The temporal association between the occurrence of neurological diseases, many autoimmune diseases, and vaccination against SARS-CoV-2 has been topically interesting and remains hotly debated both in the medical literature and the clinic. Given the very low incidences of these events both naturally occurring and in relation to vaccination, it is challenging to determine with certainty whether there is any causative association and most certainly what the pathophysiology of that causation could be.
In this narrative review, the authors found that data from international cohorts including millions of vaccinated individuals suggested that there was a probable association between the adenovirus-vectored vaccines and Guillain-Barré syndrome (GBS). Further associations between other SARS-CoV-2 vaccines and GBS or Bell palsy had not been clearly demonstrated in large cohort studies. It is also yet to be clearly demonstrated that any other neurological diseases, such as central nervous system demyelinating disease or myasthenia gravis, have any causative association with vaccination against SARS-CoV-2 using any vaccine type, although it was possible that vaccination may rarely trigger a relapse or worsen symptoms or first presentation in already-diagnosed or susceptible individuals.
The authors concluded that the associated risk between SARS-CoV-2 vaccination and GBS, and possibly Bell palsy, was slight, and this should not change the recommendation for individuals to be vaccinated. The same advice should be given to those with preexisting neurological autoimmune disease.
Willison AG, Pawlitzki M, Lunn MP, Willison HJ, Hartung HP, Meuth SG. SARS-CoV-2 Vaccination and Neuroimmunological Disease: A Review. JAMA Neurol. 2024 Jan 16. doi: 10.1001/jamaneurol.2023.5208.