DEAR DR. ROACH: I am a 73-year-old female with atrial fibrillation (AFib) who recently had a pacemaker implant and has been doing well since. I also have a thyroid gland disorder, and I’m taking daily medication treatments for both my thyroid and heart. Over 20 years ago, I was hospitalized and diagnosed with Guillain-Barre syndrome (GBS), and have had no long-lasting side effects from the illness. My primary doctor gave me the OK to get a seasonal flu shot three years ago. But, recently, an urgent care doctor strongly recommended that I should never get a flu shot.
I have received the two Moderna COVID-19 shots, as well as two Moderna booster shots, the last one dated July 18. My question to you is, do you recommend I receive the new COVID and flu shots that just came out recently? Should I avoid ever getting a flu shot in the future due to my past diagnosis of GBS? I’ll be traveling to Europe in mid-October, and I’m not sure what to do. — A.G.
ANSWER: GBS is a disease of the nervous system where the body’s own immune system attacks a key portion of the nerve cell — the myelin sheath that protects the cells and enhances the electrical nerve signal. GBS may be triggered after vaccination, but it is much more likely to be triggered after infection, including both influenza and COVID-19.
There remains controversy, with some physicians (like your urgent care doctor) advising against vaccines, while most doctors and authorities recommend getting the routine vaccines, realizing that the risk of infection is far greater than the risk of immunization.
I know of two studies that looked at flu vaccines in people with a history of GBS. In one study of 107 people who chose to get the vaccine after having had GBS, none had a recurrence of GBS. Another study, with 279 subjects, also showed zero episodes of recurrent GBS. These studies do not show it is impossible to get GBS after a flu vaccine, but strongly suggest that the risk is very low. We do not have similar data for the COVID vaccine, but the risk of GBS after the COVID vaccine appears to be very low with both the Pfizer and Moderna vaccines.
Ultimately, the decision is up to you and your doctor, but for my patients with a history of GBS, I advise that the benefit of the vaccine outweighs the risk. People with more medical illnesses, especially of the heart and lungs, are at greater risk for complications of the flu and COVID, and are more likely to benefit from vaccination.
DEAR DR. ROACH: My wife, age 84, has suffered from sciatica most of her life. For the last three years, she has been confined to a wheelchair. She has tried therapy, acupuncture and other measures to no avail. Now, her surgeon suggests a laminectomy. Might that help? — B.C.
ANSWER: Sciatica is the sensation of lower back pain, usually radiating down the leg, and is most commonly caused by physical pressure on the sciatic nerve, a very large nerve running down the length of the leg. However, there are many different conditions that can cause these symptoms, and only a few of them are helped with surgery.
A person who has been confined to a wheelchair for three years tends to have a worse prognosis, but I just don’t have enough information to say whether surgery might help her. Most surgeons are very cautious about recommending surgery, so I would take the suggestion seriously and also consider a second surgical opinion.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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