Faculty Opinions recommendation of Risk of Guillain-Barré syndrome after seasonal influenza vaccination and influenza health-care encounters: a self-controlled study.

Author(s):  
Larry Bush
Neurology ◽  
2020 ◽  
Vol 94 (20) ◽  
pp. e2168-e2179 ◽  
Author(s):  
Clémence Grave ◽  
Pauline Boucheron ◽  
Jérémie Rudant ◽  
Yann Mikaeloff ◽  
Pascale Tubert-Bitter ◽  
...  

ObjectiveTo evaluate the risk of Guillain-Barré syndrome (GBS) following seasonal influenza vaccination based on French nationwide data.MethodsAll cases of GBS occurring in metropolitan France between September 1 and March 31 from 2010 to 2014 were identified from the French national health data system. Data were analyzed according to the self-controlled case series method. The risk period started 1 day after the patient received vaccine (D1) until 42 days after vaccination (D42). The incidence of GBS during this risk period was compared to that of the control period (D43–March 31). The incidence rate ratio (IRR) was estimated after adjusting for seasonality and presence or not of acute infections.ResultsBetween September and March, of the 2010/2011 to 2013/2014 influenza vaccination seasons, 3,523 cases of GBS occurred in metropolitan France and were included in the study. Among them, 15% (527 patients) had received influenza vaccination. A total of 140 patients developed GBS during the 42 days following influenza vaccination. The crude risk of developing GBS was not significantly increased during the 42 days following influenza vaccination (IRR, 1.02; 95% confidence interval [CI], 0.83–1.25; p = 0.85). This result remained nonsignificant after adjustment for calendar months and the incidence of acute gastrointestinal and respiratory tract infections (IRR, 1.10; 95% CI, 0.89–1.37; p = 0.38). In contrast, the risk of GBS was fourfold higher after acute respiratory tract infection (IRR, 3.89; 95% CI, 3.52–4.30; p < 0.0001) or gastrointestinal infection (IRR, 3.64; 95% CI, 3.01–4.40; p < 0.0001).ConclusionsNo association between seasonal influenza vaccination and GBS was shown during the 42 days following vaccination.


Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 150 ◽  
Author(s):  
Marek Petráš ◽  
Ivana Králová Lesná ◽  
Jana Dáňová ◽  
Alexander M. Čelko

While the weight of epidemiological evidence does not support a causal link with influenza vaccination evaluated over the last 30 years, Guillain–Barré syndrome (GBS) has been considered a vaccine-associated adverse event of interest since 1976. To investigate the existence of GBS risk after vaccination against seasonal influenza, a systematic review and meta-analysis have been conducted based on 22 eligible epidemiological studies from 1981 to 2019 reporting 26 effect sizes (ESs) in different influenza seasons. The primary result of our meta-analysis pointed to no risk of vaccine-associated GBS, as documented by a pooled ES of 1.15 (95% CI: 0.97–1.35). Conversely, an obvious high risk of GBS was observed in patients with previous influenza-like illness (ILI), as demonstrated by a pooled ES of 9.6 (95% CI: 4.0–23.0) resulting from a supplementary analysis. While the meta-analysis did not confirm the putative risk of vaccine-associated GBS suggested by many epidemiological studies, vaccination against seasonal influenza reduced the risk of developing ILI-associated GBS by about 88%. However, to obtain strong evidence, more epidemiological studies are warranted to establish a possible coincidence between vaccination and ILI prior to GBS onset.


2003 ◽  
Vol 107 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Mark R. Geier ◽  
David A. Geier ◽  
Arthur C. Zahalsky

2019 ◽  
Vol 18 (4) ◽  
pp. 214-223
Author(s):  
Upasana Chalise ◽  
Jill A. McDonald ◽  
Anup Amatya ◽  
Martha Morales

Introduction: Seasonal influenza vaccination is recommended for pregnant women, but half of the pregnant women in the United States remain unvaccinated. Vaccine coverage in U.S.–Mexico border states has not been examined in depth even though risk factors for low vaccine coverage exist in these states, especially in the counties bordering Mexico. Method: Using 2012-2014 New Mexico (NM) Pregnancy Risk Assessment and Monitoring System data, this study examined the weighted annual seasonal influenza vaccination rates and the relationship of various factors to vaccination among NM residents with a live birth during those years. Results: Among respondents, 53.8% were Hispanic, 15.7% were Native American, and 30.5% were non-Hispanic White. The vaccination rate in NM increased from 49.0% in 2012 to 64.8% in 2014. The adjusted odds of vaccination were higher among women whose health care provider recommended/offered vaccination during the year prior to delivery compared to women whose provider did not (AOR = 11.92, 95% confidence interval [CI: 9.86, 14.42]) and among those living in the U.S.–Mexico nonborder counties compared to those living in the border counties (AOR = 1.23, 95% CI [1.18, 1.25]). Conclusion: Efforts to increase the vaccination rate among pregnant women in border states should concentrate on health care providers and the highest risk women, such as those resident in the border region.


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