ArticleNature medicine2021
Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection.
Article in Nature medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 224 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
224 citing papers in PubMed, 6 syntheses or guidelines pooled it, 399 citations in OpenAlex.
- Systematic review and meta-analysis of respiratory viral triggers for acute myocardial infarction and stroke.Cardiovascular research · 2025Pooled it
- Guillain-Barré syndrome and COVID-19 vaccination: a systematic review and meta-analysis.Journal of neurology · 2024Pooled it
- Clinical characteristics and prognosis of temporary miller fisher syndrome following COVID-19 vaccination: a systematic review of case studies.BMC neurology · 2023Pooled it
- Adverse events following COVID-19 mRNA vaccines: A systematic review of cardiovascular complication, thrombosis, and thrombocytopenia.Immunity, inflammation and disease · 2023Pooled it
- Guillain-Barré syndrome in association with COVID-19 vaccination: a systematic review.Immunologic research · 2022Pooled it
- Multiple sclerosis relapse after COVID-19 vaccination: A case report-based systematic review.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2022Pooled it
- A narrative review of considerations when assessing potential relationships between Guillain-Barré syndrome and vaccines.Human vaccines & immunotherapeutics · 2026Review
- Associations of viral infections and antiviral vaccinations with anti-NMDAR and other forms of autoimmune encephalitis.Brain, behavior, & immunity - health · 2026Review
- Proteomic analysis reveals divergent inflammatory mechanisms of COVID-associated Guillain-Barré syndrome.Journal of molecular medicine (Berlin, Germany) · 2026Article
- Article
- Enhanced adenoviral reactivity in Guillain-Barré syndrome after SARS-CoV-2 infection and vaccination.Brain : a journal of neurology · 2026Article
- Reduced Hospital Incidence of Autoimmune Encephalitis During the COVID-19 Pandemic.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- No excess risk of death or multimorbidity following hemorrhagic stroke after mRNA vaccination compared with historical cases: a population-based cohort study.Brain, behavior, & immunity - health · 2026Article
- Estimating Risk of Guillain-Barré Syndrome in US Medicare-enrolled Older Adults Following Medically Attended Respiratory Syncytial Virus Disease: A Self-controlled Case Series Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Disproportionality Analysis and Timing of Drug-Associated Guillain-Barré Syndrome Onset Based on the Japanese Adverse Drug Event Report Database.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Risk of stroke following SARS-CoV-2 infection in a nationwide self-controlled case series study in qatar.Scientific reports · 2026Observational
- Autoimmune Features of Post-COVID-19 Vaccination Syndrome and Their Impacts on the Renin-Angiotensin System.Vaccines · 2026Review
- Incidence of Guillain-Barré Syndrome Following COVID-19 Vaccination and SARS-CoV-2 Infection: A Population-Based Cohort Study Using the Valencia Health System Integrated Database (Spain).Pharmaceuticals (Basel, Switzerland) · 2026Article
- The Role and Safety of Aluminum Adjuvants in Childhood Vaccines.Pediatrics · 2026Review
- COVID-19 vaccination and short-term mortality risk: a nationwide self-controlled case series study in The Netherlands.European journal of epidemiology · 2026Article
164 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
19 authors at 10 institutions in 1 country.
Funding
Abstract
Emerging reports of rare neurological complications associated with COVID-19 infection and vaccinations are leading to regulatory, clinical and public health concerns. We undertook a self-controlled case series study to investigate hospital admissions from neurological complications in the 28 days after a first dose of ChAdOx1nCoV-19 (n = 20,417,752) or BNT162b2 (n = 12,134,782), and after a SARS-CoV-2-positive test (n = 2,005,280). There was an increased risk of Guillain-Barré syndrome (incidence rate ratio (IRR), 2.90; 95% confidence interval (CI): 2.15-3.92 at 15-21 days after vaccination) and Bell's palsy (IRR, 1.29; 95% CI: 1.08-1.56 at 15-21 days) with ChAdOx1nCoV-19. There was an increased risk of hemorrhagic stroke (IRR, 1.38; 95% CI: 1.12-1.71 at 15-21 days) with BNT162b2. An independent Scottish cohort provided further support for the association between ChAdOx1nCoV and Guillain-Barré syndrome (IRR, 2.32; 95% CI: 1.08-5.02 at 1-28 days). There was a substantially higher risk of all neurological outcomes in the 28 days after a positive SARS-CoV-2 test including Guillain-Barré syndrome (IRR, 5.25; 95% CI: 3.00-9.18). Overall, we estimated 38 excess cases of Guillain-Barré syndrome per 10 million people receiving ChAdOx1nCoV-19 and 145 excess cases per 10 million people after a positive SARS-CoV-2 test. In summary, although we find an increased risk of neurological complications in those who received COVID-19 vaccines, the risk of these complications is greater following a positive SARS-CoV-2 test.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.