Immunization Safety Review: Influenza Vaccines and Neurological Complications


Infection with the influenza virus can have a serious effect on the health of people of all ages, although it is particularly worrisome for infants, the elderly, and people with underlying heart or lung problems.  At least 35,000 people die in the United States every year from influenza infection.  A vaccine exists that can greatly decrease the impact of influenza.  Because the strains of virus that are expected to cause serious illness and death are slightly different every year, the vaccine is also slightly different every year and it must be given every year, unlike other vaccines.  The influenza vaccine that was used in 1976 for the expected Swine Flu epidemic (which never materialized) was associated with cases of a nervous system condition called Guillain-Barre syndrome (GBS).  Ever since that time, public health leaders, doctors and nurses, and the public have wondered whether every year's influenza vaccine can cause GBS or other similar conditions.
The Immunization Safety Review committee reviewed the data on influenza vaccine and neurological conditions and concluded that the evidence favored acceptance of a causal relationship between the 1976 Swine Influenza vaccine and GBS in adults.  The evidence about GBS for influenza vaccines of other years is not clear one way or the other (that is, the evidence is inadequate to accept or reject a causal relationship). 

The committee concluded that the evidence favored rejection of a causal relationship between influenza vaccines and exacerbation of multiple sclerosis.  For the other neurological conditions studied, the committee concluded the evidence about the effects of influenza vaccine is inadequate to accept or reject a causal relationship. The committee also reviewed theories on how the influenza vaccine could damage the nervous system.  The evidence was at most weak that the vaccine could act in humans in ways that could lead to these neurological problems.