Is an Increased Risk of Developing Guillain–Barré Syndrome Associated with Seasonal Influenza Vaccination? A Systematic Review and Meta-Analysis
Open Access
- 27 March 2020
- Vol. 8 (2), 150
- https://doi.org/10.3390/vaccines8020150
Abstract
While the weight of epidemiological evidence does not support a causal link with influenza vaccination evaluated over the last 30 years, Guillain–Barré syndrome (GBS) has been considered a vaccine-associated adverse event of interest since 1976. To investigate the existence of GBS risk after vaccination against seasonal influenza, a systematic review and meta-analysis have been conducted based on 22 eligible epidemiological studies from 1981 to 2019 reporting 26 effect sizes (ESs) in different influenza seasons. The primary result of our meta-analysis pointed to no risk of vaccine-associated GBS, as documented by a pooled ES of 1.15 (95% CI: 0.97–1.35). Conversely, an obvious high risk of GBS was observed in patients with previous influenza-like illness (ILI), as demonstrated by a pooled ES of 9.6 (95% CI: 4.0–23.0) resulting from a supplementary analysis. While the meta-analysis did not confirm the putative risk of vaccine-associated GBS suggested by many epidemiological studies, vaccination against seasonal influenza reduced the risk of developing ILI-associated GBS by about 88%. However, to obtain strong evidence, more epidemiological studies are warranted to establish a possible coincidence between vaccination and ILI prior to GBS onset.Funding Information
- Univerzita Karlova v Praze (UK PROGRES Q16)
This publication has 40 references indexed in Scilit:
- Risk of Guillain-Barré syndrome after 2010–2011 influenza vaccinationEuropean Journal of Epidemiology, 2013
- The Impact of Influenza Vaccinations on the Adverse Effects and Hospitalization Rate in the Elderly: A National Based Study in an Asian CountryPLOS ONE, 2012
- GRADE guidelines: 9. Rating up the quality of evidenceJournal of Clinical Epidemiology, 2011
- Guillain-Barre Syndrome, Influenzalike Illnesses, and Influenza Vaccination During Seasons With and Without Circulating A/H1N1 VirusesAmerican Journal of Epidemiology, 2011
- GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tablesJournal of Clinical Epidemiology, 2011
- Population Incidence of Guillain-Barré Syndrome: A Systematic Review and Meta-AnalysisNeuroepidemiology, 2011
- Guillain-Barré Syndrome and Preceding Infection with Campylobacter, Influenza and Epstein-Barr Virus in the General Practice Research DatabasePLOS ONE, 2007
- Influenza,CampylobacterandMycoplasmaInfections, and Hospital Admissions for Guillain-Barré Syndrome, EnglandEmerging Infectious Diseases, 2006
- Measuring inconsistency in meta-analysesBMJ, 2003
- Guillain-Barré Syndrome and the 1978–1979 Influenza VaccineThe New England Journal of Medicine, 1981