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dc.contributor.authorGreene, Sharon K.en_US
dc.contributor.authorRett, Melisa D.en_US
dc.contributor.authorVellozzi, Claudiaen_US
dc.contributor.authorLi, Linglingen_US
dc.contributor.authorKulldorff, Martinen_US
dc.contributor.authorMarcy, S. Michaelen_US
dc.contributor.authorDaley, Matthew F.en_US
dc.contributor.authorBelongia, Edward A.en_US
dc.contributor.authorBaxter, Rogeren_US
dc.contributor.authorFireman, Bruce H.en_US
dc.contributor.authorJackson, Michael L.en_US
dc.contributor.authorOmer, Saad B.en_US
dc.contributor.authorNordin, James D.en_US
dc.contributor.authorJin, Roberten_US
dc.contributor.authorWeintraub, Eric S.en_US
dc.contributor.authorVijayadeva, Vinuthaen_US
dc.contributor.authorLee, Grace M.en_US
dc.date.accessioned2014-02-18T18:10:49Z
dc.date.issued2013en_US
dc.identifier.citationGreene, S. K., M. D. Rett, C. Vellozzi, L. Li, M. Kulldorff, S. M. Marcy, M. F. Daley, et al. 2013. “Guillain-Barré Syndrome, Influenza Vaccination, and Antecedent Respiratory and Gastrointestinal Infections: A Case-Centered Analysis in the Vaccine Safety Datalink, 2009–2011.” PLoS ONE 8 (6): e67185. doi:10.1371/journal.pone.0067185. http://dx.doi.org/10.1371/journal.pone.0067185.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:11717521
dc.description.abstractBackground: Guillain-Barré Syndrome (GBS) can be triggered by gastrointestinal or respiratory infections, including influenza. During the 2009 influenza A (H1N1) pandemic in the United States, monovalent inactivated influenza vaccine (MIV) availability coincided with high rates of wildtype influenza infections. Several prior studies suggested an elevated GBS risk following MIV, but adjustment for antecedent infection was limited. Methods: We identified patients enrolled in health plans participating in the Vaccine Safety Datalink and diagnosed with GBS from July 2009 through June 2011. Medical records of GBS cases with 2009–10 MIV, 2010–11 trivalent inactivated influenza vaccine (TIV), and/or a medically-attended respiratory or gastrointestinal infection in the 1 through 141 days prior to GBS diagnosis were reviewed and classified according to Brighton Collaboration criteria for diagnostic certainty. Using a case-centered design, logistic regression models adjusted for patient-level time-varying sources of confounding, including seasonal vaccinations and infections in GBS cases and population-level controls. Results: Eighteen confirmed GBS cases received vaccination in the 6 weeks preceding onset, among 1.27 million 2009–10 MIV recipients and 2.80 million 2010–11 TIV recipients. Forty-four confirmed GBS cases had infection in the 6 weeks preceding onset, among 3.77 million patients diagnosed with medically-attended infection. The observed-versus-expected odds that 2009–10 MIV/2010–11 TIV was received in the 6 weeks preceding GBS onset was odds ratio = 1.54, 95% confidence interval (CI), 0.59–3.99; risk difference = 0.93 per million doses, 95% CI, −0.71–5.16. The association between GBS and medically-attended infection was: odds ratio = 7.73, 95% CI, 3.60–16.61; risk difference = 11.62 per million infected patients, 95% CI, 4.49–26.94. These findings were consistent in sensitivity analyses using alternative infection definitions and risk intervals for prior vaccination shorter than 6 weeks. Conclusions: After adjusting for antecedent infections, we found no evidence for an elevated GBS risk following 2009–10 MIV/2010–11 TIV influenza vaccines. However, the association between GBS and antecedent infection was strongly elevated.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0067185en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694016/pdf/en
dash.licenseLAAen_US
dc.subjectBiologyen
dc.subjectPopulation Biologyen
dc.subjectEpidemiologyen
dc.subjectInfectious Disease Epidemiologyen
dc.subjectMedicineen
dc.subjectAnatomy and Physiologyen
dc.subjectNeurological Systemen
dc.subjectClinical Immunologyen
dc.subjectImmunityen
dc.subjectVaccinationen
dc.subjectVaccinesen
dc.subjectDrugs and Devicesen
dc.subjectAdverse Reactionsen
dc.subjectPharmacoepidemiologyen
dc.subjectEpidemiological Methodsen
dc.subjectInfectious Diseasesen
dc.subjectViral Diseasesen
dc.subjectInfluenzaen
dc.subjectGastrointestinal Infectionsen
dc.subjectNeurologyen
dc.subjectDemyelinating Disordersen
dc.subjectPublic Healthen
dc.subjectImmunizationsen
dc.subjectPulmonologyen
dc.subjectRespiratory Infectionsen
dc.titleGuillain-Barré Syndrome, Influenza Vaccination, and Antecedent Respiratory and Gastrointestinal Infections: A Case-Centered Analysis in the Vaccine Safety Datalink, 2009–2011en
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorRett, Melisa D.en_US
dc.date.available2014-02-18T18:10:49Z
dc.identifier.doi10.1371/journal.pone.0067185*
dash.authorsorderedfalse
dash.contributor.affiliatedRett, Melisa D.
dash.contributor.affiliatedLee, Grace
dash.contributor.affiliatedLi, Lingling
dash.contributor.affiliatedKulldorff, Martin


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