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


METHODS
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.


METHODS
Three health maintenance organizations.


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


METHODS
None.


METHODS
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.


CONCLUSIONS
Vaccination against hepatitis B, influenza, tetanus, measles, or rubella is not associated with an increased risk of multiple sclerosis or optic neuritis.
DeStefano
Frank
F
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. fdestefano@cdc.gov
Verstraeten
Thomas
T
Jackson
Lisa A
LA
Okoro
Catherine A
CA
Benson
Patti
P
Black
Steven B
SB
Shinefield
Henry R
HR
Mullooly
John P
JP
Likosky
William
W
Chen
Robert T
RT
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006279:Health Maintenance Organizations; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects; D009103:Multiple Sclerosis / Q000139:chemically induced / Q000276:immunology*; D016017:Odds Ratio; D009902:Optic Neuritis / Q000139:chemically induced / Q000276:immunology*; D018570:Risk Assessment; D012307:Risk Factors; D012411:Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects; D013745:Tetanus Toxoid / Q000008:administration & dosage / Q000009:adverse effects; D013997:Time Factors; D014481:United States; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*
D017325:Hepatitis B Vaccines; D007252:Influenza Vaccines; D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D012411:Rubella Vaccine; D013745:Tetanus Toxoid; D014612:Vaccines