title: The risk of systemic lupus erythematosus associated with vaccines: an international case-control study.
abstract: OBJECTIVE
  Studies have suggested that systemic lupus erythematosus (SLE) may be triggered by vaccinations. We undertook this study to investigate the relationship between vaccination and onset of SLE.
  
  
  METHODS
  This international case-control study was conducted between April 2008 and June 2012 in 36 specialist referral centers (34 in France and 2 in Quebec, Canada) and recruited patients ≤60 years old recently diagnosed as having either definite SLE (meeting ≥4 American College of Rheumatology [ACR] criteria including at least 1 immunologic criterion) or probable SLE (meeting 3 ACR criteria including at least 1 immunologic criterion). Controls were recruited from general practice settings through a closely monitored protocol and matched to patients by age, sex, region of residence, and date of recruitment. Vaccinations and other potential risk factors for SLE were assessed using a standardized telephone interview. We compared proportions of patients and controls who were vaccinated 12 and 24 months before the index date (date of first clinical symptom presented by the patient) using odds ratios (ORs) from conditional logistic regression.
  
  
  RESULTS
  We assessed 105 patients (89 with definite SLE and 16 with probable SLE) and 712 controls. Twenty-two of the 105 patients (21.0%) and 181 of the 712 controls (25.4%) had received at least 1 vaccination within 24 months before the index date (adjusted OR 0.9 [95% confidence interval 0.5-1.5]). The proportions of patients and controls vaccinated within the previous 12 months were also similar.
  
  
  CONCLUSIONS
  Our study showed no association between exposure to vaccination and risk of developing SLE.
authors.affiliation: LA-SER and Conservatoire National des Arts et Métiers, Paris, France.
authors.forename: Lamiae
authors.initials: L
authors.lastname: Grimaldi-Bensouda
authors.forename: Veronique
authors.initials: V
authors.lastname: Le Guern
authors.forename: Isabelle
authors.initials: I
authors.lastname: Kone-Paut
authors.forename: Elodie
authors.initials: E
authors.lastname: Aubrun
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
authors.forename: Michel
authors.initials: M
authors.lastname: Ruel
authors.forename: Laurent
authors.initials: L
authors.lastname: Machet
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Viallard
authors.forename: Nadine
authors.initials: N
authors.lastname: Magy-Bertrand
authors.forename: Eric
authors.initials: E
authors.lastname: Daugas
authors.forename: Michel
authors.initials: M
authors.lastname: Rossignol
authors.forename: Lucien
authors.initials: L
authors.lastname: Abenhaim
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costedoat-Chalumeau
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014611:Vaccination / Q000009:adverse effects*; D055815:Young Adult