Authors: Stowe, Julia; Andrews, Nick; Wise, Lesley; Miller, Elizabeth

Source: American Journal of Epidemiology, Volume 169, Number 3, 1 February 2009 , pp. 382-388(7)

Publisher: Oxford University Press

Abstract:

In 1976, the national swine influenza vaccination program in the United States was suspended because of an increased risk of Guillain-Barr syndrome. Subsequent studies of seasonal influenza vaccine have given conflicting results. The authors used the self-controlled case series method to investigate the relation of Guillain-Barr syndrome with influenza vaccine and influenzalike illness using cases recorded in the General Practice Research Database from 1990 to 2005 in the United Kingdom. The relative incidence of Guillain-Barr syndrome within 90 days of vaccination was 0.76 (95% confidence interval: 0.41, 1.40). In contrast, the relative incidence of Guillain-Barr syndrome within 90 days of an influenzalike illness was 7.35 (95% confidence interval: 4.36, 12.38), with the greatest relative incidence (16.64, 95% confidence interval: 9.37, 29.54) within 30 days. The relative incidence was similar (0.89, 95% confidence interval: 0.42, 1.89) when the analysis was restricted to a subset of validated cases. The authors found no evidence of an increased risk of Guillain-Barr syndrome after seasonal influenza vaccine. The finding of a greatly increased risk after influenzalike illness is consistent with anecdotal reports of a preceding respiratory illness in Guillain-Barr syndrome and has important implications for the risk/benefit assessment that would be carried out should pandemic vaccines be deployed in the future.

Keywords: association; Great Britain; Guillain-Barr syndrome; influenza, human; influenza vaccines; safety

Document Type: Research article

DOI: http://dx.doi.org/10.1093/aje/kwn310

Publication date: 2009-02-01

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• The American Journal of Epidemiology is the premier epidemiological journal devoted to the publication of empirical research findings, methodological developments in the field of epidemiological research and opinion pieces. It is aimed at both fellow epidemiologists and those who use epidemiological data, including public health workers and clinicians.

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