Investigation of the Temporal Association of Guillain-Barré Syndrome With Influenza Vaccine and Influenzalike Illness Using the United Kingdom General Practice Research Database

摘要

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