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Risk of Guillain-Barre syndrome after seasonal influenza vaccination and influenza health-care encounters: a self-controlled study.
Abstract
Background The possible risk of Guillain-Barré syndrome from influenza vaccines remains a potential obstacle to achieving high vaccination coverage. However, influenza infection might also be associated with Guillain-Barré syndrome. We aimed to assess the risk of Guillain-Barré syndrome after seasonal influenza vaccination and after influenza-coded health-care encounters.Methods We used the self-controlled risk interval design and linked universal health-care system databases from Ontario, Canada, with data obtained between 1993 and 2011. We used physician billing claims for influenza vaccination and influenza-coded health-care encounters to ascertain exposures. Using fixed-effects conditional Poisson regression, we estimated the relative incidence of hospitalisation for primary-coded Guillain-Barré syndrome during the risk interval compared with the control interval.Findings We identified 2831 incident admissions for Guillain-Barré syndrome; 330 received an influenza vaccine and 109 had an influenza-coded health-care encounter within 42 weeks before hospitalisation. The risk of Guillain-Barré syndrome within 6 weeks of vaccination was 52% higher than in the control interval of 9-42 weeks (relative incidence 1·52; 95% CI 1·17-1·99), with the greatest risk during weeks 2-4 after vaccination. The risk of Guillain-Barré syndrome within 6 weeks of an influenza-coded health-care encounter was greater than for vaccination (15·81; 10·28-24·32). The attributable risks were 1·03 Guillain-Barré syndrome admissions per million vaccinations, compared with 17·2 Guillain-Barré syndrome admissions per million influenza-coded health-care encounters.Interpretation The relative and attributable risks of Guillain-Barré syndrome after seasonal influenza vaccination are lower than those after influenza illness. Patients considering immunisation should be fully informed of the risks of Guillain-Barré syndrome from both influenza vaccines and influenza illness.Funding Canadian Institutes of Health Research.
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“The attributable risks of admissions for GBS within 6 weeks were 1⋅03 per million vaccinations, compared with 17⋅2 GBS admissions per million influenza-coded health-care encounters (Kwong et al., 2013).”
From Vaccine Safety: Myths and Misinformation (2020) · cites this paper as Kwong et al., 2013
In the citing paper
“The risk of GBS within 6 weeks of influenza infection is greater than after the vaccine.”
From Vaccine Safety: Myths and Misinformation (2020) · cites this paper as Kwong et al., 2013
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Cites
Fiore, A. E., Shay, D. K., Broder, K. R., Iskander, J. K., Uyeki, T. M., Mootrey, G., Bresee, J. S., & Cox, N. S. (2001) · PsycEXTRA Dataset · doi:10.1037/e548312006-001 · Cited by 5,006
Fiore, A. E., Uyeki, T. M., Broder, K. R., Finelli, L., Euler, G. L., Singleton, J. A., Iskander, J. K., Wortley, P. M., Shay, D. K., Bresee, J., et al. (2009) · PubMed · Cited by 1,964
Time Lines of Infection and Disease in Human Influenza: A Review of Volunteer Challenge Studies
Carrat, F., Vergu, E., Ferguson, N. M., Lemaître, M., Cauchemez, S., Leach, S., & Valleron, A. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwm375 · Cited by 1,116
Antibody response to influenza vaccination in the elderly: A quantitative review
GOODWIN, K., VIBOUD, C., & SIMONSEN, L. (2006) · Vaccine · doi:10.1016/j.vaccine.2005.08.105 · Cited by 1,064
(2011) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2011.03793.x · Cited by 957
The spectrum of antecedent infections in Guillain-Barre syndrome
Jacobs, B. C., Rothbarth, P. H., van der Meché, F. G. A., Herbrink, P., Schmitz, P. I. M., de Klerk, M. A., & van Doorn, P. A. (1998) · Neurology · doi:10.1212/wnl.51.4.1110 · Cited by 824
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
Relative Incidence Estimation from Case Series for Vaccine Safety Evaluation
Farrington, P. (1995) · Biometrics · doi:10.2307/2533328 · Cited by 363
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BackgroundGuillain-Barre syndrome and influenza vaccines: a meta-analysis.
