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• W2985944717 abstract "In their Comment, Lucija Tomljenovic and Yehuda Shoenfeld raise doubts about the results presented by Jeff rey Kwong and colleagues about the risk of Guillain-Barre syndrome after seasonal influenza vaccination. They claim that a risk interval of 6 weeks after immunisation could introduce a type II error bias in the analysis of a possible association between vaccination and Guillain-Barre syndrome. The authors cite two studies in support of their claim: a case-control study and a case report. The casecontrol study focused on the risk of CNS demyelination in childhood after hepatitis B immunisation; the investigators reported an increased risk associated with exposure to one brand of the hepatitis B vaccine more than 3 years before the onset of the disease. However, according to the Global Advisory Committee on Vaccine Safety, some methodological limitations affected the results of the study, which therefore did not provide convincing evidence that hepatitis B vaccination, or any brand of the vaccine, is associated with CNS demyelination. The patient described in the case report received the A/New Jersey/1976/H1N1 vaccine on Nov 17, 1976. From mid-December, 1976, he had a range of neurological symptoms (eg, paraesthesia of the hands and feet) and difficulty in performing some common tasks (eg, climbing stairs, walking, and running). On Aug 19, 1977, he had an enteric infection and 3 days later developed a polyneuropathy. According to the investigators, 1 month after vaccination the patient had a progressive but unrecognised Guillain-Barre syndrome, which was subsequently exacerbated by an enteric infection. Although interesting, this observation does not constitute conclusive evidence that the commonly accepted 6 weeks’ risk interval could be inadequate. About two-thirds of patients with Guillain-Barre syndrome have had an infection within 6 weeks before syndrome onset. Campylobacter jejuni, Mycoplasma pneumoniae, and several viral infections (including influenza, cytomegalovirus, and Epstein-Barr virus) have been identifi ed as possible triggers of the disease. During an extended period an individual can acquire several infections, some of which might be undetected; therefore, expanding the risk interval might bias the results. A long latency between immunisation and onset of GuillainBarre syndrome makes it impossible to rule out other causes. The Brighton Collaboration GBS Working Group highlighted that the biological plausibility of an association of Guillain-Barre syndrome with an infection or a vaccination inevitably decreases beyond 6 weeks. The Comment by Tomljenovic and Shoenfeld is insuffi ciently supported by evidence and could therefore be misleading." @default.
• W2985944717 created "2019-11-22" @default.
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• W2985944717 date "2014-01-01" @default.
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• W2985944717 title "Influenza vaccination and Guillain-Barré syndrome" @default.
• W2985944717 hasPublicationYear "2014" @default.
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