The DOI matches its Crossref record; 54 of the 54 references it cites were found in a registry or an index.
Guillain-Barre syndrome and influenza vaccines: a meta-analysis.
Abstract
Cases of Guillain-Barré syndrome (GBS) have been occasionally associated with influenza vaccines; this possible risk, even if rare, is a matter of much concern. To investigate the strength of this association, a systematic review and a meta-analysis have been conducted; for the purpose, controlled observational studies addressing the risk of GBS associated with different influenza vaccines were sought. We finally selected 39 studies of interest published between 1981 and 2014 (seasonal influenza vaccines, 22; pandemic influenza vaccines, 16; both vaccines simultaneously administered, 1); funnel plot did not identify publication bias. At the association between any influenza vaccine - whether seasonal or pandemic - with GBS, the overall relative risk was 1.41 (95% CI, 1.20-1.66). Pandemic vaccines presented a higher risk (RR=1.84; 95% CI, 1.36-2.50) compared to seasonal vaccines (RR=1.22; 95% CI, 1.01-1.48); the latter should be considered as marginally statistically significant. Pandemic adjuvanted vaccines were not found to be related to a higher risk compared to non-adjuvanted vaccines. The results of the present meta-analysis point to a small but statistically significant association between influenza vaccines, particularly the pandemic ones, and GBS, which is consistent with current explanations upon possible mechanisms for this condition to appear.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“A metanalysis of 39 controlled observational studies found that the relative risk of GBS following receipt of any influenza vaccine was 1.41 (Martin Arias et al., 2015).”
From Vaccine Safety: Myths and Misinformation (2020) · cites this paper as Martin Arias et al., 2015
Citations
Cites
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
Yuki, N., & Hartung, H. (2012) · New England Journal of Medicine · doi:10.1056/nejmra1114525 · Cited by 1,270
Population Incidence of Guillain-Barré Syndrome: A Systematic Review and Meta-Analysis
Sejvar, J. J., Baughman, A. L., Wise, M. P., & Morgan, O. W. (2011) · Neuroepidemiology · doi:10.1159/000324710 · Cited by 959
Schonberger, L. B., Bregman, D. J., SULLIVAN-BOLYAI, J. Z., Keenlyside, R. A., Ziegler, D. W., RETAILLIAU, H. F., EDDINS, D. L., & Bryan, J. A. (1979) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112795 · Cited by 784
Tutorial in biostatistics: the self‐controlled case series method
Whitaker, H. J., Paddy Farrington, C., Spiessens, B., & Musonda, P. (2006) · Statistics in Medicine · doi:10.1002/sim.2302 · Cited by 719
The Guillain–Barré Syndrome and the 1992–1993 and 1993–1994 Influenza Vaccines
Lasky, T., Terracciano, G. J., Magder, L. S., Koski, C. L., Ballesteros, M., Nash, D., Clark, S., Haber, P., Stolley, P. D., Schonberger, L. B., et al. (1998) · New England Journal of Medicine · doi:10.1056/nejm199812173392501 · Cited by 501
Vaccines and Guillain-Barré Syndrome
Haber, P., Sejvar, J. J., Mikaeloff, Y., & Destefano, F. R. (2009) · Drug Safety · doi:10.2165/00002018-200932040-00005 · Cited by 235
Salmon, D. A., Proschan, M. A., Forshee, R. A., Gargiullo, P. M., Bleser, W. K., Burwen, D. R., Cunningham, F. E., Garman, P. M., Greene, S. K., Lee, G. M., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(12)62189-8 · Cited by 212
Guillain-Barré Syndrome After Influenza Vaccination in Adults
Juurlink, D. N. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.20.2217 · Cited by 201
Guillain-Barré syndrome after exposure to influenza virus
