Leneman (1966) reviewed the literature prior to 1966 and described 1,100 case reports of GBS published between 1949 and 1966. In five cases, vaccination with IPV was mentioned, although the time interval between vaccination and the onset of GBS was not described. Changes in diagnostic procedures since 1949 might also disqualify some of the cases included in that summary. This secondhand summary of case reports does not supply sufficient information to determine whether IPV is associated with GBS.

In a study in Sweden, which utilized IPV exclusively, Andersen and Eeg-Olofsson (1976) discussed 10 cases of GBS that occurred in 1971 in individuals less than 60 years of age. In nine of the individuals, the onset of GBS occurred more than 1 year after a vaccination with IPV. The authors concluded that there was no association between IPV and GBS.

Data from the MSAEFI noted 14 cases of GBS following OPV administration from 1979 to 1990. In most cases OPV was given in combination with DPT, or MMR, or both. VAERS listed two cases of GBS (submitted between November 1990 and July 1992) following administration of OPV in combination with DPT and either MMR or Hib vaccine.

Controlled Observational Studies

Two controlled studies examined the association between GBS and polio vaccine (Table 7-6).

The first study took place in a southern province of Finland (Uusimaa), where continuing surveillance of GBS from 1981 to 1986 uncovered an increase in the incidence of GBS following a nationwide program of immu-

TABLE 7-6 Reports Associating Guillain-Barré Syndrome with Polio Vaccines

Reference (location)

No. of Cases

Age of Patients (yr)

Time of Onser After Vaccination

Vaccines Given

Andersen and Eeg-Olofsson, 1976 (Sweden)

10

2-53

>1 yr for all except one case

IPV; others not discussed

Kinnunen et al., 1989 (Finland)

10

15-73

<10 wk

OPV alone (nine patients); IPV + OPV (one patient)

Uhari et al., 1989 (Finland)

27

0.4-14.3

<10 wk

Five patients were immunized with OPV



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