Guillain-Barré syndrome after vaccination in United States: data from the Centers for Disease Control and Prevention/Food and Drug Administration Vaccine Adverse Event Reporting System (1990-2005).

BACKGROUND

There are isolated reports of Guillain-Barré syndrome (GBS) after receiving vaccination.

OBJECTIVE

To determine the rates and characteristics of GBS after administration of vaccination in United States

METHODS

We used data for 1990 to 2005 from the Vaccine Adverse Event Reporting System, which is a cooperative program of the Centers for Disease Control and Prevention and the US Food and Drug Administration.

RESULTS

There were 1000 cases (mean age, 47 years) of GBS reported after vaccination in the United States between 1990 and 2005. The onset of GBS was within 6 weeks in 774 cases, >6 weeks in 101, and unknown in 125. Death and disability after the event occurred in 32 (3.2%) and 167 (16.7%) subjects, respectively. The highest number (n = 632) of GBS cases was observed in subjects receiving influenza vaccine followed by hepatitis B vaccine (n = 94). Other vaccines or combinations of vaccines were associated with 274 cases of GBS. The incidence of GBS after influenza vaccination was marginally higher in subjects <65 years compared with those >or=65 years (P = 0.09); for hepatitis vaccine, the incidence was significantly higher (P < 0.0001) in the <65 group. Death was more frequent in subjects >or=65 years compared with those <65 years (P < 0.0001).

CONCLUSIONS

Our results suggest that vaccines other than influenza vaccine can be associated with GBS. Vaccination-related GBS results in death or disability in one fifth of affected individuals, which is comparable to the reported rates in the general GBS population.