Lehmann, H. C., Hartung, H., Kieseier, B. C., & Hughes, R. A. (2010) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(10)70140-7 · Cited by 199
Tam, C. C., O’Brien, S. J., Petersen, I., Islam, A., Hayward, A. C., & Rodrigues, L. C. (2007) · PLoS ONE · doi:10.1371/journal.pone.0000344 · Cited by 193
Stowe, J., Andrews, N. J., Wise, L., & Miller, E. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwn310 · Cited by 192
Vellozzi, C., Burwen, D. R., Dobardzic, A., Ball, R., Walton, K., & Haber, P. (2009) · Vaccine · doi:10.1016/j.vaccine.2009.01.125 · Cited by 188
Guillain-Barré Syndrome and the 1978–1979 Influenza Vaccine
Hurwitz, E. S., Schonberger, L. B., Nelson, D. B., & Holman, R. C. (1981) · New England Journal of Medicine · doi:10.1056/nejm198106253042601 · Cited by 176
Kaplan, J. (1982) · JAMA · doi:10.1001/jama.248.6.698 · Cited by 176
Dieleman, J. P., Romio, S., Johansen, K., Weibel, D. M., Bonhoeffer, J., Sturkenboom, M., & and the VAESCO-GBS Case-Control Study Group (2011) · BMJ · doi:10.1136/bmj.d3908 · Cited by 175
Waddington, C. S., Walker, W. T., Oeser, C., Reiner, A., John, T. M., Wilkins, S., Casey, M., Eccleston, P., Allen, R., Okike, I. O., et al. (2010) · BMJ · doi:10.1136/bmj.c2649 · Cited by 161
Guillain-Barré Syndrome in the United States, 1979-1980 and 1980-1981
Kaplan, J. E. (1982) · JAMA · doi:10.1001/jama.1982.03330060038030 · Cited by 125
Kwong, J. C., Vasa, P. P., Campitelli, M. A., Hawken, S., Wilson, K., Rosella, L. C., Stukel, T. A., Crowcroft, N. S., McGeer, A. J., Zinman, L., et al. (2013) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(13)70104-x · Cited by 115
Nachamkin, I., Shadomy, S. V., Moran, A. P., Cox, N., Fitzgerald, C., Ung, H., Corcoran, A. T., Iskander, J. K., Schonberger, L. B., & Chen, R. T. (2008) · The Journal of Infectious Diseases · doi:10.1086/589624 · Cited by 113
Dodd, C. N., Romio, S., BLACK, S. B., Vellozzi, C. J., Andrews, N. J., Sturkenboom, M., ZUBER, P. L. F., Hua, W., Bonhoeffer, J., Buttery, J. P., et al. (2013) · Vaccine · doi:10.1016/j.vaccine.2013.06.032 · Cited by 109
Lack of Association of Guillain-Barre Syndrome With Vaccinations
Baxter, R. P., Bakshi, N., FIREMAN, B. H., Lewis, E. M., Ray, P., Vellozzi, C. J., & Klein, N. P. (2013) · Clinical Infectious Diseases · doi:10.1093/cid/cit222 · Cited by 109
Prothro, C., Kudish, K. S., Fielline, M., Meek, J. I., Tellman, N., Milewski, M., Hogan, B. C., Holtzman, C., Danila, R., DUNNING, L. H., et al. (2010) · PubMed · Cited by 108
No Association Between Immunization and Guillain-Barré Syndrome in the United Kingdom, 1992 to 2000
Hughes, R. A., Charlton, J., Latinovic, R., & Gulliford, M. C. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.12.1301 · Cited by 100
Wise, M. E., Viray, M. A., Sejvar, J. J., Lewis, P., Baughman, A. L., Connor, W., Danila, R., Giambrone, G. P., Hale, C. R., Hogan, B., et al. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kws196 · Cited by 94
Greene, S. K., Rett, M., Weintraub, E. S., Li, L., Yin, R., Amato, A. A., Ho, D. T., Sheikh, S. I., Fireman, B. H., Daley, M. F., et al. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kws195 · Cited by 91
Risk of Guillain-Barré Syndrome Following H1N1 Influenza Vaccination in Quebec
Wals, P. D., Deceuninck, G., Toth, E., Boulianne, N., Brunet, D., Boucher, R., Landry, M., & Serres, G. D. (2012) · JAMA · doi:10.1001/jama.2012.7342 · Cited by 85
Grimaldi‐Bensouda, L., Alpérovitch, A., Besson, G., Vial, C., Cuisset, J., Papeix, C., Lyon‐Caen, O., Bénichou, J., Rossignol, M., & Lucien Abenhaim for the GBS-PGRx Study Group (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwr072 · Cited by 76
Blum, S., & McCombe, P. (2014) · Journal of the Peripheral Nervous System · doi:10.1111/jns5.12074 · Cited by 71
