SARS-CoV-2 Vaccination Safety in Guillain-Barré Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, and Multifocal Motor Neuropath.

ABSTRACT

BACKGROUND AND OBJECTIVES: There are concerns on the safety of SARS-CoV-2 vaccination in patients with a history of Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). The aim of this study is to determine the risk of recurrence of GBS, and exacerbations of CIDP or MMN following SARS-CoV-2 vaccination. METHODS: We conducted a prospective, multicenter cohort study from January 2021 to August 2021. Patients known in one of three Dutch University Medical Centers with research focus on immune-mediated neuropathy, and members of the Dutch Patient Association for Neuromuscular Diseases were invited to participate if they were 18 years or older, and diagnosed with GBS, CIDP or MMN. PARTICIPANTS: completed a series of questionnaires at four different time points study baseline (1), within 48 hours before any SARS-CoV-2 vaccination (2 and 3, if applicable), and six weeks after their last vaccination (4). Participants unwilling to get vaccinated completed the last questionnaire (4) four months after study baseline. We assessed recurrences of GBS, any worsening of CIDP or MMN related symptoms, treatment alterations, and hospitalization. RESULTS: Of 1152 individuals to whom we sent the questionnaires, 674 (59%) signed informed consent. We excluded 153 individuals, most often because they had already received a SARS-CoV-2 vaccination or had had the infection (84%) prior to study baseline. Of 521 participants included in analyses, 403 (81%) completed the last questionnaire (time point 4). None of 162 participants with a history of GBS had a recurrence after vaccination. Of 188 participants with CIDP, ten participants (5%) reported a worsening of symptoms within six weeks following vaccination. In five (3%) of these patients, maintenance treatment was modified. Two out of 53 participants with MMN (4%) reported a worsening of symptoms, and treatment modification was reported by one participant.Discussion. We found no increased risk of GBS recurrence, and a low to negligible risk of worsening of CIDP or MMN related symptoms following SARS-CoV-2 vaccination. Based on our data, SARS-CoV-2 vaccination in patients with these immune-mediated neuropathies appears to be safe.