Johnson & Johnson and Guillain-Barre warning: What you need to know

The Johnson & Johnson COVID-19 vaccine will now include a U.S. Food and Drug Administration warning because of the chance of an increase in the risk for a rare neurological disorder.

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The disorder, known as Guillain-Barre syndrome, has been linked with Johnson & Johnson’s one-dose vaccine, but not with the Pfizer or Moderna vaccines.

The FDA announced Tuesday that a warning would be issued with the vaccine that tells people there is a risk — albeit a small one — of contracting the disorder after a vaccination with the Johnson & Johnson product.

The Johnson & Johnson vaccine is not the first vaccine linked to Guillain-Barre. The disorder has also been seen during the annual flu season, when roughly one to two cases of Guillain-Barre are seen for every million seasonal flu vaccines administered.

The connection between the vaccine and the syndrome is not exactly known. Physicians report that they have seen the condition in people recently vaccinated, as well as in some who were not vaccinated and who contracted COVID-19.

What is Guillain-Barre syndrome and are the symptoms? Here is what we know about the disorder now.

What is Guillain-Barre syndrome?

Guillain-Barre (gee-YAH-buh-RAY) is an autoimmune disorder. With Guillain-Barre, the body’s immune system attacks the nerves.

What are the symptoms of Guillain-Barre?

According to the Mayo Clinic, Guillain-Barre syndrome (GBS) often begins with tingling and weakness in a person’s feet and legs. Eventually, the tingling spreads to the upper body and arms. Others will first feel the symptoms in the arms or face.

Here are the symptoms the Mayo Clinic says Guillain-Barre syndrome may include:

Prickling, pins and needles sensations in your fingers, toes, ankles or wrists

Weakness in your legs that spreads to your upper body

Unsteady walking or inability to walk or climb stairs

Difficulty with eye or facial movements, including speaking, chewing or swallowing

Severe pain that may feel achy or cramp-like and may be worse at night

Difficulty with bladder control or bowel function

Rapid heart rate

Low or high blood pressure

Difficulty breathing

People with Guillain-Barre syndrome usually experience their most significant weakness within two to four weeks after symptoms begin.

There are several types of Guillain-Barre

There are three types of Guillain-Barre. The three types are:

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP). This is the most common form of the disorder. AIDP usually begins with muscle weakness that starts in the lower part of the body and spreads upward.

Miller Fisher syndrome (MFS). This form of GBS starts with paralysis in the eyes, and often an unsteady gait. MFS occurs in about 5% of people with Guillain-Barre syndrome in the U.S. but is more common in Asia, the Mayo Clinic says.

Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN). These versions of the disorder are more common in China, Japan and Mexico.

What causes it?

The cause of GBS is unknown, but is often seen shortly after an infection in the respiratory or digestive tract, and after some vaccinations.

Who is likely to get it?

Young adult males are most likely to get GBS. Other risk factors that can trigger GBS are:

An infection caused by campylobacter, a type of bacteria often found in undercooked poultry

Influenza virus

Cytomegalovirus

Epstein-Barr virus

Zika virus

Hepatitis A, B, C and E

HIV, the virus that causes AIDS

Mycoplasma pneumonia

Surgery

Hodgkin lymphoma

Rarely, influenza vaccinations or childhood vaccinations

What kind of complications can it cause?

GBS affects the nerves, and that can cause problems throughout your body. Some of the problems people with GBS can experience include:

Breathing difficulties, if the disorder affects the muscles that control breathing.

Residual numbness or other sensations if you do not fully recover from the disorder. Most people, however, do fully recover.

Heart and blood pressure problems.

Nerve pain.

Bowel and bladder function problems, if those nerves are affected.

Blood clots, if you are unable to easily move about.

How is Guillain-Barre syndrome treated?

There are two types of treatment for the disorder. One is intravenous injections of immunoglobulins, proteins made by the immune system. These injections come from donors.

The other treatment is an exchange of plasma, the liquid part of the blood. The plasma is removed and the blood cells are returned to the patient. Physical therapy is also used to help regain muscle strength.

What is the prognosis for Guillain-Barre?

As Guillain-Barre syndrome progresses, muscle weakness can evolve into paralysis. However, most people fully recover from GBS over several months.

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