The Centers for Disease Control and Prevention (CDC) recommend vaccination as the first step to reduce the risk of infection with seasonal and pandemic flu. In very rare cases, influenza vaccines are associated with serious neurological side effects. All of the syndromes identified involve an interaction between the flu vaccine and the immune system.
Guillain-Barre Syndrome
Guillain-Barre syndrome (GBS) is an autoimmune disorder in which the body manufactures antibodies against sites on the peripheral nerves. According to the National Institute of Neurological Disorders and Stroke, initial symptoms of GBS include muscle weakness and tingling that begins in the legs and progressively moves up the body. In severe cases, a person may be completely paralyzed and require a ventilator to breathe, due to paralysis of the diaphragm. In 90 percent of patients, symptoms peak at approximately three weeks. Between five percent and six percent of people with GBS die. Among those who survive, recovery is prolonged; 30 percent of patients still report residual weakness three years after infection. GBS is usually related to bacterial infection with Campylobacter jejuni. However, one in 1 million people who received a swine flu vaccine in 1976 and seasonal flu vaccine between 1992 and 1994 also developed the disease.
Giant Cell Arteritis
According to a 2002 article in, "Current Opinions in Neurology," giant cell arteritis (GCE) due to influenza vaccination was first described in 2000. GCE, also known as "temporal arteritis" or "cranial arteritis," presents with symptoms including new, severe headaches, visual disturbances, jaw and tongue pain associated with swallowing, and tenderness in the visible arteries across the forehead. In most cases, symptoms have resolved with prolonged steroid treatment (up to three years). Few cases have been reported, and the CDC does not include warnings about GCE in its patient information for flu vaccine.
Optic Neuritis
Optic Neuritis (ON) consists of eye pain and vision loss that affects one or both eyes. According to a 2008 article in the Journal of Clinical Neuroscience, cases of ON following vaccination with inactivated-virus vaccine were reported in 1996, 1997, 1998 and 2004. The patient in 1996 experienced a resolution of symptoms, only to have them recur with re-vaccination in 1997. The link is still considered inconclusive, and the CDC website does not list ON among the complications of influenza vaccination.
Acute Disseminated Encephalomyelitis
Acute Disseminated Encephalomyelitis (ADE) presents with simultaneous onset of fever motor weakness, increased or decreased reflexes, vision changes, impaired balance, loss of ability to read or write, problems remembering words and other symptoms. Symptoms usually onset abruptly within at least three months of receiving the vaccine. The fever resolves, but the neurological deficits may persist for months or years and resolve spontaneously, or after steroid treatment. According to a 2008 article in the Journal of Clinical Neuroscience, ADE is more common in children than adults and has been associated with vaccines for rabies, diphtheria, polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza and hepatitis B, as well as flu. ADE is extremely rare. ADE and vaccine administration are correlated, but evidence of causation is lacking.
References
- National Institute of Neurological Disorders and Stroke: Guillian-Barre
- Current Opinions in Neurology; Neurological Adverse Events Associated with Vaccination; S Piyasirisilp, T Hemachudha; June 15 2002
- Journal of Clinical Neuroscience; Post-Vaccination Encephalomyelitis: Literature Review and Illustrative Case; W Huynh, DJ Cordato, E Kehdi, LT Masters, C Dedousis; 2008
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