The committee concludes that the evidence favors acceptance of a causal relationship between 1976 swine influenza vaccine and Guillain-Barré syndrome in adults.

The committee concludes that the evidence is inadequate to accept or reject a causal relationship between GBS in adults and influenza vaccines administered after 1976 (that is, subsequent to the swine influenza vaccine program).

The committee concludes that the evidence favors rejection of a causal relationship between influenza vaccines and relapse of multiple sclerosis in adults.

The committee concludes that the evidence is inadequate to accept or reject a causal relationship between influenza vaccines and incident MS in adults.

The committee concludes that the evidence is inadequate to accept or reject a causal relationship between influenza vaccines and optic neuritis in adults.

The committee concludes that the evidence is inadequate to accept or reject a causal relationship between influenza vaccines and other demyelinating neurological disorders.

The committee concludes that there is no evidence bearing on a causal relationship between influenza vaccines and demyelinating neurological disorders in children aged 6-23 months.

The committee concludes that there is weak evidence for biological mechanisms related to immune-mediated processes, including molecular mimicry and bystander activation, by which receipt of any influenza vaccine could possibly influence an individual’s risk of developing the neurological complications of GBS, MS, or other demyelinating conditions such as optic neuritis.

In the absence of experimental or human evidence regarding the direct neurotoxic effect of influenza vaccines, the committee concludes that this mechanism is only theoretical.

The committee does not recommend a policy review of the recommendations for influenza vaccination by any of the national or federal vaccine advisory bodies on the basis of concerns about neurological complications. Current and