COVID-19: J&J Vaccine Is Linked To Increased Risk Of Guillain-Barré Syndrome

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J&J Vaccine Or Ad.26.COV2.S Turning Out to Be The Pariah Among COVID-19 Vaccines After U.S. CDC Links Its Use To Increased Risk Of Guillain-Barré Syndrome

The Johnson and Johnson or Janssen COVID-19 Vaccine (Ad.26.COV2.S) that has been authorized for emergency use in various countries including the United States is now turning out to the ‘pariah’ among the COVID-19 vaccines with many countries and individuals avoiding it due to a litany of issues including the latest involving the U.S.CDC study that shows its use is linked to a higher risk of developing Guillain-Barré Syndrome.

Already the Janssen vaccine initial debut was marred with issues of increased risk of clotting effects or thrombosis with thrombocytopenia syndrome (TTS). Most reports of this serious condition, which involves blood clots with low platelets, have been in adult women younger than 50 years old. 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/JJUpdate.html

What You Need to Know

  • On April 23, 2021 CDC and the U.S. Food and Drug Administration (FDA) recommended use of Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 vaccine resume in the United States after a temporary pause.
  • Reports after the use of J&J/Janssen COVID-19 vaccine suggested an increased risk of a rare adverse event called thrombosis with thrombocytopenia syndrome (TTS). Most reports of this serious condition, which involves blood clots with low platelets, have been in adult women younger than 50 years old.
  • A review of available data showed that the J&J/Janssen COVID-19 vaccine’s known and potential benefits outweigh its known and potential risks.
  • However, women younger than 50 years old especially should be aware of the rare but increased risk of this adverse event, and they should know about other available COVID-19 vaccine options for which this risk has not been seen.
  • CDC and FDA continue to monitor the safety of all COVID-19 vaccines.


 
Then as early as July, the US FDA included a new warning on the Janssen vaccine after there have been 100 preliminary reports of Guillain-Barré syndrome in the US out of 12.8 million Johnson and Johnson vaccine doses given as of 30 June. 

https://www.fda.gov/media/146304/download
 
The US Food and Drug Administration (FDA) has updated its label for the vaccine to reflect the possibility of increased risk for this rare side effect within 42 days following vaccination.


Since the outbreak of the pandemic by the SARS-CoV-2 virus, it became rapidly obvious that the virus not only causes lung disease (COVID-19) but affects other organs as well, particularly the central and peripheral nervous system (PNS, CNS), the kidneys, the intestines, and the heart [1,2,3].

The most disabling PNS disorder is polyradiculitis (polyradiculoneuritis, Guillain-Barre syndrome (GBS)) [4]. GBS comprises a number of subtypes which include acute, inflammatory, demyelinating neuropathy (AIDP) (classic type), acute, motor, axonal neuropathy (AMAN), acute, motor and sensory, axonal neuropathy (AMSAN), Miller-Fisher syndrome (MFS), polyneuritis cranialis (PNC), the pharyngeal, cervical, and brachial (PCB) variant, and Bickerstaff encephalitis (BFE) [5].

GBS is usually diagnosed according to the Brighton criteria if there is bilateral, progressive, flaccid lower > upper limb paraparesis, if tendon reflexes in weak limbs are diminished, if the disease course is monophasic and if time between onset and nadir ranges from 12 h to 28 days, if cerebrospinal fluid (CSF) investigations reveal a cell count < 50cells/μL, if CSF protein is elevated (dissociation cyto-albuminque (DCA)), and if nerve conduction studies show a demyelinating lesion of motor nerves (AIDP), an axonal lesion of motor nerves (AMAN), or an axonal lesion of motor and sensory nerves (AMSAN) [5].

MFS is diagnosed if there is acute onset ophthalmoplegia, areflexia, ataxia, and DCA. PNC is diagnosed in case of a lesion of a single or multiple cranial nerves and DCA. PCB is diagnosed if there is progressive dysphagia, dysphonia, upper limb weakness, and DCA [5]. BFE is diagnosed if there are pyramidal signs and impaired consciousness in addition to MFS. In the early stages of GBS, upper or lower limb paraplegia with preserved tendon reflexes may occur [5].

There can be even hyperreflexia if the pyramidal tract is involved. All GBS subtypes occur in the setting of a preceding viral or bacterial infection. The type of preceding infection largely determines the subtype and clinical course of GBS. This systematised review summarises and discusses recent findings and future perspectives concerning the pathophysiology, clinical presentation, diagnosis, treatment, and outcome of SARS-CoV-2-associated GBS (SC2-GBS).

reference link: https://ejnpn.springeropen.com/articles/10.1186/s41983-021-00310-7


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