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Vaccinations and risk of central nervous system demyelinating diseases in adults.
Arch Neurol 2003; 60(4):504-9AN

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.

Authors+Show Affiliations

National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. fdestefano@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 -