Guillain-Barre syndrome during the 2009-2010 H1N1 influenza vaccination campaign: population-based surveillance among 45 million Americans.

Autor(es): Wise Matthew E,Viray Melissa,Sejvar James J,Lewis Paige,Baughman Andrew L,Connor Walter,Danila Richard,Giambrone Greg P,Hale Christa,Hogan Brenna C,Meek James I,Murphree Rendi,Oh John Y,Reingold Arthur,Tellman Norisse,Conner Susan M,Singleton James A.; Lu Peng-Jun; DeStefano Frank; Fridkin Scott K.; Vellozzi Claudia; Morgan Oliver W.

Resumo: Because of widespread distribution of the influenza A (H1N1) 2009 monovalent vaccine (pH1N1 vaccine) and the prior association between Guillain-Barré syndrome (GBS) and the 1976 H1N1 influenza vaccine, enhanced surveillance was implemented to estimate the magnitude of any increased GBS risk following administration of pH1N1 vaccine. The authors conducted active, population-based surveillance for incident cases of GBS among 45 million persons residing at 10 Emerging Infections Program sites during October 2009-May 2010; GBS was defined according to published criteria. The authors determined medical and vaccine history for GBS cases through medical record review and patient interviews. The authors used vaccine coverage data to estimate person-time exposed and unexposed to pH1N1 vaccine and calculated age- and sex-adjusted rate ratios comparing GBS incidence in these groups, as well as age- and sex-adjusted numbers of excess GBS cases. The authors received 411 reports of confirmed or probable GBS. The rate of GBS immediately following pH1N1 vaccination was 57% higher than in person-time unexposed to vaccine (adjusted rate ratio = 1.57, 95% confidence interval: 1.02, 2.21), corresponding to 0.74 excess GBS cases per million pH1N1 vaccine doses (95% confidence interval: 0.04, 1.56). This excess risk was much smaller than that observed during the 1976 vaccine campaign and was comparable to some previous seasonal influenza vaccine risk assessments.

Imprenta: American Journal of Epidemiology, v. 175, n. 11, p. 1110-1119, 2012

Identificador do objeto digital: 10.1093/aje/kws196

Descritores: Guillain-Barre Syndrome - Pathogenesis ; Guillain-Barre Syndrome - Viral infections ; Guillain-Barre Syndrome - Virus ; Guillain-Barre Syndrome - Vaccine ; Guillain-Barre Syndrome - Epidemiology ; Guillain-Barre Syndrome - Immunology ; Guillain-Barre Syndrome - Public health

Data de publicação: 2012