Goud R, Lufkin B, Duffy J, et al. - In this study, an increased risk of developing Guillain-Barré Syndrome (GBS) was evident following vaccination with recombinant zoster vaccine (RZV).

• In this case series cohort study, 849 397 RZV-vaccinated and 1 817 099 zoster vaccine live (ZVL or Zostavax)-vaccinated beneficiaries aged 65 years or older were included to assess risk of developing Guillain-Barré syndrome post-vaccination with zoster vaccine.

• In the cohort analysis, RZV vaccines conferred an increased risk of Guillain-Barré syndrome vs ZVL vaccines (rate ratio [RR], 2.34).

• A rate ratio of 2.84 between the risk and control windows was found in a medical record–based, self-controlled analysis of GBS cases after RZV vaccination; leading to an attributable risk of 3 cases per million RZV (Shingrix) doses.

• This elevated risk was corroborated by the medical record–based analysis (RR, 4.96).