, which swaps out your blood plasma for plasma unaffected by GBS.
What causes Guillain-Barré Syndrome?
According to Damania, Guillain-Barré syndrome is often associated with infections, most commonly campylobacter, a gastrointestinal infection you can get from puppies that can cause bloody diarrhea, fever, the common flu, and even—in rare cases—Epstein-Barr Virus (EBV). Today, experts believe a theory known as molecular mimicry may explain GBS. In short, molecular mimicry occurs when something in a virus or bacteria (in this case, possibly the adenovirus in the J&J vaccine) strongly resembles a component of your body, Damania says. With GBS, the thinking goes, the antibodies your immune system creates bind to your peripheral nerves and cause inflammation there. (Although researchers are still trying to find a definitive answer.)
How would you know if you had Guillain-Barré?
Typically, GBS occurs anywhere from 10 days to two months after the virus or bacteria enter your body, Damania says. “It doesn’t happen right away because you need time to build up the antibody response.” If you’re feeling any of the symptoms associated with GBS, like weak muscles, particularly in the eyes or the legs, or a pins and needles sensation in the hands and feet, Damania recommends that you see a doctor.
What’s the potential relationship between vaccines and Guillain-Barré syndrome?
Some studies have shown similar, albeit rare (one to two cases in two million), 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 (VAERS), 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 cases—100 in 13 million doses—is no reason the average person should be concerned. This condition primarily targets men who are 50 and older—a 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 disease—but chances are, most people aren’t at risk of getting it from a vaccine, according to Damania.
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