ImportanceThe temporal association between the occurrence of neurological diseases, many autoimmune diseases, and vaccination against SARS-CoV-2 has been topically interesting and remains hotly debated both in the medical literature and the clinic. Given the very low incidences of these events both naturally occurring and in relation to vaccination, it is challenging to determine with certainty whether there is any causative association and most certainly what the pathophysiology of that causation could be.ObservationsData from international cohorts including millions of vaccinated individuals suggest that there is a probable association between the adenovirus-vectored vaccines and Guillain-Barré syndrome (GBS). Further associations between other SARS-CoV-2 vaccines and GBS or Bell palsy have not been clearly demonstrated in large cohort studies, but the possible rare occurrence of Bell palsy following messenger RNA vaccination is a topic of interest. It is also yet to be clearly demonstrated that any other neurological diseases, such as central nervous system demyelinating disease or myasthenia gravis, have any causative association with vaccination against SARS-CoV-2 using any vaccine type, although it is possible that vaccination may rarely trigger a relapse or worsen symptoms or first presentation in already-diagnosed or susceptible individuals.Conclusions and RelevanceThe associated risk between SARS-CoV-2 vaccination and GBS, and possibly Bell palsy, is slight, and this should not change the recommendation for individuals to be vaccinated. The same advice should be given to those with preexisting neurological autoimmune disease.

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SARS-CoV-2 疫苗接种与神经免疫疾病

重要性神经系统疾病、许多自身免疫性疾病的发生与 SARS-CoV-2 疫苗接种之间的时间关联一直是人们关注的话题，并且在医学文献和临床中仍然存在激烈争论。鉴于这些自然发生的事件和与疫苗接种相关的事件的发生率非常低，因此很难确定是否存在任何因果关系，以及最确定该因果关系的病理生理学可能是什么。来自国际队列的观察数据，包括数百万疫苗接种者个人认为腺病毒载体疫苗与格林-巴利综合征 (GBS) 之间可能存在关联。其他 SARS-CoV-2 疫苗与 GBS 或贝尔麻痹之间的进一步关联尚未在大型队列研究中得到明确证明，但信使 RNA 疫苗接种后可能罕见发生贝尔麻痹是一个令人感兴趣的话题。尚未明确证明任何其他神经系统疾病，例如中枢神经系统脱髓鞘疾病或重症肌无力，与使用任何类型的疫苗接种 SARS-CoV-2 疫苗有任何因果关系，尽管疫苗接种可能很少见引发复发或症状恶化，或在已诊断或易感个体中首次出现。结论和相关性 SARS-CoV-2 疫苗接种与 GBS 以及可能的贝尔麻痹之间的相关风险很小，这不应改变对个人接种疫苗的建议接种疫苗。对于那些患有神经性自身免疫性疾病的人也应该给予同样的建议。