Presented at the annual AAN conference in Philadelphia, April 30, 2014:
[S34.005] Vaccines and the Risk of Multiple Sclerosis and Other CNS Demyelinating Diseases
Annette Langer-Gould, Lie Chen, Sara Y. Tartof, Chun Chao, Hung-Fu Tseng
Pasadena, CA, USA
OBJECTIVE:
To determine whether vaccines increase the risk of multiple sclerosis (MS) or other CNS demyelinating diseases over the short and longer-term.
BACKGROUND:
Clinicians have reported temporal associations between vaccine administration and onset of MS or other CNS demyelinating diseases. Yet, whether vaccines, particularly for hepatitis B (HepB) and human papilloma virus (HPV), can trigger MS or other CNS demyelinating diseases remains controversial.
DESIGN/METHODS:
We conducted a case-control study from the membership of Kaiser Permanente Southern California (KPSC). Cases were identified through the KPSC Acquired Demyelinating Diseases (ADS) Cohort between 2008 and 2011. Five controls per case were matched on age, sex and zip code. Data were obtained from the complete electronic health record and analyzed using conditional logistic regression, adjusted for race/ethnicity, health care utilization, and infectious illnesses prior to symptom onset.
RESULTS:
We identified 780 incident cases of CNS ADS and 3885 controls, of which 92 cases and 459 controls were women ages 9-26 years, the indicated age rage for HPV vaccination. There were no associations between hepatitis B vaccination (OR 1.12, 95% CI 0.72-1.73); HPV vaccination (OR 1.05 95% CI 0.62-1.78); or any vaccination (OR 1.03, 95% CI 0.86-1.22) and the risk of CNS ADS up to 3 years later.
Vaccination of any type was associated with an increased risk of CNS ADS onset within the first 30 days after vaccination in younger (<50 years) individuals only (OR 2.32, 95%CI 1.18-4.57).
CONCLUSIONS:
We found no longer-term association of vaccines with MS or other CNS demyelinating diseases, which argues against a causal association. The short-term increase in risk suggests vaccines may accelerate the transition from subclinical to overt autoimmunity in patients with existing disease.
Our findings do not suggest a need for change in vaccine policy.
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Study Supported by:
Kaiser Permanente Direct Community Benefit Funds and NIH-NINDS, 1R01NS075308 PI: Langer-Gould)
Category - MS and CNS Inflammatory Disease: Basic Science
S34: Platform Blitz: MS and CNS Inflammatory Disease: Risk Factors for Multiple Sclerosis Disease and Course