{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T19:53:57Z","timestamp":1762199637740,"version":"build-2065373602"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002489"],"award-info":[{"award-number":["UL1TR002489"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Some vaccines have a small risk of triggering Guillain\u2013Barr\u00e9 syndrome (GBS), an autoimmune disorder where nerve damage leads to paralysis. There is a CDC precaution for patients whose GBS was associated with an influenza or tetanus toxoid\u2010containing vaccine (GBS occurring within 42\u2009days following vaccination).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We described vaccine patterns before and after a GBS diagnosis with a matched cohort design in a 20% random sample of fee\u2010for\u2010service Medicare enrollees. We defined the index date as an ICD\u20109\u2010CM or ICD\u201010\u2010CM GBS diagnosis code in the primary position of an inpatient claim. We matched each GBS patient to five non\u2010GBS comparators on sex, exact age, racial and ethnic category, state of residence and the month of preventive health visits during baseline; used weighting to balance covariates; and measured frequency of vaccines received per 100 people during year before and after the index date using the weighted mean cumulative count (wMCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 1567 patients with a GBS diagnosis with at least 1\u2009year of prior continuous enrollment in Medicare A and B that matched to five comparators each. The wMCCs in the 1\u2009year before the index date were similar for both groups, with a wMCC of 74 vaccines\/100 people in the GBS group (95% CI 71, 77). Within 1\u2009year after the index date, patients with GBS had received 26 vaccines\/100 people (95% CI 23, 28), which was 41 fewer vaccines than matched non\u2010GBS comparators (95% CI \u221244, \u221238). Among GBS patients, 11% were diagnosed with GBS within 42\u2009days after a vaccine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GBS diagnosis has a strong impact on reducing subsequent vaccination even though there is no warning or precaution about future vaccines for most patients diagnosed with GBS. These data suggest discordance between clinical practice and current vaccine recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19110","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:10:56Z","timestamp":1722557456000},"page":"3055-3067","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vaccine patterns among older adults with Guillain\u2013Barr\u00e9 syndrome and matched comparators, 2006\u20132019"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8612-3807","authenticated-orcid":false,"given":"Samantha R.","family":"Eiffert","sequence":"first","affiliation":[{"name":"Division of Pharmaceutical Outcomes and Policy University of North Carolina School of Pharmacy  Chapel Hill North Carolina 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School of Pharmacy  Chapel Hill North Carolina USA"},{"name":"Center for Health Equity Research and Promotion Veterans Affairs Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-1302","authenticated-orcid":false,"given":"Rebecca","family":"Traub","sequence":"additional","affiliation":[{"name":"Department of Neurology University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-189X","authenticated-orcid":false,"given":"Sudha R.","family":"Raman","sequence":"additional","affiliation":[{"name":"Population Health Sciences Duke University School of Medicine  Durham North Carolina 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