Abstract
In Reply. —Since we initiated the studies that have now led to a reevaluation of the alleged association of the swine influenza vaccine and Guillain-Barre syndrome (GBS) as reported by the Centers for Disease Control (CDC), 1 Atlanta, we shall reply on behalf of our coauthors of the publications cited by Alvord. 2-4 He has criticized two relatively minor points and has ignored the major arguments in this series of articles, the principal one being that the CDC accepted as GBS the reported cases obtained by nonclinical health officers and their paramedical assistants, without a systematic review of the medical records by clinical neurologists and frequently without any follow-up information. There is now reason to suspect that many of the CDC cases would not meet reasonable diagnostic criteria for GBS; but whether and how the relative risks as reported by the CDC will be affected awaits the reevaluation in which the CDC
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