Risk of Guillain-Barré syndrome after 2010-2011 influenza vaccination

Francesca Galeotti, Marco Massari, Roberto D'Alessandro, Ettore Beghi, Adriano Chiò, Giancarlo Logroscino, Graziella Filippini, Maria Donata Benedetti, Maura Pugliatti, Carmela Santuccio, Roberto Raschetti

Research output: Contribution to journalArticlepeer-review

Abstract

Influenza vaccination has been implicated in Guillain Barré Syndrome (GBS) although the evidence for this link is controversial. A case-control study was conducted between October 2010 and May 2011 in seven Italian Regions to explore the relation between influenza vaccination and GBS. The study included 176 GBS incident cases aged ≥18 years from 86 neurological centers. Controls were selected among patients admitted for acute conditions to the Emergency Department of the same hospital as cases. Each control was matched to a case by sex, age, Region and admission date. Two different analyses were conducted: a matched case-control analysis and a self-controlled case series analysis (SCCS). Case-control analysis included 140 cases matched to 308 controls. The adjusted matched odds ratio (OR) for GBS occurrence within 6 weeks after influenza vaccination was 3.8 (95 % CI: 1.3, 10.5). A much stronger association with gastrointestinal infections (OR = 23.8; 95 % CI 7.3, 77.6) and influenza-like illness or upper respiratory tract infections (OR = 11.5; 95 % CI 5.6, 23.5) was highlighted. The SCCS analysis included all 176 GBS cases. Influenza vaccination was associated with GBS, with a relative risk of 2.1 (95 % CI 1.1, 3.9). According to these results the attributable risk in adults ranges from two to five GBS cases per 1,000,000 vaccinations.

Original languageEnglish
Pages (from-to)433-444
Number of pages12
JournalEuropean Journal of Epidemiology
Volume28
Issue number5
DOIs
Publication statusPublished - May 2013

Keywords

  • Case-control study
  • Guillain-Barrè Syndrome
  • Influenza vaccination
  • Self controlled case series

ASJC Scopus subject areas

  • Epidemiology

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