The first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China, in December 2019. In December 2020, the FDA approved two vaccines for the prevention of COVID-19 infection. In the clinical trials of the vaccine, multiple side effects have been reported ranging from mild symptoms including injection site pain, myalgia, fatigue, and fever to more serious side effects including anaphylactic shock. However, Guillain-Barre Syndrome (GBS) after receiving COVID-19 vaccine was not been reported till (February 2, 2021) to the best of our knowledge. We reported the first case of GBS after receiving the first dose of Pfizer COVID-19 vaccine.

An 82-year-old highly functional female presented to the emergency department with generalized body aches, paresthesia, and difficulty walking. She received first dose of the Pfizer COVID vaccine two weeks prior to presentation. Physical examination demonstrated 5/5 strength in bilateral upper extremities in proximal and distal muscles, 4/5 in hip flexors and decrease sensation to light touch and pinprick in bilateral lower extremities up to the knees. Areflexia in both upper and lower extremities. Cerebrospinal fluid analysis showed albuminocytologic dissociation (protein of 88 and WBC of 4) suggestive of Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP). MRI lumbar spine demonstrated the enhancement of cauda equina nerve roots consistent with the diagnosis of GBS. The patient completed five days of IVIG with significant improvement and was discharged to acute rehabilitation facility. 

In this pandemic and with ongoing worldwide mass vaccination campaign, it is critically important for clinicians to rapidly recognize neurological complications associated with COVID-19 vaccination. We would like to highlight that the risk of neurological complications or any other adverse effect associated with COVID-19 vaccination is low and the benefits of the vaccination outweigh any potential risks or side effects, both at the individual and society levels.