title: Risk of Guillain-Barré syndrome after 2010-2011 influenza vaccination.
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.
authors.affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Galeotti
authors.forename: Marco
authors.initials: M
authors.lastname: Massari
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Alessandro
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
authors.forename: Adriano
authors.initials: A
authors.lastname: Chiò
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.forename: Graziella
authors.initials: G
authors.lastname: Filippini
authors.forename: Maria Donata
authors.initials: MD
authors.lastname: Benedetti
authors.forename: Maura
authors.initials: M
authors.lastname: Pugliatti
authors.forename: Carmela
authors.initials: C
authors.lastname: Santuccio
authors.forename: Roberto
authors.initials: R
authors.lastname: Raschetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000009:adverse effects*; D007251:Influenza, Human / Q000517:prevention & control*; D007558:Italy / Q000453:epidemiology; D008297:Male; D032541:Mass Vaccination / Q000009:adverse effects; D008875:Middle Aged; D016017:Odds Ratio; D058873:Pandemics; D011159:Population Surveillance; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D007252:Influenza Vaccines
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