Lack of association of Guillain-Barré syndrome with vaccinations.

Abstract

BACKGROUND:

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy, thought to be an autoimmune process. Although cases of GBS have been reported following a wide range of vaccines, a clear association has only been established with the 1976 H1N1 inactivated influenza vaccine.

METHODS:

We identified hospitalized GBS cases from Kaiser Permanente Northern California (KPNC) from 1995 through 2006. The medical record of each suspected case was neurologist-reviewed according to the Brighton Collaboration GBS case definition; only confirmed cases were included in the analyses, and cases of Miller Fisher syndrome were excluded. Using a case-centered design, we compared the odds of vaccination in the 6 and 10 weeks prior to onset of GBS to the odds of vaccination during the same time intervals in all vaccinated individuals in the entire KPNC population.

RESULTS:

We confirmed 415 incident cases of GBS (including Brighton levels 1, 2, and 3) during the study period (>30 million person-years). Incidence peaked during the winter months. The odds ratio of influenza vaccination within a 6-week interval prior to GBS, compared with the prior 9 months, was 1.1 (95% confidence interval [CI], .4-3.1). The risk in the 6-week interval compared to the prior 12 months for tetanus diphtheria combination, 23-valent pneumococcal polysaccharide, and for all vaccines combined was 1.4 (95% CI, .3-4.5), 0.7 (95% CI, .1-2.9), and 1.3 (95% CI, .8-2.3), respectively.

CONCLUSIONS:

In this large retrospective study, we did not find evidence of an increased risk of GBS following vaccinations of any kind, including influenza vaccination.

• Authors: Roger Baxter, Nandini Bakshi, Bruce Fireman, Edwin Lewis, Paula Ray, Claudia Vellozzi, Nicola P Klein
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 57 Issue 2 Pg. 197-204 (Jul 2013) ISSN: 1537-6591 [Electronic] United States
• PMID: 23580737 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• California (epidemiology)
• Child
• Child, Preschool
• Female
• Guillain-Barre Syndrome (chemically induced, epidemiology)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Vaccination (adverse effects)
• Young Adult