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Swine Influenza Vaccine and Guillain-Barré Syndrome: Lies, Damn Lies, and...

Ellsworth C. Alvord, Jr, MD
Arch Neurol. 1986;43(10):979-979. doi:10.1001/archneur.1986.00520100005002
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To the Editor.  —With the increasing effort to apply the scientific method in Medicine, it was surprising to see a classic example of comparisons of apples and oranges in the recent articles on the Guillain-Barré syndrome (GBS) by Beghi et al1 and Kurland et al.2The unnumbered figure on page 10561 in Beghi and coworker's article shows what happens when the nationwide attributed risk for GBS following swine influenza vaccination as reported by Schonberger et al3 is compared with (1) the nationwide weekly incidence rate also reported by Schonberger et al,3 (2) the Michigan rate reported by Breman and Hayner,4 and (3) the Olmsted County, Minnesota, rate reported by Beghi et al.1Since one of the basic tenets of statistics maintains that the information concerning the "experimental" and "control" populations should be gathered simultaneously, preferably by blind observers unbiased toward the outcome, it

REFERENCES

Beghi E, Kurland LT, Mulder DW, et al:  Guillain-Barré syndrome: Clinicoepidemiologic features and effect of influenza vaccine . Arch Neurol 1985;;42:1053-1057.
Kurland LT, Wiederholt WC, Kirkpatrick JW, et al:  Swine influenza vaccine and Guillain-Barré syndrome: Epidemic or artifact? Arch Neurol 1985;;42:1089-1090.
Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, et al:  Guillain-Barré syndrome following vaccination in the National Influenza Immunization Program, United States, 1976-1977 . Am J Epidemiol 1979;;110:105-123.
Breman JG, Hayner NS:  Guillain-Barré syndrome and its relationship to swine influenza vaccination in Michigan, 1976-1977 . Am J Epidemiol 1984;;119:880-889.
Ziegler DW, Gardner JJ, Warfield DT, et al:  Experimental allergic neuritis-like disease in rabbits after injection with influenza vaccine mixed with gangliosides and adjuvants . Infect Immun 1983;;42:824-830.
Jahnke U, Fischer EH, Alvord EC Jr:  Sequence homology between certain viral proteins and proteins related to encephalomyelitis and neuritis . Science 1985;;229:282-284.
Alvord EC Jr, Kornfeld M, Farmer PM, et al:  Neuroptic myelitis following swine flu immunization . J Neuropathol Exp Neurol 1984;;43:294.
Alvord EC Jr:  Disseminated encephalomyelitis: Its variations in form and their relationships to other diseases of the nervous system , in Vinken PJ, Bruyn GW, Klawans HL (eds): Handbook of Clinical Neurology . New York, Elsevier Science Publishing Co Inc, 1985;, vol 3, pp 467-502.

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Beghi E, Kurland LT, Mulder DW, et al:  Guillain-Barré syndrome: Clinicoepidemiologic features and effect of influenza vaccine . Arch Neurol 1985;;42:1053-1057.
Kurland LT, Wiederholt WC, Kirkpatrick JW, et al:  Swine influenza vaccine and Guillain-Barré syndrome: Epidemic or artifact? Arch Neurol 1985;;42:1089-1090.
Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, et al:  Guillain-Barré syndrome following vaccination in the National Influenza Immunization Program, United States, 1976-1977 . Am J Epidemiol 1979;;110:105-123.
Breman JG, Hayner NS:  Guillain-Barré syndrome and its relationship to swine influenza vaccination in Michigan, 1976-1977 . Am J Epidemiol 1984;;119:880-889.
Ziegler DW, Gardner JJ, Warfield DT, et al:  Experimental allergic neuritis-like disease in rabbits after injection with influenza vaccine mixed with gangliosides and adjuvants . Infect Immun 1983;;42:824-830.
Jahnke U, Fischer EH, Alvord EC Jr:  Sequence homology between certain viral proteins and proteins related to encephalomyelitis and neuritis . Science 1985;;229:282-284.
Alvord EC Jr, Kornfeld M, Farmer PM, et al:  Neuroptic myelitis following swine flu immunization . J Neuropathol Exp Neurol 1984;;43:294.
Alvord EC Jr:  Disseminated encephalomyelitis: Its variations in form and their relationships to other diseases of the nervous system , in Vinken PJ, Bruyn GW, Klawans HL (eds): Handbook of Clinical Neurology . New York, Elsevier Science Publishing Co Inc, 1985;, vol 3, pp 467-502.

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