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

Galeotti F, Massari M, D'Alessandro R, Beghi E, Chiò A, Logroscino G, Filippini G, Benedetti MD, Pugliatti M, Santuccio C, Raschetti R, ITANG study gro - Eur. J. Epidemiol. (2013)

Bottom Line: Controls were selected among patients admitted for acute conditions to the Emergency Department of the same hospital as cases.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.

View Article: PubMed Central - PubMed

Affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.

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.

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Forest plot showing the results of the final conditional regression analysis. a ILI = Influenza-like illness; URI = Upper respiratory tract infections, b Any occurrence of chronic comorbidities among: malignancies, immunocompromised states (e.g. transplantation, use of immunosuppressants, HIV infection), autoimmune disorders (e.g. thyroiditis, diabetes type I, rheumatoid arthritis, vasculitis) and past surgical intervention
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Fig3: Forest plot showing the results of the final conditional regression analysis. a ILI = Influenza-like illness; URI = Upper respiratory tract infections, b Any occurrence of chronic comorbidities among: malignancies, immunocompromised states (e.g. transplantation, use of immunosuppressants, HIV infection), autoimmune disorders (e.g. thyroiditis, diabetes type I, rheumatoid arthritis, vasculitis) and past surgical intervention

Mentions: In the multivariate final model we defined two composite variables: the first considered any occurrence of ILI or URI (as the two may be misclassified) and the second any occurrence of chronic comorbidities (i.e. malignancies, immune-compromised status, autoimmune disorders) or surgical interventions. The results of the final conditional regression analysis are reported in Fig. 3 as a forest plot.Fig. 3


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

Galeotti F, Massari M, D'Alessandro R, Beghi E, Chiò A, Logroscino G, Filippini G, Benedetti MD, Pugliatti M, Santuccio C, Raschetti R, ITANG study gro - Eur. J. Epidemiol. (2013)

Forest plot showing the results of the final conditional regression analysis. a ILI = Influenza-like illness; URI = Upper respiratory tract infections, b Any occurrence of chronic comorbidities among: malignancies, immunocompromised states (e.g. transplantation, use of immunosuppressants, HIV infection), autoimmune disorders (e.g. thyroiditis, diabetes type I, rheumatoid arthritis, vasculitis) and past surgical intervention
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3672511&req=5

Fig3: Forest plot showing the results of the final conditional regression analysis. a ILI = Influenza-like illness; URI = Upper respiratory tract infections, b Any occurrence of chronic comorbidities among: malignancies, immunocompromised states (e.g. transplantation, use of immunosuppressants, HIV infection), autoimmune disorders (e.g. thyroiditis, diabetes type I, rheumatoid arthritis, vasculitis) and past surgical intervention
Mentions: In the multivariate final model we defined two composite variables: the first considered any occurrence of ILI or URI (as the two may be misclassified) and the second any occurrence of chronic comorbidities (i.e. malignancies, immune-compromised status, autoimmune disorders) or surgical interventions. The results of the final conditional regression analysis are reported in Fig. 3 as a forest plot.Fig. 3

Bottom Line: Controls were selected among patients admitted for acute conditions to the Emergency Department of the same hospital as cases.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.

View Article: PubMed Central - PubMed

Affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.

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.

Show MeSH
Related in: MedlinePlus