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Miranda, S., Chaignot, C., Collin, C., Dray‐Spira, R., Weill, A., & Zureik, M. (2017) · Vaccine · doi:10.1016/j.vaccine.2017.06.030 · Cited by 109
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Pellegrino, P., Carnovale, C., Pozzi, M., Antoniazzi, S., Perrone, V., Salvati, D., Gentili, M., Brusadelli, T., Clementi, E., & Radice, S. (2014) · Autoimmunity Reviews · doi:10.1016/j.autrev.2014.01.054 · Cited by 86
“The possible risk of Guillain–Barré syndrome (GBS), an acute inflammatory demyelinating polyneuropathy, is a potential concern for largescale vaccination programmes such as those against influenza or HPV [34,35].”
BackgroundVaccine-preventable diseases, vaccines and Guillain-Barre’ syndrome
Principi, N., & Esposito, S. (2018) · Vaccine · doi:10.1016/j.vaccine.2018.05.119 · Cited by 90
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Shang, P., Zhu, M., Wang, Y., Zheng, X., Wu, X., Zhu, J., Feng, J., & Zhang, H. (2020) · Journal of Neurology · doi:10.1007/s00415-020-09742-2 · Cited by 79
Adversomics: a new paradigm for vaccine safety and design
Whitaker, J. A., Ovsyannikova, I. G., & Poland, G. A. (2015) · Expert Review of Vaccines · doi:10.1586/14760584.2015.1038249 · Cited by 71
“Guillain–Barre syndrome Although the risk of Guillain–Barre syndrome (GBS) following influenza vaccination has been shown to be lower than after influenza illness [62], there is still significant public concern regarding vaccination leading to this neurologic condition.”
Rose, L., Mckim, D. A., Leasa, D. J., Nonoyama, M. L., Tandon, A., Bai, Y., Amin, R., Katz, S. L., Goldstein, R. S., & Gershon, A. S. (2019) · PLoS ONE · doi:10.1371/journal.pone.0210574 · Cited by 71
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Winkelmann, A., Loebermann, M., Barnett, M. H., Hartung, H., & Zettl, U. K. (2022) · Nature Reviews Neurology · doi:10.1038/s41582-022-00646-5 · Cited by 64
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Koike, H., Chiba, A., & Katsuno, M. (2021) · Neurology and Therapy · doi:10.1007/s40120-021-00261-4 · Cited by 62
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Principi, N., & Esposito, S. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.00361 · Cited by 54
Influenza vaccination and Guillain–Barré syndrome: Reality or fear
Babazadeh, A., Afshar, Z. M., Javanian, M., Mohammadnia‐Afrouzi, M., Karkhah, A., Masrour-Roudsari, J., Sabbagh, P., Koppolu, V., Vasigala, V. R., & Ebrahimpour, S. (2019) · Journal of Translational Internal Medicine · doi:10.2478/jtim-2019-0028 · Cited by 51
“[4] Other studies investigating the association between GBS and seasonal influenza vaccines after 1976 indicated the risk as very minimal with less than one case per million.[53] Risk of GBS is maximum in the first 2–3 weeks post vaccination, but in most cases the estimated risk was one to two cases per million vaccin…”
BackgroundThe safety of influenza vaccines in children: An Institute for Vaccine Safety white paper
Halsey, N. A., Talaat, K. R., Greenbaum, A. H., Mensah, E., Dudley, M. Z., Proveaux, T. M., & Salmon, D. A. (2015) · Vaccine · doi:10.1016/j.vaccine.2015.10.080 · Cited by 50
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Witteman, H. O., Dansokho, S. C., Exe, N. L., Dupuis, A., Provencher, T., & Zikmund‐Fisher, B. J. (2015) · Risk Analysis · doi:10.1111/risa.12418 · Cited by 47
The incidence and triggers of adult‐onset Guillain−Barré syndrome in southwestern Finland 2004–2013
Sipilä, J., & Soilu‐Hänninen, M. (2014) · European Journal of Neurology · doi:10.1111/ene.12565 · Cited by 45
“Previous results on the subject have been contradictory [5] but recent results have shown influenza infection to be a more potent risk factor for GBS than an influenza vaccination [8,13].”
