Key clinical point: There is an increased risk of neurological complications following COVID-19 vaccination; however, this risk is substantially higher following SARS-CoV-2 infection.
Major finding: There was an increased risk for Guillain-Barré syndrome and Bell’s palsy following vaccination with ChAdOx1nCoV-19 (incidence rate ratio [IRR], 2.90 [95% CI, 2.15-3.92] and 1.29 [95% CI, 1.08-1.56], respectively) and for hemorrhagic stroke following vaccination with BNT162b2 (IRR, 1.38; 95% CI, 1.12-1.71). The risk for all neurological complications was significantly higher within 28 days of a positive SARS-CoV-2 test, including Guillain-Barré syndrome (IRR, 5.25; 95% CI, 3.00-9.18).
Study details: The data come from an analysis of 20,417,752 individuals who received ChAdOx1nCoV-19 (AstraZeneca) COVID-19 vaccine, 12,134,782 who received BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine, and 2,005,280 who tested positive for COVID-19.
Disclosures: No specific funding information was available. A Sheikh, D Hunt, K Khunti, C Robertson, and J Hippisley-Cox reported ties with various research organizations and/or advisory groups. The remaining authors declared no conflict of interests.
Source: Patone M et al. Nat Med. 2021 Oct 25. doi: 10.1038/s41591-021-01556-7 .