Guillain-Barre syndrome after influenza vaccination in adults - A population-based study
Guillain-Barre syndrome after influenza vaccination in adults - A population-based study
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DOI：
10.1001/archinte.166.20.2217
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发表时间：
2006-11-13
影响因子：
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通讯作者：
Wilson, Kumanan
中科院分区：
文献类型：
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作者：
Juurlink, David N.;Stukel, Therese A.;Wilson, Kumanan
背景资料：是否流感疫苗接种与格林-巴利综合征（GBS）仍不确定。方法：我们进行了2项研究，使用人口为基础的卫生保健数据从加拿大的安大略省。在第一项研究中，我们使用自匹配的病例系列方法来探讨可能的流感疫苗接种（成人在10月和11月期间接种疫苗）和随后因GBS住院之间的时间关联。在第二项研究中，我们使用时间序列分析，以确定是否在2000年10月的机构的普遍流感免疫接种计划与随后的增加，因为GBS在人口level.Results：从1992年4月1日，到2004年3月31日，我们确定了1601事件入院治疗，因为GBS在安大略。在269名患者中，GBS在接种流感疫苗后43周内被诊断出来。主要危险期（第2 - 7周）与对照期（第20 - 43周）相比，GBS的估计相对发病率为1.45（95%置信区间，1.05-1.99; P=. 02）。在使用不同持续时间的风险和控制间隔的几项敏感性分析中，这种关联持续存在。然而，一个单独的时间序列分析表明没有证据的季节性，并没有发现统计学上显着增加，因为GBS的入院后，引进的普遍流感免疫programme.Conclusion：流感疫苗接种与一个小的，但显着增加的风险住院治疗，因为GBS。
Background: Whether influenza vaccination is associated with Guillain-Barre syndrome (GBS) remains uncertain.Methods: We conducted 2 studies using population-based health care data from the province of Ontario, Canada. In the first study, we used the self-matched case-series method to explore the temporal association between probable influenza vaccination ( adults vaccinated during October and November) and subsequent hospitalization because of GBS. In the second study, we used time-series analysis to determine whether the institution of a universal influenza immunization program in October 2000 was associated with a subsequent increase in hospital admissions because of GBS at the population level.Results: From April 1, 1992, to March 31, 2004, we identified 1601 incident hospital admissions because of GBS in Ontario. In 269 patients, GBS was diagnosed within 43 weeks of vaccination against influenza. The estimated relative incidence of GBS during the primary risk interval ( weeks 2 through 7) compared with the control interval ( weeks 20 through 43) was 1.45 (95% confidence interval, 1.05-1.99; P=. 02). This association persisted in several sensitivity analyses using risk and control intervals of different durations. However, a separate time-series analysis demonstrated no evidence of seasonality and revealed no statistically significant increase in hospital admissions because of GBS after the introduction of the universal influenza immunization program.Conclusion: Influenza vaccination is associated with a small but significantly increased risk for hospitalization because of GBS.