Importance Because of historical associations between vaccines and Guillain-Barré syndrome (GBS), the condition was a prespecified adverse event of special interest for COVID-19 vaccine monitoring. I think that an additional limitation is that there was no secondary review for the non-verified GBS cases hypothetically, there might be additional cases that could be classified as Brighton level 1, 2 or 3. It is commented in the limitations of the study that a quality review was done only for 20% of the verified cases. It might be interesting though if the authors had done an exploratory analysis with the assumption that these 106 cases have a similar number of verified GBS verified cases, adjusted by vaccine and available demographics. I understand that one could argue that these 106 cases could be fundamentally different although we don't know whether the available information of the VAERS reports would support such hypothesis (type of vaccine, gender and age group of patient, reporting source etc). If we assume that the 106 cases without records would have a similar rate of verified cases this would yield additional 39 cases of GBS. recorded were not available for 106 cases. The analysis was based on 295 verified cases of 806 cases with medical records available, which corresponds to approx. It would be interesting to know the cause of death for the other 3 cases, too. 10 deaths were noted, 7 of which were related to GBS. I'd like to highlight some points that could increase the in depth presentation of this significant and well prepared paper: Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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