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Volume 21, Number 2—February 2015

Simulation Study of the Effect of Influenza and Influenza Vaccination on Risk of Acquiring Guillain-Barré Syndrome

Steven Hawken, Jeffrey C. Kwong, Shelley L. Deeks, Natasha S. Crowcroft, Allison McGeer, Robin Ducharme, Michael A. Campitelli, Doug Coyle, and Kumanan WilsonComments to Author 
Author affiliations: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (S. Hawken, J.C. Kwong, R. Ducharme, M.A. Campitelli, K. Wilson); Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (S. Hawken, R. Ducharme, K. Wilson); University of Ottawa, Ottawa (S. Hawken, D. Coyle, K. Wilson); Public Health Ontario, Toronto (J.C. Kwong, S.L. Deeks, N.S. Crowcroft); Dalla Lana School of Public Health, University of Toronto, Toronto (J.C. Kwong, S.L. Deeks, N.S. Crowcroft, A.J. McGeer); University of Toronto, Toronto (J.C. Kwong, N.S. Crowcroft, A.J. McGeer)

Main Article

Table 1

Decision tree model inputs in a simulated study of the effect of influenza and influenza vaccination on the risk of acquiring GBS*

Parameter Expected value (95% CI) Range of values modeled in sensitivity analyses References†
Relative risk for GBS from influenza vaccination
1.52 (1.17–1.99)
(11), online Technical Appendix Table 1
Relative risk for GBS from influenza illness
15.81 (10.28–24.32)
(11), online Technical Appendix Table 1
Joint risk of influenza vaccination and influenza illness
17.33 (additive)
15.81 (subadditive) to 24.03 (multiplicative)
No available data
GBS incidence rate
0.45–3.72 cases/100,000 person years‡
0.45 in youngest girls to 3.72 in oldest men
Influenza illness incidence rate
10% (base case)
See online Technical Appendix Table 2
Vaccine effectiveness 20%–80% (3, 2527)
<65 y of age 0.61 (0.30–0.52)
>65 y of age 0.50 (0.27–0.91)

*GBS, Guillain-Barré syndrome.
†The online Technical Appendix is available at
‡Depending on age and sex.

Main Article

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Page created: January 20, 2015
Page updated: January 20, 2015
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