Vaccines After Guillain-Barre Syndrome

Most people who have had Guillain-Barre syndrome (GBS) can still be vaccinated, including against flu. The main exception is if your GBS started within 6 weeks of a flu shot. In that case, US vaccine guidelines treat another flu vaccine as a precaution, and most people in that group are advised not to have one unless they are at high risk from flu itself. Either way, talk to your doctor before your next vaccine and tell them you have had GBS.

The short answer by situation

"Precaution" is not the same as a ban. It means a doctor should weigh the possible risk against the benefit for you before giving the vaccine.

How likely is GBS to come back after a vaccine?

GBS comes back (recurs) in only a small number of people. A large US study looked at 550 confirmed GBS cases at Kaiser Permanente Northern California between 1995 and 2006:

• After their GBS, 279 people received 989 vaccine doses between them, including 405 flu shots given to 107 people.
• Six people (1.1%) had GBS again, and none of them had received any vaccine in the 2 months before it came back.
• Eighteen people's first GBS had started within 6 weeks of a flu shot. Two of them were later vaccinated against flu again, and neither had a recurrence.

The researchers concluded that the risk of recurrence was low and found no cases of GBS returning after a flu vaccine. Only two people in the highest-concern group were revaccinated, so the study can't rule out a small risk for them.

For more on why GBS can return, and the related long-term condition CIDP, see can Guillain-Barre syndrome come back?

Flu vaccine

If seasonal flu shots raise the risk of GBS at all, the increase is very small, about 1 to 2 extra cases per million doses. People are more likely to develop GBS after having flu than after a flu shot. For the full history and figures, see GBS and the flu shot.

If you can't have a flu vaccine, your doctor may suggest antiviral medicine to help prevent flu during the season instead.

Shingles vaccine (Shingrix)

In 2021, the FDA added a GBS warning to the Shingrix label. Studies in adults aged 65 and over suggested about 3 extra cases of GBS per million doses in the 42 days after vaccination. The FDA said the evidence was not enough to show the vaccine causes GBS, and that the benefits of Shingrix continue to outweigh its risks.

RSV vaccines (Abrysvo and Arexvy)

In January 2025, the FDA required a GBS warning for the RSV vaccines Abrysvo and Arexvy. In adults aged 65 and over, it estimated about 9 extra cases per million doses of Abrysvo and 7 per million doses of Arexvy, in the 42 days after vaccination. The FDA said the benefits of both vaccines continue to outweigh their risks.

COVID-19 vaccines

CDC found evidence of a higher risk of GBS in adults after the Johnson & Johnson (Janssen) COVID-19 vaccine. It did not find a higher risk with the Pfizer-BioNTech or Moderna vaccines.

Putting the risks in context

These are small numbers. Flu itself can cause severe illness and death, and the FDA has judged that the benefits of Shingrix, Abrysvo and Arexvy outweigh their risks.

Questions to ask your doctor

• Was my GBS linked to a vaccine, or did it follow an infection?
• Am I at higher risk of severe flu, RSV or shingles complications?
• Which vaccines do you recommend for me, and is there any reason to delay them?
• If I shouldn't have a flu vaccine, should I take antiviral medicine if I'm exposed to flu?

When to get help

After any vaccine, contact a doctor urgently if you develop tingling or weakness that is spreading, especially in your legs or arms. Call 911 (UK: 999) or go to the ER if breathing or swallowing becomes difficult, your face droops, or you can't walk or lift your arms. These symptoms often have other causes, but they need checking quickly.

Most people who develop GBS recover. See Guillain-Barre syndrome life expectancy and survival and is GBS permanent?