Lee Hankil, Kang Hye-Young, Jung Sun-Young, Lee Young-Mock
CONNECT-AI research center, Yonsei University Health System, Seoul 03722, Korea.
College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon 21983, Korea.
Vaccines (Basel). 2020 Jul 31;8(3):431. doi: 10.3390/vaccines8030431.
We aimed to analyze the incidence of Guillain-Barré syndrome (GBS) and its association with influenza vaccination (IV) in the elderly population. This study included 2470 patients hospitalized with GBS (G61.0) between 2014 and 2016 based on the Korean National Health Insurance Service (NHIS) claims data. We reviewed every medical claim in the 42 days preceding GBS diagnosis looking for precedent causes of GBS. To assess the relationship between IV and the development of GBS, data from the NHIS and the National Vaccination Registry were combined and analyzed. Using a self-controlled case series (SCCS) approach, we calculated the incidence rate ratio by setting the risk period as 42 days following vaccination. The annual background incidence of GBS was estimated at 4.15 per 100,000 persons. More than half of the patients with newly developed GBS had a previous infection or surgery. The incidence of GBS within 42 days of IV was estimated at 0.32 per 100,000 vaccinated persons. SCCS analysis showed that the risk of GBS was not significantly higher. While GBS can potentially develop from various infections, no association was found between GBS and IV. These results will contribute to developing an evidence-based vaccine policy that includes a clear causality assessment of adverse events.
我们旨在分析老年人群中吉兰-巴雷综合征(GBS)的发病率及其与流感疫苗接种(IV)的关联。本研究基于韩国国民健康保险服务(NHIS)的理赔数据,纳入了2014年至2016年间因GBS(G61.0)住院的2470例患者。我们回顾了GBS诊断前42天内的每一份医疗理赔记录,以寻找GBS的先前病因。为评估IV与GBS发病之间的关系,我们合并并分析了NHIS和国家疫苗接种登记处的数据。采用自控病例系列(SCCS)方法,我们将接种疫苗后42天设定为风险期,计算发病率比。GBS的年背景发病率估计为每10万人中有4.15例。超过一半新发生GBS的患者曾有过感染或手术史。IV后42天内GBS的发病率估计为每10万接种者中有0.32例。SCCS分析表明,GBS的风险没有显著升高。虽然GBS可能由各种感染引发,但未发现GBS与IV之间存在关联。这些结果将有助于制定基于证据的疫苗政策,其中包括对不良事件进行明确的因果关系评估。