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Open AccessReview

Is an Increased Risk of Developing Guillain–Barré Syndrome Associated with Seasonal Influenza Vaccination? A Systematic Review and Meta-Analysis

1
Department of Epidemiology and Biostatistics, Charles University in Prague-Third Faculty of Medicine, 100 00 Prague, Czech Republic
2
Laboratory for Atherosclerosis Research, Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
*
Author to whom correspondence should be addressed.
Vaccines 2020, 8(2), 150; https://doi.org/10.3390/vaccines8020150
Received: 4 March 2020 / Revised: 24 March 2020 / Accepted: 26 March 2020 / Published: 27 March 2020
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. View Full-Text
Keywords: Guillain–Barré syndrome; vaccine against seasonal influenza; influenza-like illness; vaccine-associated autoimmune disease Guillain–Barré syndrome; vaccine against seasonal influenza; influenza-like illness; vaccine-associated autoimmune disease
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Petráš, M.; Králová Lesná, I.; Dáňová, J.; Čelko, A.M. Is an Increased Risk of Developing Guillain–Barré Syndrome Associated with Seasonal Influenza Vaccination? A Systematic Review and Meta-Analysis. Vaccines 2020, 8, 150.

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