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.
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;The ITANG study Group [Clinical research assistants: Sara Marconi; Giorgia Giussani; Enrica Bersano and Umberto Manera; Stefano Zoccolella and Antonio Leo; Roberta Barki; Marco Turatti; Stefania Leoni; Steering committee of the study: Ettore Beghi; Maria Donata Benedetti; Andrea Calvo and Adriano Chiò; Roberto D’Alessandro; Fernanda Ferrazin; Graziella Filippini; Giancarlo Logroscino; Giampiero Mazzaglia; Maura Pugliatti; Roberto Raschetti; Carmela Santuccio; Loriana Tartaglia and Francesco Trotta; Clinical centers and co-investigators: E. Romagna: Roberto MICHELUCCI; Patrizia RIGUZZI; Tommaso SACQUEGNA; Anna Maria BORGHI; Vittoria MUSSUTO; Patrizia DE MASSIS; Fabio CIRIGNOTTA; Rita Rinaldi; Walter NERI; Carlo GUIDI; Maria Rosaria TOLA; Enrico GRANIERI; Valentina SIMIONI; Paolo NICHELLI; Jessica MANDRIOLI; Donata GUIDETTI; Emilio TERLIZZI; Mario Giovanni TERZANO; Giovanni PAVESI; Fabrizio RASI; Claudio CALLEGARINI; Norina MARCELLO; Massimo BONDAVALLI; Alessandro RAVASIO; Marco CURRÒ DOSSI; Annamaria MAURO; Chiara MINARDI; Gabriele GRECO; Stefano AMIDEI; Enrico MONTANARI; Doriana MEDICI; Lombardy: Tommaso RICCARDI; Elisabetta D’ADDA; Luigi BETTONI; Luciano ABRUZZI; Elio AGOSTONI; Francesco BASSO; Andrea MAGNONI; Vittorio CRESPI; Maria REPACI; Antonella CHELDI; Mariagrazia BELLOTTI; Carlo FERRARESE; Natale Augusto CURTÒ; Giovanni MEOLA; Giuseppe ROTONDO; Eduardo NOBILE-ORAZIO; Fabrizia TERENGHI; Franco SASANELLI; Alessio GALBUSSERA; Marco MATTIOLI; Marco TIRITICCO; Caterina NASCIMBENE; Alessandra VANOTTI; Stefano JANN; Luisa DE TONI FRANCESCHINI; Vincenzo SILANI; Nicola TICOZZI; Giancarlo COMI; Raffaella FAZIO; Patrizia PERRONE; Andrea GIORGETTI; Alessandro ROMORINI; Pietro BASSI; Domenico SANTORO; Nereo BRESOLIN; Simone TONIETTI; Massimo SUARDELLI; Giacomo BEZZI; Daria BALDINI; Angelo Maurizio CLERICI; Giuseppina CAFASSO; Daniele PORAZZI; Isidoro LA SPINA; Giampiero GRAMPA; Davide ZARCONE; Michele PERINI; Marco POLONI; Emanuela AGAZZI; Massimiliano FILOSTO; Alessandro PADOVANI; Renato BESANA; Edoardo DONATI; Eugenio MAGNI; Marco ARNABOLDI; Vincenzo BELCASTRO; Mario GUIDOTTI; Raffaella CLERICI; Maurizio RIVA; Eugenio VITELLI; Paolo PREVIDI; Giuseppe MICIELI; Elisa CANDELORO; Carlo DALLOCCHIO; Carla ARBASINO; Piedmont: Andrea CALVO: Scdu Neurologia 4—AOU S. Giovanni Battista; Cristina MOGLIA: Scdu Neurologia 4—AOU S. Giovanni Battista; Marco VERCELLINO; Bruno FERRERO; Pietro PIGNATTA; Enrico ODDENINO; Daniele IMPERIALE; Daniela LEOTTA; Maurizio GIONCO; Carlo RAVETTI; Roberto CAVALLO; Nicoletta Di Vito; Claudio GEDA; Simona BORTOLOTTO; Emilio LUDA DI CORTEMIGLIA; Giovanna LIOTTA; Emilio URSINO; Mario PALERMO; Luca AMBROGIO; Piero MEINERI; Michele DOTTA;Paolo GHIGLIONE; Joseph MAISTRELLI; Susana ONORATO; Maurizio LEONE; Diego Maria PAPURELLO; Angelo VILLANI; Roberto CONTI; Franco COPPO; Fabiana TESSER; Lucia Testa; Silvia Isabella Cattaneo; Maria Teresa Penza; Graziano Gusmaroli; Katia Savio; Franco Perla; Fabrizio Pisano; Fabio Poglio; Luca Pradotto; Valle d’Aosta: Edo Fausto BOTTACCHI; Puglia: Paolo LIVREA; Francesco FEDERICO; Maria TROJANO; Vito COVELLI; Bruno MAGGIO; Vito SANTAMATO; Bruno PASSARELLA; Giovanni ZIMATORE; Giorgio TRIANNI; Gerardo CIARDO; Salvatore INTERNO’; Veneto: Corrado MARCHINI; Sandro ZAMBITO MARSALA; Giorgio MICHIELI; Carlo BORSATO; Giuseppe DIDONÈ; Emma FRASSON; Alberto POLO; Vincenza ARGENTIERO; Vincenzo ROMEO; Novenia PERLOTTO; Roberto L’ERARIO; Gianfranco MICAGLIO; Tiziana ROSSO; Sandro BRUNO; Bruno GIOMETTO; Mirco SERENA; Rocco QUATRALE; Ernesto GASTALDO; Francesco PERINI; Michele DILEONE; Alessandro CASANO; Lauretta SILVESTRI; Alessandro BURLINA; Virginia MUNERATI; Sebastiano D’Anna; Flavio SANSON; Valeria SARTORI; Giuseppe MORETTO; Giovanna SQUINTANI; Salvatore MONACO; Maria Donata BENEDETTI; Simone FUSINA; Claudio BIANCONI; Fabiana PIMAZZONI; Angela BONOMETTI; Giampietro ZANETTE; Marco TURATTI; Sardinia: Stefania LEONI; Giuseppe MURA; Anna TICCA; Piernicola MARCHI; Davide MANCA]. - In: EUROPEAN JOURNAL OF EPIDEMIOLOGY. - ISSN 0393-2990. - STAMPA. - 28:5(2013), pp. 433-444. [10.1007/s10654-013-9797-8]
Risk of Guillain-Barré syndrome after 2010-2011 influenza vaccination
D'ALESSANDRO, ROBERTO;CIRIGNOTTA, FABIO;
2013
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