ResultCardiovascular and Neuropsychiatric Events after Varenicline Use for Smoking Cessation
Gershon, A. S., Campitelli, M. A., Hawken, S., Victor, C. J., Sproule, B. A., Kurdyak, P. A., & Selby, P. L. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201706-1204oc · Cited by 41
Schwartz, K. L., Jembere, N., Campitelli, M. A., Buchan, S. A., Chung, H., & Kwong, J. C. (2016) · CMAJ Open · doi:10.9778/cmajo.20160009 · Cited by 39
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Garg, M., Mufti, N., Palmore, T. N., & Hasni, S. (2018) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.04.006 · Cited by 41
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BackgroundHuang, Y., Wang, H., & Tam, W. (2017) · Current Medical Research and Opinion · doi:10.1080/03007995.2017.1329140 · Cited by 36
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Grave, C., Boucheron, P., Rudant, J., Mikaeloff, Y., Tubert‐Bitter, P., Escolano, S., Hocine, M. N., Coste, J., & Weill, A. (2020) · Neurology · doi:10.1212/wnl.0000000000009180 · Cited by 33
“Studies on the first month after vaccination could be developed in order to determine this association with higher accuracy.(12,20) Ta b le 4 In ci d en ce ra te ra ti o (IR R )o f G u ill ai n -B ar ré sy n d ro m e (G B S) af te r in fl en za va cc in at io n ac co rd in g to ye ar”
BackgroundMethodArya, D., Said, M. A., Izurieta, H. S., Pérez-Vilar, S., Zinderman, C. E., Wernecke, M., Alexander, M., White, T., Su, I., Lufkin, B., et al. (2019) · Vaccine · doi:10.1016/j.vaccine.2019.08.045 · Cited by 29
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Hawken, S., Potter, B. K., Little, J., Benchimol, E. I., Mahmud, S. M., Ducharme, R., & Wilson, K. R. (2016) · BMC Medical Research Methodology · doi:10.1186/s12874-016-0225-0 · Cited by 27
Kim, A., Lee, H., Lee, Y., & Kang, H. (2021) · Journal of Clinical Neurology · doi:10.3988/jcn.2021.17.2.257 · Cited by 24
Petráš, M., Lesná, I. K., Dáňová, J., & Čelko, A. M. (2020) · Vaccines · doi:10.3390/vaccines8020150 · Cited by 26
“Furthermore, some studies have reported ILI in vaccinated patients within the GBS risk interval [37,38].”
BackgroundResultInfluentialInfluenza Virus and SARS-CoV-2 Vaccines
Sandor, A., Sturdivant, M. S., & Ting, J. P. ‐. (2021) · The Journal of Immunology · doi:10.4049/jimmunol.2001287 · Cited by 23
“Although exceptionally rare and the mechanism is still unclear, the 1976 swine influenza vaccine has been associated with activation of autoimmune disorders such as Guillain-Barr e syndrome (99, 100).”
BackgroundSpanish GBS Epidemiology Study Group, Alcalde-Cabero, E., Almazán‐Isla, J., López, F. J. G., Ara, J. R., Avellanal, F., Casasnovas, C., Cemillán, C. A., Cuadrado, J. I., Duarte, J., et al. (2016) · BMC Neurology · doi:10.1186/s12883-016-0598-z · Cited by 20
“for potential confounders like ILI-RTI or GTI and seasonal patterns of GBS onset [30, 31].”
BackgroundRadzišauskienė, D., Vitkauskaitė, M., Žvinytė, K., & Mameniškienė, R. (2020) · Brain and Behavior · doi:10.1002/brb3.1916 · Cited by 20
“Although the particular mechanism of antiviral therapy effect in the treatment of neurological complications is unclear, it is assumed that antiviral drugs suppress the viral expression leading to a reduction of the inflammatory response (Klein et al., 2016; Kwong et al., 2013; Paksu et al., 2018).”
