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We interviewed 180 of 273 adults with the Guillain-Barre syndrome; 15 declined to participate, and the remaining 78 could not be contacted. The vaccine providers confirmed influenza vaccination in the six weeks before the onset of Guillain-Barre syndrome for 19 patients. The relative risk of the Guillain-Barre syndrome associated with vaccination, adjusted for age, sex, and vaccine season, was 1.7 (95 percent confidence interval, 1.0 to 2.8; P=0.04). The adjusted relative risks were 2.0 for the 1992 - 1993 season (95 percent confidence interval, 1.0 to 4.3) and 1.5 for the 1993 - 1994 season (95 percent confidence interval, 0.8 to 2.9). In 9 of the 19 vaccine-associated cases, the onset was in the second week after vaccination, all between day 9 and day 12. There was no increase in the risk of vaccine-associated Guillain-Barre syndrome from 1992 - 1993 to 1993 - 1994. For the two seasons combined, the adjusted relative risk of 1.7 suggests slightly more than one additional case of Guillain-Barre syndrome per million persons vaccinated against influenza. |
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