330.   Guillain-Barré Syndrome Following Vaccination
Session: Poster Abstract Session: Challenges in Vaccinology and Vaccine Exploration
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • GBS IDSA poster 10-6-11.pdf (233.3 kB)
  • Background:  Guillain-Barré syndrome (GBS) is an acute polyradiculopathy, thought to be an autoimmune disorder.  While cases of GBS have been reported following a wide range of vaccines, with the exception of the 1976 Swine Flu vaccine, there have not been any studies that established a clear association between GBS and vaccination.

    Methods: We identified all hospitalized GBS cases from Kaiser Permanente Northern California (KPNC) from 1995 into 2006. Each medical record was Neurologist-reviewed according to the GBS Brighton case definition; only confirmed cases were included in the analyses.  Vaccinations were determined from the KPNC immunization tracking system.  We assessed the odds of vaccination during the 6 weeks prior to GBS compared with 6 weeks to 9 months prior to vaccination using age and sex-adjusted case-centered analyses which inherently control for seasonality.  We assessed the association with GBS of each vaccine individually as well as any vaccine

    Results:  We identified 550 confirmed cases of GBS (including Brighton levels 1, 2, and 3) during the study period. 

    Table:  Case-centered analysis of the risk of post-vaccination GBS

     Vaccine  

    GBS in  

    <6 wks

    post-vax   

    GBS in

    6-39 wks

    post-vax    

     Odds Ratio  

    95% CI

     P-value  

     Hep B  

     1  

     11  

    0.43

     0.02, 2.56

     0.455  

     Tetanus-diphtheria

     3  

     17  

    1.43

     0.33, 4.56

     0.558  

     Inactivated Influenza

     18  

     74  

    1.11

     0.39, 3.08

     0.830  

     Any Licensed Vaccine

     25  

     128  

    1.35

     0.77, 2.27

     0.285  

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    <>Conclusion:  In this large retrospective study, using a method that controls for multiple covariates, including seasonality, we did not find evidence for an increased risk of GBS during the 6 week period following any vaccine, including influenza.


    Subject Category: I. Adult and Pediatric Vaccines

    Roger Baxter, MD1, Nandini Bakshi, MD2, Ned Lewis, MPH1, Bruce Fireman, MS1 and Nicola Klein, MD, PhD1, (1)Kaiser Permanente Vaccine Study Center, Oakland, CA, (2)The Permanente Medical Group, Walnut Creek, CA

    Disclosures:

    R. Baxter, Sanofi Pasteur: Grant Investigator, Research grant
    Merck & Co.: Grant Investigator, Research grant
    GSK: Grant Investigator, Research grant
    MedImmune: Grant Investigator, Research grant
    Novartis: Grant Investigator, Research grant
    Pfizer: Grant Investigator, Research grant

    N. Bakshi, None

    N. Lewis, None

    B. Fireman, None

    N. Klein, Sanofi Pasteur: Grant Investigator, Research grant
    Merck & Co.: Grant Investigator, Research grant
    GSK: Grant Investigator, Research grant
    Novartis: Grant Investigator, Research grant
    MedImmune: Grant Investigator, Research grant
    Pfizer: Grant Investigator, Research grant

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.