Yih, W. K., Lee, G. M., Lieu, T. A., Ball, R., Kulldorff, M., Rett, M. D., Wahl, P. M., McMahill‐Walraven, C. N., Platt, R. G., & Salmon, D. A. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kws197 · Cited by 71
Guillain-Barré Syndrome Incidence in a Large United States Cohort (2000–2009)
Shui, I. M., Rett, M. D., Weintraub, E., Marcy, M., Amato, A. A., Sheikh, S. I., Ho, D. T., Lee, G. M., & Yih, W. K. (2012) · Neuroepidemiology · doi:10.1159/000339248 · Cited by 70
Guillain-Barré Syndrome: Modern Theories of Etiology
Hardy, T. A., Blum, S., McCombe, P., & Reddel, S. (2011) · Current Allergy and Asthma Reports · doi:10.1007/s11882-011-0190-y · Cited by 63
Romio, S., Weibel, D. M., Dieleman, J. P., Olberg, H. K., de Vries, C. S., Sammon, C., Andrews, N. J., Svanström, H., Mølgaard‐Nielsen, D., Hviid, A. P., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0082222 · Cited by 59
Greene, S. K., Rett, M. D., Vellozzi, C., Li, L., Kulldorff, M., Marcy, S. M., Daley, M. F., Belongia, E. A., Baxter, R., Fireman, B. H., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0067185 · Cited by 59
Evaluation of Guillain-Barré Syndrome Among Recipients of Influenza Vaccine in 2000 and 2001
Burwen, D. R., Ball, R., Bryan, W. W., Izurieta, H. S., Voie, L. L., Gibbs, N. A., Kliman, R. E., & Braun, M. M. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.05.022 · Cited by 56
Tokars, J. I., Lewis, P., Destefano, F. R., Wise, M. E., Viray, M. A., Morgan, O. W., Gargiullo, P. M., & Vellozzi, C. J. (2012) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3220 · Cited by 54
Kawai, A. T., Li, L., Kulldorff, M., Vellozzi, C. J., Weintraub, E., Baxter, R. P., Belongia, E. A., Daley, M. F., Jacobsen, S. J., Naleway, A. L., et al. (2014) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3575 · Cited by 53
Isai, A., Durand, J., Meur, S. L., Hidalgo‐Simon, A., & Kurz, X. (2012) · Vaccine · doi:10.1016/j.vaccine.2012.09.032 · Cited by 53
Tam, C. C., O’Brien, S. J., & Rodrigues, L. C. (2006) · Emerging infectious diseases · doi:10.3201/eid1212.051032 · Cited by 51
Risk of Guillain-Barré syndrome after 2010–2011 influenza vaccination
The ITANG study group, Galeotti, F., Massari, M., D’Alessandro, R., Beghi, E., Chiò, A., Logroscino, G., Filippini, G., Benedetti, M. D., Pugliatti, M., et al. (2013) · European Journal of Epidemiology · doi:10.1007/s10654-013-9797-8 · Cited by 49
Vellozzi, C. J., Iqbal, S., Stewart, B., Tokars, J. I., & Destefano, F. R. (2014) · American Journal of Public Health · doi:10.2105/ajph.2013.301651 · Cited by 48
Andrews, N. J., Stowe, J., Salman, R. A., & Miller, E. (2011) · Vaccine · doi:10.1016/j.vaccine.2011.08.069 · Cited by 47
Polakowski, L., Sandhu, S. K., Martin, D. B., Ball, R., MaCurdy, T. E., Franks, R. L., Gibbs, J. M., Kropp, G., Avagyan, A., Kelman, J. A., et al. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kwt051 · Cited by 40
Guillain-Barre Syndrome Associated with Campylobacter jejuni Infection in England, 2000-2001
Tam, C. C., Rodrigues, L. C., & O’Brien, S. J. (2003) · Clinical Infectious Diseases · doi:10.1086/375845 · Cited by 36
Risk of Guillain–Barré syndrome following pandemic influenza A(H1N1) 2009 vaccination in Germany
Prestel, J., Volkers, P., Mentzer, D., Lehmann, H. C., Hartung, H., Keller‐Stanislawski, B., & for the GBS Study Group (2014) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3638 · Cited by 35
Crawford, N. W., Cheng, A., Andrews, N. J., Charles, P. G. P., Clothier, H. J., Day, B. J., Day, T., Gates, P., Macdonell, R. A. L., Roberts, L. J., et al. (2012) · The Medical Journal of Australia · doi:10.5694/mja12.10534 · Cited by 32
Guillain-Barré Syndrome Following Influenza Vaccination: Causal or Coincidental?
