tetano
Editor, Senior Moderator
CNS Drugs. 2019 Oct 1. doi: 10.1007/s40263-019-00670-y. [Epub ahead of print] [h=1]Do Vaccines Trigger Neurological Diseases? Epidemiological Evaluation of Vaccination and Neurological Diseases Using Examples of Multiple Sclerosis, Guillain-Barr? Syndrome and Narcolepsy.[/h]
Stowe J[SUP]1[/SUP], Andrews N[SUP]2[/SUP], Miller E[SUP]3[/SUP].
[h=3]Author information[/h] 1 Immunisation and Countermeasures, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK. Julia.stowe@phe.gov.uk. 2 Statistics and Modelling Economics Unit, Public Health England, London, NW9 5EQ, UK. 3 Immunisation and Countermeasures, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.
[h=3]Abstract[/h] This article evaluates the epidemiological evidence for a relationship between vaccination and neurological disease, specifically multiple sclerosis, Guillain-Barr? syndrome and narcolepsy. The statistical methods used to test vaccine safety hypotheses are described and the merits of different study designs evaluated; these include the cohort, case-control, case-coverage and the self-controlled case-series methods. For multiple sclerosis, the evidence does not support the hypothesized relationship with hepatitis B vaccine. For Guillain-Barr? syndrome, the evidence suggests a small elevated risk after influenza vaccines, though considerably lower than after natural influenza infection, with no elevated risk after human papilloma virus vaccine. For narcolepsy, there is strong evidence of a causal association with one adjuvanted vaccine used in the 2009/10 influenza pandemic. Rapid investigation of vaccine safety concerns, however biologically implausible, is essential to maintain public and professional confidence in vaccination programmes.
PMID: 31576507 DOI: 10.1007/s40263-019-00670-y
Stowe J[SUP]1[/SUP], Andrews N[SUP]2[/SUP], Miller E[SUP]3[/SUP].
[h=3]Author information[/h] 1 Immunisation and Countermeasures, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK. Julia.stowe@phe.gov.uk. 2 Statistics and Modelling Economics Unit, Public Health England, London, NW9 5EQ, UK. 3 Immunisation and Countermeasures, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.
[h=3]Abstract[/h] This article evaluates the epidemiological evidence for a relationship between vaccination and neurological disease, specifically multiple sclerosis, Guillain-Barr? syndrome and narcolepsy. The statistical methods used to test vaccine safety hypotheses are described and the merits of different study designs evaluated; these include the cohort, case-control, case-coverage and the self-controlled case-series methods. For multiple sclerosis, the evidence does not support the hypothesized relationship with hepatitis B vaccine. For Guillain-Barr? syndrome, the evidence suggests a small elevated risk after influenza vaccines, though considerably lower than after natural influenza infection, with no elevated risk after human papilloma virus vaccine. For narcolepsy, there is strong evidence of a causal association with one adjuvanted vaccine used in the 2009/10 influenza pandemic. Rapid investigation of vaccine safety concerns, however biologically implausible, is essential to maintain public and professional confidence in vaccination programmes.
PMID: 31576507 DOI: 10.1007/s40263-019-00670-y