To the Editor.—There are several omissions in the case report of Guillain-Barré syndrome (GBS) following therapy with mumps-rubella vaccine that was published in the Journal (125:834, 1973) that make the virologic interpretation difficult.
No dates are given for the acute and convalescent sera with respect to the date of immunization.
No rubella antibody titers are given. Since about 7% of recipients of rubella vaccine do not manifest seroconversion, vaccine-rubella infection cannot be assumed in this patient. (Indeed it is noted that he did not develop antibodies to the mumps virus component of the mumps-rubella vaccine.) Without seroconversion, there is little basis for an association of rubella vaccine with the subsequent GBS.
Conversely, very high rubella titers (by hemagglutination-inhibition) in both acute and convalescent sera would suggest an anamnestic antibody response in an immune host. The occurrence of GBS after administration of rubella vaccine in such a patient would be interesting
GROSE C. Guillain-Barré Syndrome. Am J Dis Child. 1974;127(3):444. doi:10.1001/archpedi.1974.02110220142026