BackgroundLevison, L. S., Thomsen, R. W., & Andersen, H. (2022) · European Journal of Neurology · doi:10.1111/ene.15516 · Cited by 20
“0) [26] assessed within 30 and 42 days, respectively.”
BackgroundResultRose, L., Mckim, D. A., Leasa, D. J., Nonoyama, M. L., Tandon, A., Bai, Y., Amin, R., Katz, S. L., Goldstein, R. S., & Gershon, A. S. (2018) · European Respiratory Journal · doi:10.1183/13993003.00754-2018 · Cited by 19
“We grouped diagnostic codes for NMD (ICD and OHIP) into 12 categories: amyotrophic lateral sclerosis/motor neurone disease (ALS/MND); cerebral palsy [26]; Guillain-Barre [27]; metabolic disorders; multiple sclerosis [28]; muscular dystrophy; myasthenia gravis [29]; neuromuscular disorders (non-specific); neuropathy; p…”
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Etzioni, T., & Etzioni, A. (2020) · Acta Haematologica · doi:10.1159/000511760 · Cited by 19
Froes, F., Timóteo, A. L. P. P., Almeida, B., Raposo, J. F., de Oliveira, J. E. D., Carrageta, M., Duque, S., & Morais, A. (2023) · Pulmonology · doi:10.1016/j.pulmoe.2023.11.003 · Cited by 17
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Palácios, R., Poland, G. A., & Kalil, J. E. (2016) · Vaccine · doi:10.1016/j.vaccine.2016.03.059 · Cited by 17
Hawken, S., Kwong, J. C., Deeks, S. L., Crowcroft, N. S., McGeer, A., Ducharme, R., Campitelli, M. A., Coyle, D., & Wilson, K. R. (2015) · Emerging infectious diseases · doi:10.3201/eid2102.131879 · Cited by 15
“Previous studies of the risk for GBS from seasonal influenza vaccination and illness either looked solely at vaccination (4–6) or considered seasonal influenza illness and vaccination separately within the same study (7,8,11).”
BackgroundResultInfluentialInduction of broadly reactive influenza antibodies increases susceptibility to autoimmunity
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“Specifically, we assessed antibodies reactive against gangliosides and MAG because these antibodies are connected with GBS, which was associated with a higher risk in individuals exposed to the 2009 H1N1 pandemic strain (Ghaderi et al., 2016; Kwong et al., 2013; Vellozzi et al., 2014).”
BackgroundMethodResultInfluentialLohia, N., & Baranwal, M. (2014) · Viral Immunology · doi:10.1089/vim.2013.0135 · Cited by 15
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Álvarez, D. A. G., López-Cortés, L. F., & Cordero, E. (2016) · Expert Review of Respiratory Medicine · doi:10.1586/17476348.2016.1157474 · Cited by 14
Nasreen, S., Jiang, Y., Han, L., Lee, A. C.-L., Cutland, C., de Gentile, A. S., Giglio, N., Macartney, K. K., Deng, L., Liu, B. C., et al. (2025) · Vaccine · doi:10.1016/j.vaccine.2025.127291 · Cited by 15
Pullagura, G. R., Waite, N. M., Houle, S. K. D., Violette, R., & Wong, W. W. L. (2019) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2019.02.011 · Cited by 11
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“Most importantly perhaps is the evidence frommultiple studies that influenza infection has a stronger association with GBS than vaccines.(17,18)”
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“The GBS may occur in five [87] or six [108] weeks after vaccination.”
BackgroundGoedee, H. S., Attarian, S., Küntzer, T., den Bergh, P. Y. K. V., & Rajabally, Y. A. (2021) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2019-321663 · Cited by 10
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“In order to estimate the incidence rate of GBS following influenza vaccination, we selected patients who had a history of influenza vaccination among the new patients with GBS, from which we extracted those who developed GBS within 42 days (6 weeks) or 90 days (3 months) after the influenza vaccination [19,27].”
