Gullian-Barre Syndrome: Causable by every disease/vaccine?

Okay, I realize that cases of Gullian-Barre Syndrome (hereafter GBS, just in case I’m misspelling one of the guys’ names) connectible to the H1N1 vaccine are vanishingly rare. I also know that it’s possible to get GBS, at a much higher rate, from the flu itself.

It’s combining these two facts that is the basis of my GQ.

Given what I know of GBS, I get the impression that any vaccine could cause it. Is this true? Why the specific focus on the H1N1 vaccine? Is it only because of the incident in the Seventies? Is there something unique about flu vaccines that make it more likely to cause GBS? If I’ve had other vaccines before with no difficulty, what does that say, if anything, about my chances of getting it from the current H1N1 vaccine?

For that matter, could any disease cause GBS? Or are some more likely to cause it than others?

Regarding vaccination, several vaccines have been linked to GBS. These include influenza, hepatitis-B, hepatitis-A, and rabies but no others (AFAIK). As you’d expect from the media attention, influenza is the most common of the vaccine causes of GBS.

Here is a link to a recent paper on influenza vaccination and GBS. It is full free-text and has a number of free full-text references.

Here is an abstract (with, unfortunately, no free text link) of a paper looking at all cases of post-vaccination GBS in a given interval. I believe it is the paper most relevant to your question.

Many diseases have been linked to the development of GBS. Here is a reasonable list.

My cousin was afflicted in Dec 08 with GBS. He is a lifelong smoker and was being treated with radiation for prostate cancer at the time. He had a vigorous rehab program and is now back at work.

So no info on whether having those other vaccinations without difficulty says anything about my probable risk with the H1N1/general flu vaccine?

Now that I think about it, is there any research on H1N1 vs. seasonal flu vaccines as far as any differences in GBS risk?

I don’t believe there is any data yet beyond theoretical considerations.

It was speculated that the 1976 vaccine contained something that caused the body to form antibodies not only against the flu, but also against a component of human nerves called GM[sub]1[/sub]. That is to say, vaccination with that vaccine taught your body to “reject” not just that strain of flu, but your nerves as well.

Since a bacteria called Campylobacter jejuni contains something that is similar in structure to GM[sub]1[/sub] and since people infected with C. jejuni have a high rate of GBS (with infection by that germ accounting for about 70 or 80 percent of GBS cases), it was theorized that the 1976 vaccine may have been contaminated with by that bacteria. Turned out not to be the case.

However, even though the 1976 vaccine didn’t contain the culprit bacteria, it did contain something (precisely what is still unknown) that mimics (i.e. immunologically resembles) GM[sub]1[/sub]. So, after being vaccinated with that vaccine (and some others - see this link), people can form antibodies not just again that strain of influenza but also to GM[sub]1[/sub]. In other words, administration of that vaccine causes you to form antibodies against the virus and also against your nerves. When that happens, GBS may result.

As an aside, this notion of “molecular mimicry”, where part of a germ immunologically resembles a part of your body, is felt to underlie the development of many ‘auto-immune’ diseases.

I just noticed that the official fact sheet’s wording on GBS risks differ for the injection vrsion of the vaccine and the nasal spray. Is one “safer” than the other for any reason or any appreciable amount?

May I recommend thisCDC resource to help with your questions?

*"How common is GBS, and how common is it after people are vaccinated for seasonal influenza?
GBS is rare. Each year, about 3,000 to 6,000 people in the United States develop GBS whether or not they received a vaccination – that’s 1 to 2 people out of every 100,000 people. This is referred to as the background rate.

In 1976, there was a small risk of GBS following influenza (swine flu) vaccination (approximately 1 additional case per 100,000 people who received the swine flu vaccine). That number of GBS cases was slightly higher than the background rate for GBS. Since then, numerous studies have been done to evaluate if other flu vaccines were associated with GBS. In most studies, no association was found, but two studies suggested that approximately 1 additional person out of 1 million vaccinated people may be at risk for GBS associated with the seasonal influenza vaccine. It is important to keep in mind that severe illness and possible death can be associated with influenza, and vaccination is the best way to prevent influenza infection and its complications.

What happened in 1976 with GBS and the swine flu vaccine?
Scientists first reported a suspected link between GBS and vaccinations in 1976, during a national campaign to vaccinate people against a swine flu virus. The investigation found that vaccine recipients had a higher risk for GBS than those who were not vaccinated (about 1 additional case occurred per 100,000 people vaccinated). Given this association, and the fact that the swine flu disease was limited, the vaccination program was stopped.
Since then, numerous studies have been done to evaluate if other flu vaccines were associated with GBS. In most studies, no association was found, but two studies suggested that approximately 1 additional person out of 1 million vaccinated people may be at risk for GBS associated with the seasonal influenza vaccine.

Why did some people develop GBS after they received the 1976 swine flu vaccine?
The Institute of Medicine (IOM) conducted a thorough scientific review in 2003 and concluded that people who received the 1976 swine influenza vaccine had a slight increased risk for developing GBS. Scientists have multiple theories on why this increased risk may have occurred, but the exact reason for this association remains unknown.

Do you expect that the 2009 H1N1 vaccine will be associated with GBS?
We expect the 2009 H1N1 vaccine to have a similar safety profile as seasonal flu vaccines, which have very good safety track records. The seasonal influenza vaccine has not been consistently associated with GBS."*

In short, we don’t have any robust clusters or overall increase in incidence of GBS right now associated with H1N1 or its vaccine, but it’s not out of the question there will be. My own bias is that if the vaccine increases the incidence, it’s likely the native disease will as well, so it’s not much of a reason to avoid the vaccine.

Here is a link to an abstract talking about the incidence of post-influenza GBS at a French reference center over the period of 1996-2004.

Of course the medical profession and the vaccine industry keep all complications under the radar as part of their overall conspiracy :wink:

Hmm. So is there any reason why the verbiage for the nasal spray is different?

KarlGauss: I reread the abstract in your second link, and it mentions that the vast majority of cases happen within six weeks. Is that where the number for the time limitation I’ve seen mentioned to officially tie the vaccination to GBS comes from? And do you happen to know more specific times for the “within six weeks” timeframe? Or have you not seen the actual paper yourself?

And finally, also to KarlGauss, would your reply in post 5 cover both questions you quote?