Something I learned from this pandemic is that one way to combat “fake news” is to anticipate explanations about facts that can be used to cause fear and, consequently, make it difficult to control covid-19.
I know that the topic I am going to address here can be used for “destructive” purposes by deniers and people who are against vaccines. However, we cannot fail to bring important information to the population, even to prevent this information from being manipulated by the “destructive” groups I mentioned above.
Today I’m going to talk about a study carried out in Israel, a reference country in the work of vaccination against covid-19, but which failed to take into account some precautions, as happened (and happens) in other countries. For example, Israel’s Ministry of Health and its national immunization guidelines say nothing about the fact that people who have had Guillain-Barré Syndrome need to exercise some precaution or are even contraindicated for covid-19 vaccine. Something made by the study that I’m going to discuss here.
Before, I want to emphasize that, as I have already explained, Anvisa (National Health Surveillance Agency) made a warning about rare cases of Guillain-Barré syndrome after vaccination with AstraZeneca, Janssen and CoronaVac. But, as it is a very rare effect, the agency maintained the recommendation to continue vaccination in Brazil, as the benefits that immunizing agents offer are vastly greater than those of serious adverse cases.
However, something that did not happen in Israel —or here in Brazil— was to guide patients with a previous diagnosis of Guillain-Barré Syndrome on which cases they should or should not get the vaccine, to reduce the risk of a recurrence of this syndrome. I say this because the objective of the study in Israel was precisely to establish the recurrence rates of Guillain-Barré Syndrome in people with the condition and who received the Pfizer-BioNTech vaccine.
The study was carried out descriptively and retrospectively, in an area where the health service serves more than 2.5 million people, representing a quarter of the Israeli population. The database includes extensive clinical and hospital diagnoses, and data from medical records were obtained to identify patients diagnosed with Guillain-Barré Syndrome.
Thus, 702 cases of people who had Guillain-Barré Syndrome between 2000 and 2020 were identified. Of these patients, 579 received at least one dose of vaccine and 539 received two doses.
Forty-eight of the 579 patients were seen at a hospital. Twenty-four had visited the emergency department and were released after less than 24 hours for non-neurological reasons, and the others required hospitalization for a variety of conditions.
Only five were referred to the hospital for neurological reasons. Of that, two patients had paresthesia (a feeling of numbness or tingling from some part of the body), one patient had several months of tremor duration, and one patient was evaluated for a seizure. But, all were released from the emergency room without further medical observation. The fifth patient had a history of previously diagnosed Guillain-Barré Syndrome and was properly treated, with no residual neurological symptoms.
But, it is noteworthy that the patient had progressive weakness in the legs and paresthesia, which began soon after receiving the first dose of the vaccine and lasted for several weeks. Several days after the administration of the second dose of vaccine, the patient was admitted to the hospital. The clinical picture and evidence, with specific diagnoses, were suggestive of Guillain-Barré Syndrome.
The article reinforces that this was the first study to assess the safety of using a vaccine with mRNA technology against covid-19 in people with Guillain-Barré syndrome. And that, of the 702 patients, only one needed short-term medical care due to a recurrence of the syndrome, which represents a minimal risk, but it is worth paying attention so that we do not have problems in any person who is vaccinated, thus maintaining what the vaccine offers the best efficacy to control contagious infectious diseases, and social security.