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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00768

Gulllain-Barre Syndrome after trivalent influenza vaccination in adults

 Kuo-Hsuan Chang1, Rong-Kuo Lyu1,  Wan-Ting Lin2,  Yu-Tung Huang2, Huang-Shen Lin3 and  Shang-Hung Chang4*
  • 1Department of Neurology, Linkou Chang Gung Memorial Hospital, Taiwan
  • 2Center for Big Data Analytics and Statistics, Taoyuan Chang Gung Memorial Hospital, Taiwan
  • 3Division of infectious diseases, Chang Gung Memorial Hospital, Taiwan
  • 4Department of Cardiology, Linkou Chang Gung Memorial Hospital, Taiwan

Lines of evidence suggest trivalent influenza vaccination may be associated with Guillain-Barre syndrome (GBS), an immune-mediated acute inflammatory neuropathy. On the other hand, this vaccination protects against influenza infection, which has been demonstrated as a trigger of GBS. To clarify the net effect of trivalent influenza vaccines on GBS, we conducted a retrospective nationwide nested case-control study using the database of the Taiwan National Health Insurance program. We identified 182 hospitalized patients with GBS aged ≥ 50 years from 2007 to 2016 as the cases, and 910 hospitalized patients, matched by gender, age, date of hospitalization, comorbidities and medications, as the control subjects. Nearby and remote exposures of vaccination were defined as subjects who had received trivalent influenza vaccine 42 (nearby exposure) and 90 days (remote exposure) before the date of hospitalization, respectively. We found 7 (3.85%) GBS patients and 26 (2.86%) matched control subjects demonstrated nearby exposures of influenza vaccine (odds ratio: 1.46, 95% confidence interval: 0.56 ~ 3.78). Seventeen (9.34%) GBS patients exposed to influenza vaccines remotely, while the number of remote exposure of influenza vaccines in matched control subjects was 72 (7.91%, odds ratio: 1.26, 95% confidence interval: 0.67 ~ 2.38). These results do not support an association between trivalent influenza vaccine and GBS among the patients aged ≥ 50 years.

Keywords: Guillain-Barre Syndrome, influenza, Vaccination, polyneuropathy, flu

Received: 08 Apr 2019; Accepted: 02 Jul 2019.

Edited by:

Pamela A. McCombe, University of Queensland, Australia

Reviewed by:

Hugh J. Willison, University of Glasgow, United Kingdom
Yoshiro Ohara, Kanazawa Medical University, Japan  

Copyright: © 2019 Chang, Lyu, Lin, Huang, Lin and Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Shang-Hung Chang, Department of Cardiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, afen.chang@gmail.com