Sejvar, J. J., Pfeifer, D., & Schonberger, L. B. (2011) · Current Infectious Disease Reports · doi:10.1007/s11908-011-0194-8 · Cited by 30
Hoshino, T., Uchiyama, Y., Ito, E., Osawa, S., & Ohashi, T. (2012) · Internal Medicine · doi:10.2169/internalmedicine.51.7132 · Cited by 26
McGarvey, P. B., Süzek, B. E., Baraniuk, J. N., Rao, S., Conkright, B., Lababidi, S., Sutherland, A., Forshee, R. A., & Madhavan, S. (2014) · BMC Immunology · doi:10.1186/s12865-014-0061-0 · Cited by 24
Evaluating the safety of influenza vaccine using a claims-based health system
McCarthy, N. L., Gee, J. M., Lin, N. D., Hoffman, V., Pan, Y., Su, S., Turnbull, B., Chan, K. A., & Weintraub, E. (2013) · Vaccine · doi:10.1016/j.vaccine.2013.10.031 · Cited by 23
Safety of Pandemic (H1N1) 2009 Monovalent Vaccines in Taiwan: A Self-Controlled Case Series Study
Huang, W., Yang, H.-W., Liao, T.-L., Wu, W.-J., Yang, S.-E., Chih, Y.-C., & Chuang, J.-H. (2013) · PLoS ONE · doi:10.1371/journal.pone.0058827 · Cited by 23
Lei, T., Siu, K., Kok, K., Chan, K., Chan, E. Y. T., Hung, I. F., To, K. K., Li, P. C., Zhou, J., Zheng, B., et al. (2012) · Vaccine · doi:10.1016/j.vaccine.2012.02.009 · Cited by 15
Cited by
Sorted by citations
Grohskopf, L. A., Sokolow, L. Z., Broder, K. R., Walter, E. B., Fry, A. M., & Jernigan, D. B. (2018) · MMWR Recommendations and Reports · doi:10.15585/mmwr.rr6703a1 · Cited by 1,640
Prevention and Control of Seasonal Influenza with Vaccines
Grohskopf, L. A., Sokolow, L. Z., Broder, K. R., Olsen, S. J., Karron, R. A., Jernigan, D. B., & Bresee, J. (2016) · MMWR Recommendations and Reports · doi:10.15585/mmwr.rr6505a1 · Cited by 602
Vaccine Safety: Myths and Misinformation
Geoghegan, S., O’Callaghan, K. P., & Offit, P. A. (2020) · Frontiers in Microbiology · doi:10.3389/fmicb.2020.00372 · Cited by 275
van Doorn, P. A., den Bergh, P. Y. K. V., Hadden, R. D. M., Avau, B., Vankrunkelsven, P., Attarian, S., Blomkwist‐Markens, P. H., Cornblath, D. R., Goedee, H. S., Harbo, T., et al. (2023) · European Journal of Neurology · doi:10.1111/ene.16073 · Cited by 261
Kieseier, B. C., Mathey, E. K., Sommer, C., & Hartung, H. (2018) · Nature Reviews Disease Primers · doi:10.1038/s41572-018-0027-2 · Cited by 155
Metadata
- Authors
- Martín Arias, L. H., Sanz, R., Sáinz, M., Treceño, C., & Carvajal, A.
- Affiliations
- Universidad de Valladolid (ES)
- Corresponding author
- Carvajal, A.
- ORCID
- Carvajal, A.
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 33
- Issue
- 31
- Pages
- 3773-3778
- ISSN
- 0264-410X (ISSN-L)
- OpenAlex
- W324672716
- Cited by
- 132
- References
- 54
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 11 · 2023: 11 · 2022: 15 · 2021: 28 · 2020: 13 · 2019: 11 · 2018: 10 · 2017: 8 · 2016: 6
- FWCI
- 1.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Vaccine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- Guillain-Barré syndrome, influenza vaccination, vaccine adverse events, pandemic influenza vaccine, seasonal influenza vaccine, adjuvanted vaccine, relative risk, vaccine safety
- MeSH terms
- Influenza Vaccines, Guillain-Barre Syndrome, Observational Studies as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review