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Carpentier, V. T., Guennec, L. L., Fall, S. A. A., Viala, K., Demeret, S., & Weiss, N. (2022) · La Revue de Médecine Interne · doi:10.1016/j.revmed.2021.12.005 · Cited by 7
Lee, H., Kim, H. J., Choe, Y. J., & Shin, J. (2020) · Vaccine · doi:10.1016/j.vaccine.2020.06.038 · Cited by 8
ATAGI Targeted Review 2023: Vaccination for prevention of influenza in Australia
Australian Technical Advisory Group on Immunisation (ATAGI), Imai, C., Jayasinghe, S. H., McRae, J. E., Li‐Kim‐Moy, J. P., Chiu, C., Macartney, K. K., Burns, P. L., Cooper, K., Cheng, A. C., et al. (2024) · Communicable Diseases Intelligence · doi:10.33321/cdi.2024.48.25 · Cited by 6
Guillain–BarrÉ Syndrome After Immunization in Canadian Children (1996–2012)
Top, K. A., Desai, S. N., MOORE, D. L., LAW, B. J., Vaudry, W., Halperin, S. A., & Bettinger, J. A. (2015) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0000000000000903 · Cited by 6
“Temporal associations between GBS and more recent influenza vaccines, diphtheria–tetanus–pertussis vaccines and measles–mumps–rubella (MMR) vaccines have been reported, but epidemiologic studies have not found consistent associations.(2,3,5) Canada has 2 surveillance systems that capture GBS in children: the Canadian…”
BackgroundKeating, R., Johnson, J. L., Brice, D. C., Labombarde, J. G., Dent, A. L., & McGargill, M. A. (2020) · mBio · doi:10.1128/mbio.01859-20 · Cited by 7
Chen, J., Ma, J., Zuo, C.-H., Zhang, Q., Chen, H., & Ma, X. (2021) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03864-4 · Cited by 6
Update on Influenza Vaccines: Needs and Progress
Kennedy, R. B., Ovsyannikova, I. G., & Poland, G. A. (2021) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2021.08.003 · Cited by 6
“This association has not been observed since, and studies suggest that the risk of Guillain-Barre syndrome following influenza infection and illness is much higher than after influenza vaccination.(13) Cases of narcolepsy (a complex chronic hypersomnia syndrome) were associated with the pandemic A/H1N1 influenza vacci…”
ResultInfluentialVocal Fold Paralysis Following COVID-19 Vaccination: Query of VAERS Database
Hamdi, O. A., Jonas, R. H., & Daniero, J. J. (2022) · Journal of Voice · doi:10.1016/j.jvoice.2022.01.016 · Cited by 6
“However, studies investigating the association between GBS and seasonal influenza vaccines after 1976 indicated the risk as very minimal with less than one case per million.(12) Reports of neuropathy have been linked to several other vaccines over the year, including hepatitis B, tetanus-diphtheria-pertussis series, L…”
Chang, Y., Ling, T., Cheng, Y., Sun, C., Wu, J.-L., Tai, C.-H., Wang, J., & Sung, J. (2021) · Vaccines · doi:10.3390/vaccines9030192 · Cited by 6
COVID-19 Vaccination Strategies in the Endemic Period: Lessons from Influenza
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How to respond to flu vaccine doubters
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Guillain-Barré Syndrome and Variants
Davalos, L., Kissel, J. T., Barohn, R. J., & Dimachkie, M. M. (2025) · Neurologic Clinics · doi:10.1016/j.ncl.2025.05.011 · Cited by 5
Human genetics of responses to vaccines
Karp‐Tatham, E., Knight, J. C., & Bolze, A. (2025) · Clinical & Experimental Immunology · doi:10.1093/cei/uxaf034 · Cited by 4
Post COVID-19 Vaccination GBS—Association or Causation?
