The Development of Guillain Barre Syndrome Subsequent to Administration of Ad26.COV2.S Vaccine

Abstract

Guillain Barre Syndrome (GBS) is a rare neurologic disorder in which the immune system mistakenly attacks the peripheral nervous system due to molecular mimicry. GBS symptoms can range from a mild episode of weakness to devastating paralysis and respiratory failure. The exact cause of GBS is unknown, but it is often thought to be due to a preceding viral infection or rarely due to vaccination. To date, there has only been one reported case of Guillain Barre Syndrome associated with the administration of Ad26.COV2.S vaccine (Janssen/Johnson & Johnson COVID-19 vaccine) [3]. Here, we describe the case of a 59-year-old woman who received the Johnson & Johnson COVID-19 vaccine and subsequently developed symptoms consistent with GBS. Unfortunately, due to failure to obtain lumbar puncture (LP) and electromyography (EMG), it is only possible to diagnose Guillain Barre syndrome with Level 3 diagnostic certainty using the Brighton criteria [6]. We are of the opinion that our patient developed GBS subsequent to the vaccination, but not necessarily consequent to the vaccination, as it remains possible that she may have contracted an asymptomatic infection prior to inoculation