Dear Dr. Roach: I have multiple sclerosis, Addison’s disease, rheumatoid arthritis and lupus. I am on steroids daily as well as potent immunosuppressives. In November 2013, I received a flu shot, and 10 days later I came down with Guillain-Barre syndrome. I was paralyzed for six months. Half of my doctors say I should take the COVID vaccine; the other half say I shouldn’t. Do you have any statistics on the Pfizer or Moderna vaccines and GBS? What is your opinion?
D.D.
With nearly any decision in medicine, there are both risks of treatment and risks of withholding treatment.
In your case, the risks of remaining unvaccinated are high. COVID-19 infection would be very dangerous for you because of your medical conditions and because of the medications you are taking for them. You are at higher risk for all the complications of COVID-19, but given your history, you are at particular risk for developing Guillain-Barre syndrome, an autoimmune disease usually triggered by infection. It’s very important to do what you can to protect yourself from COVID-19.
On the other hand, it’s natural to be concerned about reports of GBS after COVID-19 vaccination. An update from the Food and Drug Administration from July 2021 identified 100 preliminary reports of GBS following vaccination with the Johnson & Johnson vaccine, an adenovirus vector vaccine, after approximately 12.5 million doses were administered. This is substantially higher than would be expected from chance alone. Consequently, I advise against you getting the Johnson & Johnson vaccine if another vaccine is available.
The Pfizer and Moderna vaccines are mRNA vaccines, and the FDA noted there has not been an increased number of GBS among recipients of either of these vaccines. I recommend you get an mRNA vaccine. You should, of course, discuss this with your doctors. I understand you must be frustrated with the mixed messages you are getting from your doctors, so if possible, discuss it further with the doctor who is most current on the COVID-19 situation, which changes daily. An infectious disease doctor might be a good choice.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