Jain, R. S., Vyas, A., Sripadma, P. V., & Rao, K. K. (2021) · Annals of Indian Academy of Neurology · doi:10.4103/aian.aian_292_21 · Cited by 4
Jeong, H. S., & Chun, B. C. (2024) · PLoS ONE · doi:10.1371/journal.pone.0297902 · Cited by 4
Wijdicks, E. F. M. (2025) · Oxford University Press eBooks · doi:10.1093/med/9780197544976.003.0045 · Cited by 3
Guillain-Barré syndrome in an older man following influenza vaccination
Finch, N. A., Guarascio, A. J., & Suda, K. J. (2014) · Journal of the American Pharmacists Association · doi:10.1331/japha.2014.13152 · Cited by 3
Harris, T. M., Wong, K. K., Nair, J., Fediurek, J., & Deeks, S. L. (2016) · Canada Communicable Disease Report · doi:10.14745/ccdr.v42i09a04 · Cited by 3
“While the evidence considering influenza vaccination and GBS is inadequate to accept or reject a causal association (35), the absolute risk of approximately one excess case per one million vaccines (36-38) is much lower than that associated with influenza disease (39,40).”
BackgroundGrima, A. A., Kwong, J. C., Richard, L., Reid, J. C., Raphael, J., Basta, N. E., Carignan, A., Top, K. A., Brousseau, N., Blanchette, P., et al. (2024) · Vaccine · doi:10.1016/j.vaccine.2024.01.023 · Cited by 4
The evidence, ethics and politics of mandatory health care worker vaccination
Born, K. B., Ikura, S., & Laupacis, A. (2014) · Journal of Health Services Research & Policy · doi:10.1177/1355819614546960 · Cited by 3
“70 per million vaccinations and is seen in a similar or greater frequency in individuals with influenza.(15,16) There is a disconnection between the evidence supporting the low frequency of serious vaccine side effects and the perceptions of health care workers.”
BackgroundPires, C. M. B. F. (2022) · Biomedical and Biopharmaceutical Research · doi:10.19277/bbr.19.1.279 · Cited by 2
Eiffert, S., Stürmer, T., Thorpe, C. T., Traub, R., Raman, S. R., Pate, V., & Kinlaw, A. C. (2023) · Vaccine · doi:10.1016/j.vaccine.2023.08.014 · Cited by 2
Using Vaccine Safety Data to Demonstrate the Potential of Pooled Data Analysis
Hawken, S., Wilson, L. A., & Wilson, K. R. (2024) · Vaccines · doi:10.3390/vaccines12091052 · Cited by 2
La grippe : mise au point pour les cliniciens
Blot, M., Chavanet, P., & Piroth, L. (2019) · La Revue de Médecine Interne · doi:10.1016/j.revmed.2018.12.010 · Cited by 3
Kroger, A. T., Pickering, L. K., Wharton, M. E., Mawle, A. C., Hinman, A. R., & Orenstein, W. A. (2015) · Elsevier eBooks · doi:10.1016/b978-1-4557-4801-3.00321-0 · Cited by 2
Siddiqi, M., Sardar, S., & Alhatou, M. I. (2023) · Qatar medical journal · doi:10.5339/qmj.2023.16 · Cited by 1
Johnson, M., Windsor, R., Schmidt, J. L., Raczek, D. J., & Moore, G. E. (2025) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.70013 · Cited by 1
Fu, H.-M., Huang, Y., Wang, X., Zhang, Y., Liu, Y., Su, Y., & Pan, L. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2025.1640498 · Cited by 1
Neuromuscular Disorders in Tropical Areas
Mathis, S., Magy, L., & Vallat, J. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-804607-4.00015-0 · Cited by 1
The systematic case-referent method
Grimaldi‐Bensouda, L., & Abenhaim, L. (2018) · Therapies · doi:10.1016/j.therap.2018.09.073 · Cited by 1
Ogawa, M., Takeuchi, Y., Iida, Y., Iwagami, M., Uemura, K., Ono, S., Michihata, N., Koide, D., Matsuyama, Y., & Yasunaga, H. (2025) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.70082 · Cited by 1
“Another self-controlled study in Canada reported an increased risk of Guillain–Barre syndrome after vaccination [12].”
