tetano
Editor, Senior Moderator
PLoS One. 2014 Sep 29;9(9):e108489. doi: 10.1371/journal.pone.0108489. eCollection 2014.
Risk of Narcolepsy Associated with Inactivated Adjuvanted (AS03) A/H1N1 (2009) Pandemic Influenza Vaccine in Quebec.
Montplaisir J1, Petit D2, Quinn MJ2, Ouakki M3, Deceuninck G4, Desautels A5, Mignot E6, De Wals P7.
Author information
Abstract
CONTEXT:
An association between an adjuvanted (AS03) A/H1N1 pandemic vaccine and narcolepsy has been reported in Europe.
OBJECTIVE:
To assess narcolepsy risk following administration of a similar vaccine in Quebec.
DESIGN:
Retrospective population-based study.
SETTING:
Neurologists and lung specialists in the province were invited to report narcolepsy cases to a single reference centre.
POPULATION:
Patients were interviewed by two sleep experts and standard diagnostic tests were performed. Immunization status was verified in the provincial pandemic influenza vaccination registry.
MAIN OUTCOME MEASURES:
Confirmed narcolepsy with or without cataplexy with onset of excessive daytime sleepiness between January 1st, 2009, and December 31st, 2010. Relative risks (RRs) were calculated using a Poisson model in a cohort analysis, by a self-controlled case series (SCCS) and a case-control method.
RESULTS:
A total of 24 cases were included and overall incidence rate was 1.5 per million person-years. A cluster of 7 cases was observed among vaccinated persons in the winter 2009-2010. In the primary cohort analysis, 16-week post-vaccination RR was 4.32 (95% CI: 1.50-11.12). RR was 2.07 (0.70-6.17) in the SCCS, and 1.48 (0.37-7.03) using the case-control method. Estimates were lower when observation was restricted to the period of pandemic influenza circulation, and tended to be higher in persons <20 years old and for cataplexy cases.
CONCLUSIONS:
Results are compatible with an excess risk of approximately one case per million vaccine doses, mainly in persons less than 20 years of age. However, a confounding effect of the influenza infection cannot be ruled out.
PMID:
25264897
[PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/25264897
Risk of Narcolepsy Associated with Inactivated Adjuvanted (AS03) A/H1N1 (2009) Pandemic Influenza Vaccine in Quebec.
Montplaisir J1, Petit D2, Quinn MJ2, Ouakki M3, Deceuninck G4, Desautels A5, Mignot E6, De Wals P7.
Author information
Abstract
CONTEXT:
An association between an adjuvanted (AS03) A/H1N1 pandemic vaccine and narcolepsy has been reported in Europe.
OBJECTIVE:
To assess narcolepsy risk following administration of a similar vaccine in Quebec.
DESIGN:
Retrospective population-based study.
SETTING:
Neurologists and lung specialists in the province were invited to report narcolepsy cases to a single reference centre.
POPULATION:
Patients were interviewed by two sleep experts and standard diagnostic tests were performed. Immunization status was verified in the provincial pandemic influenza vaccination registry.
MAIN OUTCOME MEASURES:
Confirmed narcolepsy with or without cataplexy with onset of excessive daytime sleepiness between January 1st, 2009, and December 31st, 2010. Relative risks (RRs) were calculated using a Poisson model in a cohort analysis, by a self-controlled case series (SCCS) and a case-control method.
RESULTS:
A total of 24 cases were included and overall incidence rate was 1.5 per million person-years. A cluster of 7 cases was observed among vaccinated persons in the winter 2009-2010. In the primary cohort analysis, 16-week post-vaccination RR was 4.32 (95% CI: 1.50-11.12). RR was 2.07 (0.70-6.17) in the SCCS, and 1.48 (0.37-7.03) using the case-control method. Estimates were lower when observation was restricted to the period of pandemic influenza circulation, and tended to be higher in persons <20 years old and for cataplexy cases.
CONCLUSIONS:
Results are compatible with an excess risk of approximately one case per million vaccine doses, mainly in persons less than 20 years of age. However, a confounding effect of the influenza infection cannot be ruled out.
PMID:
25264897
[PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/25264897