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Acute and Chronic Inflammatory Neuropathies and Covid-19 Vaccines

Practical recommendations form the task force of the Italian Peripheral Nervous System Association (ASNP)

The following is a brief summary of the above-mentioned article, contributed by GBS|CIDP Foundation International GMAB member, Eduardo Nobile-Orazio MD, PhD

The current pandemic of COVID-19 has raised a great concern on the population given its rapid spread, with a proportion of infected that in Italy just reached 5% of the population. This has led to a global vaccination campaign. There are however, some concerns among patients with autoimmune diseases including patients who had Guillain-Barré syndrome (GBS) or those with an active chronic immune-mediated neuropathies about the possible risk of worsening after this vaccination. Previous studies on influenza vaccination, however, showed that the slightly increased risk of Guillain-Barré syndrome (GBS) following vaccination was much less than the risk of developing it after this infection.Studies conducted on patients with different autoimmune disorders showed that vaccination is safe and it is not associated with an increased risk of relapse. Two studies investigated the risk of relapse after vaccination in GBS and chronic inflammatory demyelinating polyneuropathy (CIDP), showing that there is only a marginal risk of worsening that is mostly mild and resolve spontaneously.There also some concern on the safety and efficacy of the vaccines for COVID-19 in patients receiving immune therapies. Several studies showed however that non-live vaccines, like one used for COVID-19 are safe in the setting of immunosuppression, and that immunisation generally produce a satisfactory serological response in people under immune suppressive treatment, even it might be reduced compared to immunocompetent people.All these concerns should also take into consideration the severity of COVID-19 infection with an overall worldwide mortality of 1.5/1000, a case fatality ratio that in Italy reaches 3.5%, and with an average intensive care unit admission of 21.4%.

Based on these considerations, the Italian Peripheral Nerve Association recommends that all patients with inflammatory neuropathies should be encouraged to adhere to the vaccination campaign for COVID-19. 

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