COVID-19 and the peripheral nervous system
Béland, B., Jacob, S. M., Pfeffer, G., & Jewett, G. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-19170-1.00027-9 · Cited by 1
The Care of Patients with Neuromuscular Disease in the Neurocritical Care Unit
Daneshmand, A., & Wijdicks, E. F. M. (2020) · Current clinical neurology · doi:10.1007/978-3-030-36548-6_18 · Cited by 1
Síndrome de Guillain-Barré posterior a vacunación en lactante menor
Cepeda-Bareño, D. F., & Delgado-Serrano, J. (2020) · CES Medicina · doi:10.21615/cesmedicina.34.2.8 · Cited by 1
Papantoniou, M., Kokotis, P., Pitidis-Poutous, D., Tavernarakis, A. G., & Karakalos, D. (2023) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-023-01444-w · Cited by 1
“Moreover, subclinical infections after vaccination cannot be easily differentially diagnosed by opportunistic infections or results of immunization by the vaccine [11, 12].”
Influenza vaccination and Guillain-Barré syndrome
Kwong, J. C., Crowcroft, N. S., Wilson, K. R., McGeer, A., & Deeks, S. L. (2014) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(14)70716-9 · Cited by 1
Influenza vaccination and Guillain-Barré syndrome
Giovanetti, F. (2014) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(14)70714-5
The Hospital for Sick Children Technology Assessment at SickKids (TASK)
Ting, E. E. K., & Ungar, W. J. (2015)
Interpandemic (seasonal) influenza
Venkatesan, S., Cox, R. J., Nguyen‐Van‐Tam, J. S., & Myles, P. R. (2016) · European Respiratory Society eBooks · doi:10.1183/2312508x.10010115
Ting, E. E. K. (2015) · TSpace (University of Toronto)
Hawken, S. (2014) · uO Research (University of Ottawa) · doi:10.20381/ruor-6322
Post-vaccine gbs variant manifesting as polyneuritis cranialis and polyradiculopathy
Hooi, W. F., & Malhotra, A. (2017) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2017-316074.68
Do Vaccines Cause Guillain-Barré Syndrome (GBS)?
Dudley, M. Z., Salmon, D. A., Halsey, N. A., Orenstein, W. A., Limaye, R. J., O’Leary, S. T., & Omer, S. B. (2018) · Springer eBooks · doi:10.1007/978-3-319-94694-8_36
Critical Care Management of Guillain-Barré Syndrome
Витальевна, Б. Е., Попугаев, К. А., Udalov, Y. D., Parinov, O. V., Zabelin, M. V., & Самойлов, А. С. (2019) · Springer eBooks · doi:10.1007/978-981-13-3390-3_4
Metadata
- Authors
- 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., & Deeks, S. L.
- Affiliations
- University Health Network (CA)
- St. Michael's Hospital (CA)
- Institute for Clinical Evaluative Sciences (CA)
- University of Ottawa (CA)
- University of Toronto (CA)
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Kwong, Jeffrey C
- ORCID
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 13
- Issue
- 9
- Pages
- 769-776
- ISSN
- 1473-3099 (ISSN-L)
- OpenAlex
- W2162677016
- Cited by
- 115
- References
- 31
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 14 · 2020: 13 · 2019: 12 · 2018: 6 · 2017: 7 · 2016: 8 · 2015: 11 · 2014: 10 · 2013: 1
- FWCI
- 6.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Ministry of Health and Long-Term Care
- Department of Family and Community Medicine, University of Toronto
- Institute for Clinical Evaluative Sciences
- Canadian Institutes of Health Research
- 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, seasonal influenza vaccination, influenza, vaccine adverse events, hospitalization, attributable risk, Ontario
- MeSH terms
- Adolescent, Adult, Aged, Canada, Female, Hospitalization, Humans, Influenza, Human, Influenza Vaccines, Male, Middle Aged, Risk Factors, Seasons, Vaccination, Vaccines, Inactivated, Incidence, Guillain-Barre Syndrome, Young Adult
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