In two separate articles in the Annals of Neurology, clinicians in India and England report cases of a rare neurological disorder called Guillain-Barré syndrome after individuals were vaccinated against COVID-19.

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Both reports describe an unusual variant of Guillain-Barré syndrome characterised by prominent facial weakness. Seven cases were reported from a regional medical centre in Kerala, India, where approximately 1.2 million people were vaccinated with the AstraZeneca COVID-19 vaccine.

Four cases were reported from Nottingham, England, in an area in which approximately 700,000 people received the same vaccine. All eleven cases were among people who had received that vaccine 10–22 days earlier. The frequency of Guillain-Barré syndrome in these areas was estimated to be up to 10 times greater than expected. “If the link is causal it could be due to a cross-reactive immune response to the SARS-CoV-2 spike protein and components of the peripheral immune system”, wrote the authors of the report from England.

The authors of both articles stress that clinicians should be vigilant in looking for this rare neurological syndrome following the administration of COVID-19 vaccines.