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November 1985

The Swine Influenza Vaccination Controversy

Arch Neurol. 1985;42(11):1092. doi:10.1001/archneur.1985.04060100078028

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Although the contributors to this controversy arrive at disparate conclusions, they depart from common premises as follows: (1) Guillain-Barré syndrome (GBS) can sometimes follow vaccination, (2) epidemiologic data can suggest, but not prove, causality, and (3) the data on which their respective views are based are incomplete and probably biased.

In 1976, health planners were faced with a thankless dilemma: either undertake massive vaccination and accept the small but definite risk of complications or be less vigorous and shoulder the consequences if an influenza epidemic struck. The possibility of an influenza epidemic was so highly publicized, that when it did not materialize it was natural that attention would focus on the apparent excess of cases with GBS. Given that one finds what one looks for and GBS was sought most assiduously among the vaccinated, it is likely that GBS was overreported.

The core of the controversy centers around the question

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