Risk of Guillain–Barré syndrome after meningococcal conjugate vaccination

Velentgas, Priscilla; Amato, Anthony A.; Bohn, Rhonda L.; Chan, K. Arnold; Cochrane, Thomas; Funch, Donnie; Dashevsky, Inna; Duddy, April; Gladowski, Patricia; Greenberg, Steven A.; Kramer, Judith M.; McMahill‐Walraven, Cheryl N.; Nakasato, Cynthia; Spettell, Claire M.; Syat, Beth; Wahl, Peter; Walker, Alexander M.; Zhang, Fang; Brown, Jeffrey S.; Platt, Richard

doi:10.1002/pds.3321

Cited by 40 publications

(18 citation statements)

References 16 publications

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“…A peak in incident cases occurring during late winter and early spring has been reported and might be explained by the seasonality of preceding infections triggering the development of GBS [8,9]. Furthermore, GBS has been suggested as a severe adverse reaction to several vaccines [2,10,11,12,13,14,15,16,17,18,19,20,21]. …”

Section: Introductionmentioning

confidence: 99%

Estimation of Background Incidence Rates of Guillain-Barré Syndrome in Germany - A Retrospective Cohort Study with Electronic Healthcare Data

Hense

Schink²,

Kreisel³

et al. 2014

Neuroepidemiology

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Background: The Guillain-Barré syndrome (GBS) occurs after infections and as an adverse reaction to vaccines. No detailed information on incidence rates (IRs) in Germany is available. Methods: This retrospective cohort study estimated age- and sex-specific IRs of GBS in Germany in the years 2007-2009 based on electronic healthcare data from the German Pharmacoepidemiological Research Database (GePaRD). Two case definitions were applied. GBS cases had a main discharge diagnosis of GBS. GBS_PROCEDURE cases in addition had codes for relevant diagnostic procedures. Crude and standardized IRs (SIRs) with 95% confidence intervals were stratified by year, age group, sex, region and season. IR ratios (IRRs) for each stratification factor were calculated by multivariable Poisson regression. Results: Among 13,297,678 persons, 889 (693) incident GBS (GBS_PROCEDURE) cases were identified. Overall SIRs per 100,000 person years were 2.4 (2.2-2.5) for GBS and 1.8 (1.7-2.0) for GBS_PROCEDURE. (S)IRs increased with age, peaking in the age group 70-79 years (IR GBS: 5.5 (4.7-6.5)) and were higher in males than in females (e.g., IR GBS: IRR = 1.5 (1.3-1.7)) and in February-April, as compared to the rest of the year. No regional pattern was observed. Conclusion: (S)IRs of GBS in Germany differed by age, sex and season and were comparable to those found in other studies. Results might be used as a comparator in vaccine safety monitoring.

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Section: Introductionmentioning

confidence: 99%

Estimation of Background Incidence Rates of Guillain-Barré Syndrome in Germany - A Retrospective Cohort Study with Electronic Healthcare Data

Hense

Schink²,

Kreisel³

et al. 2014

Neuroepidemiology

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“…There is no increased risk of Guillain-Barre syndrome associated with vaccine use, although vigilance for this adverse effect is essential. 20 Immunogenicity studies of MCV4 have shown that it is safe and effective to give concomitantly with other childhood vaccines such as measles, mumps, rubella, varicella and the pneumococcal conjugate vaccine. 21 …”

Section: Meningococcal Vaccines Registered In South Africamentioning

confidence: 99%

Recommendations for the use of meningococcal vaccines in South Africa

Meiring

Hussey

Jeena

et al. 2017

Southern African Journal of Infectious Diseases

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Background: Although meningococcal disease (MD) incidence in South Africa is low, Neisseria meningitidis (NM) causes severe disease that is often life-threatening and can cause long-term disabilities. A quadrivalent protein-conjugated meningococcal vaccine (MCV4) is available, and provides protection against 75% of disease causing serogroups in South Africa. Recommendations: We advise vaccination of persons at high risk of meningococcal disease including those with complement deficiency and asplenia; laboratory personnel from reference laboratories who work with NM; and travellers to Saudi Arabia. The need for routine vaccine against meningococcal disease in South Africa is controversial given the current burden of disease. However, due to the high morbidity/mortality of MD we recommend that clinicians consider vaccination of healthy infants and children; HIV-infected persons with a CD4 count > 25%; students attending college /university /military academies; and miners. Conclusion: Protein-conjugated meningococcal vaccine is preferable to the polysaccharide vaccine given the ability of the protein-conjugated meningococcal vaccine to induce immune memory, allow for booster responses and eliminate carriage of the organism in the person vaccinated.

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“…With the exception of early rabies vaccines, development of GBS following vaccination is extremely rare, indicating that other host-specific factors, including genetic polymorphisms are likely to be important. The risk of developing GBS following immunization with oral polio vaccine [113], Menactra ® (Sanofi Pasteur, Paris, France) meningococcal conjugate vaccine (MCV4) [114], tetanus toxoid containing vaccines [115], yellow fever vaccine (17D-204) [116] or against measles mumps and rubella [117], hepatitis B virus [118,119], H. influenzae type b [120], Japanese encephalitis [120] or small pox [121] is probably very low. Early influenza and rabies vaccines on the other hand have been shown to increase risk and are discussed in more detail below.…”

Section: Vaccinationmentioning

confidence: 99%

Infectious and noninfectious triggers in Guillain–Barré syndrome

Wakerley

Yuki

2013

Expert Review of Clinical Immunology

120

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Guillain-Barré syndrome (GBS) is the commonest cause of acquired flaccid paralysis in the world and regarded by many as the prototype for postinfectious autoimmunity. Here the authors consider both infectious and noninfectious triggers of GBS and determine where possible what immunological mechanisms may account for this association. In approximately two-thirds of cases, an infectious trigger is reported in the weeks that lead up to disease onset, indicating that the host's response to infection must play an important role in disease pathogenesis. The most frequently identified bacteria, Campylobacter jejuni, through a process known as molecular mimicry, has been shown to induce cross-reactive anti-ganglioside antibodies, which can lead to the development of axonal-type GBS in some patients. Whether this paradigm can be extended to other infectious organisms or vaccines remains an important area of research and has public health implications. GBS has also been reported rarely in patients with underlying systemic diseases and immunocompromised states and although the exact mechanism is yet to be established, increased susceptibility to known infectious triggers should be considered most likely.

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Risk of Guillain–Barré syndrome after meningococcal conjugate vaccination

Abstract: Among members of five US health plans, MCV4 vaccination was not associated with increased GBS risk.

Cited by 40 publications

References 16 publications

Estimation of Background Incidence Rates of Guillain-Barré Syndrome in Germany - A Retrospective Cohort Study with Electronic Healthcare Data

Estimation of Background Incidence Rates of Guillain-Barré Syndrome in Germany - A Retrospective Cohort Study with Electronic Healthcare Data

Recommendations for the use of meningococcal vaccines in South Africa

Infectious and noninfectious triggers in Guillain–Barré syndrome

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