Guillain-Barré Syndrome and the 1978–1979 Influenza Vaccine

Abstract
An ongoing surveillance program was intensified to determine whether an increased risk of acquiring vaccine-related Guillain-Barré syndrome (GBS) (similar to that observed after vaccination with the A/New Jersey swine-influenza vaccine in 1976) existed for the approximately 12.5 million adults (≥18 years old) vaccinated in the 1978–1979 influenza campaign. In the contiguous United States (excluding Maryland) 544 cases of GBS with onset between September 1, 1978, and March 31, 1979, were reported, including 12 adults who had been vaccinated within eight weeks before the onset of GBS and 393 who had not. The relative risk of vaccine-associated GBS for adults reported in this surveillance was 1.4 (95 per cent confidence limits, 0.7 to 2.7) — significantly below the risk (6.2) associated with A/New Jersey vaccine for the equivalent eight-week period. In contrast to the A/New Jersey vaccine, the 1978–1979 influenza vaccine was not associated with a statistically significant excess risk of GBS. (N Engl J Med. 1981; 304:1557–61.)