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The risk of Guillain-Barré syndrome after tetanus-toxoid-containing vaccines in adults and children in the United States.

J Tuttle, R T Chen, H Rantala, J D Cherry, P H Rhodes and S Hadler

National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

OBJECTIVES: This study examined whether there is a risk that tetanus-toxoid-containing vaccines could cause Guillain-Barré syndrome and, if so, how large the risk is. METHODS: This study was based on previous active surveillance epidemiological studies of Guillain-Barré syndrome and vaccination history. RESULTS: A background rate of 0.3 cases of Guillain-Barré syndrome per million person-weeks has been estimated. By chance, 2.2 people with the syndrome would have received tetanus-toxoid-containing vaccine within the 6 weeks before onset, yet only 1 person had done so. Data on children show similar results. CONCLUSIONS: If an association exists, it must be extremely rare and not of public health significance.

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