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Vaccinations and risk of central nervous system demyelinating diseases in adults.

Abstract

BACKGROUND

Several case reports of the onset or exacerbation of multiple sclerosis or other demyelinating conditions shortly after vaccination have suggested that vaccines may increase the risk of demyelinating diseases.

OBJECTIVE

To evaluate the association between vaccination and onset of multiple sclerosis or optic neuritis.

DESIGN

Case-control study involving cases of multiple sclerosis or optic neuritis among adults 18 to 49 years of age. Data on vaccinations and other risk factors were obtained from computerized and paper medical records and from telephone interviews.

SETTING

Three health maintenance organizations.

PARTICIPANTS

Four hundred forty case subjects and 950 control subjects matched on health maintenance organization, sex, and date of birth.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Onset of first symptoms of demyelinating disease at any time after vaccination and during specified intervals after vaccination (<1 year, 1-5 years, and >5 years).

RESULTS

Cases and controls had similar vaccination histories. The odds ratios (95% confidence intervals), adjusted for potential confounding variables, of the associations between ever having been vaccinated and risk of demyelinating disease (multiple sclerosis and optic neuritis combined) were 0.9 (0.6-1.5) for hepatitis B vaccine; 0.6 (0.4-0.8) for tetanus vaccination; 0.8 (0.6-1.2) for influenza vaccine; 0.8 (0.5-1.5) for measles, mumps, rubella vaccine; 0.9 (0.5-1.4) for measles vaccine; and 0.7 (0.4-1.0) for rubella vaccine. The results were similar when multiple sclerosis and optic neuritis were analyzed separately. There was no increased risk according to timing of vaccination.

CONCLUSION

Vaccination against hepatitis B, influenza, tetanus, measles, or rubella is not associated with an increased risk of multiple sclerosis or optic neuritis.

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  • Authors+Show Affiliations

    ,

    National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. fdestefano@cdc.gov

    , , , , , , , , ,

    Source

    Archives of neurology 60:4 2003 Apr pg 504-9

    MeSH

    Adolescent
    Adult
    Case-Control Studies
    Female
    Health Maintenance Organizations
    Hepatitis B Vaccines
    Humans
    Influenza Vaccines
    Logistic Models
    Male
    Measles Vaccine
    Measles-Mumps-Rubella Vaccine
    Multiple Sclerosis
    Odds Ratio
    Optic Neuritis
    Risk Assessment
    Risk Factors
    Rubella Vaccine
    Tetanus Toxoid
    Time Factors
    United States
    Vaccines

    Pub Type(s)

    Journal Article
    Multicenter Study

    Language

    eng

    PubMed ID

    12707063

    Citation

    DeStefano, Frank, et al. "Vaccinations and Risk of Central Nervous System Demyelinating Diseases in Adults." Archives of Neurology, vol. 60, no. 4, 2003, pp. 504-9.
    DeStefano F, Verstraeten T, Jackson LA, et al. Vaccinations and risk of central nervous system demyelinating diseases in adults. Arch Neurol. 2003;60(4):504-9.
    DeStefano, F., Verstraeten, T., Jackson, L. A., Okoro, C. A., Benson, P., Black, S. B., ... Chen, R. T. (2003). Vaccinations and risk of central nervous system demyelinating diseases in adults. Archives of Neurology, 60(4), pp. 504-9.
    DeStefano F, et al. Vaccinations and Risk of Central Nervous System Demyelinating Diseases in Adults. Arch Neurol. 2003;60(4):504-9. PubMed PMID: 12707063.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vaccinations and risk of central nervous system demyelinating diseases in adults. AU - DeStefano,Frank, AU - Verstraeten,Thomas, AU - Jackson,Lisa A, AU - Okoro,Catherine A, AU - Benson,Patti, AU - Black,Steven B, AU - Shinefield,Henry R, AU - Mullooly,John P, AU - Likosky,William, AU - Chen,Robert T, AU - ,, PY - 2003/4/23/pubmed PY - 2003/5/8/medline PY - 2003/4/23/entrez SP - 504 EP - 9 JF - Archives of neurology JO - Arch. Neurol. VL - 60 IS - 4 N2 - BACKGROUND: Several case reports of the onset or exacerbation of multiple sclerosis or other demyelinating conditions shortly after vaccination have suggested that vaccines may increase the risk of demyelinating diseases. OBJECTIVE: To evaluate the association between vaccination and onset of multiple sclerosis or optic neuritis. DESIGN: Case-control study involving cases of multiple sclerosis or optic neuritis among adults 18 to 49 years of age. Data on vaccinations and other risk factors were obtained from computerized and paper medical records and from telephone interviews. SETTING: Three health maintenance organizations. PARTICIPANTS: Four hundred forty case subjects and 950 control subjects matched on health maintenance organization, sex, and date of birth. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Onset of first symptoms of demyelinating disease at any time after vaccination and during specified intervals after vaccination (<1 year, 1-5 years, and >5 years). RESULTS: Cases and controls had similar vaccination histories. The odds ratios (95% confidence intervals), adjusted for potential confounding variables, of the associations between ever having been vaccinated and risk of demyelinating disease (multiple sclerosis and optic neuritis combined) were 0.9 (0.6-1.5) for hepatitis B vaccine; 0.6 (0.4-0.8) for tetanus vaccination; 0.8 (0.6-1.2) for influenza vaccine; 0.8 (0.5-1.5) for measles, mumps, rubella vaccine; 0.9 (0.5-1.4) for measles vaccine; and 0.7 (0.4-1.0) for rubella vaccine. The results were similar when multiple sclerosis and optic neuritis were analyzed separately. There was no increased risk according to timing of vaccination. CONCLUSION: Vaccination against hepatitis B, influenza, tetanus, measles, or rubella is not associated with an increased risk of multiple sclerosis or optic neuritis. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/12707063/full_citation L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/vol/60/pg/504 DB - PRIME DP - Unbound Medicine ER -