Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States
OBJECTIVE:To assess the occurrence of narcolepsy after influenza vaccines used in the United States that contained the influenza A(H1N1)pdm09 virus strain. METHODS:A population-based cohort study in the Vaccine Safety Datalink with an annual population of more than 8.5 million people. All persons yo...
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| Veröffentlicht in: | Neurology 2014-11, Vol.83 (20), p.1823-1830 |
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| creator | Duffy, Jonathan Weintraub, Eric Vellozzi, Claudia DeStefano, Frank |
| description | OBJECTIVE:To assess the occurrence of narcolepsy after influenza vaccines used in the United States that contained the influenza A(H1N1)pdm09 virus strain.
METHODS:A population-based cohort study in the Vaccine Safety Datalink with an annual population of more than 8.5 million people. All persons younger than 30 years who received a 2009 pandemic or a 2010–2011 seasonal influenza vaccine were identified. Their medical visit history was searched for a first-ever occurrence of an ICD-9 narcolepsy diagnosis code through the end of 2011. Chart review was done to confirm the diagnosis and determine the date of symptom onset. Cases were patients who met the International Classification of Sleep Disorders, 2nd edition, narcolepsy diagnostic criteria. We compared the observed number of cases after vaccination to the number expected to occur by chance alone.
RESULTS:The number vaccinated with 2009 pandemic vaccine was 650,995 and with 2010–2011 seasonal vaccine was 870,530. Among these patients, 70 had a first-ever narcolepsy diagnosis code after vaccination, of which 16 had a chart-confirmed incident diagnosis of narcolepsy. None had their symptom onset during the 180 days after receipt of a 2009 pandemic vaccine compared with 6.52 expected, and 2 had onset after a 2010–2011 seasonal vaccine compared with 8.83 expected.
CONCLUSIONS:Influenza vaccines containing the A(H1N1)pdm09 virus strain used in the United States were not associated with an increased risk of narcolepsy. Vaccination with the influenza A(H1N1)pdm09 vaccine viral antigens does not appear to be sufficient by itself to increase the incidence of narcolepsy in a population. |
| doi_str_mv | 10.1212/WNL.0000000000000987 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6563919</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>25320099</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5207-2e0727edc08e735937f9af6c5c66149d878fb4359009381fbf07aea76a6ea88e3</originalsourceid><addsrcrecordid>eNp9UE1PGzEQtSqqEkL_QYV8QYLDUtub9ccFCSFokKJwKKi9WRNnTNxuvJG9AYVfX6MApRw6F0vzPub5EfKFsxMuuPj6Yzo5YW_HaPWBDHgjZCVr8XOHDBgTuqq10rtkL-dfjBVQmU9kVzS1KAIzINdTSK5rcZU3FOKchujbNcZHoGdHYz7lx3RV1rgMjj4p6D04FyL0oYuFS_sF0tsYepzT7z30mPfJRw9txs_P75DcXl7cnI-ryfW3q_OzSeUawVQlkCmhcO6YRlU3plbegJeucVLykZmXzH42KkC5WWvuZ54pQFASJILWWA_J6dZ3tZ4tiw_GPkFrVyksIW1sB8H-i8SwsHfdvZWNrA03xWC0NXCpyzmhf9VyZp8KtqVg-77gIjt4e_dV9NJoIRw-EyA7aH2C6EL-y9OmfLBkGBK95T10bY8p_27XD5jsAqHtF__P8AdZBZP5</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><source>Alma/SFX Local Collection</source><creator>Duffy, Jonathan ; Weintraub, Eric ; Vellozzi, Claudia ; DeStefano, Frank</creator><creatorcontrib>Duffy, Jonathan ; Weintraub, Eric ; Vellozzi, Claudia ; DeStefano, Frank ; Vaccine Safety Datalink</creatorcontrib><description>OBJECTIVE:To assess the occurrence of narcolepsy after influenza vaccines used in the United States that contained the influenza A(H1N1)pdm09 virus strain.
METHODS:A population-based cohort study in the Vaccine Safety Datalink with an annual population of more than 8.5 million people. All persons younger than 30 years who received a 2009 pandemic or a 2010–2011 seasonal influenza vaccine were identified. Their medical visit history was searched for a first-ever occurrence of an ICD-9 narcolepsy diagnosis code through the end of 2011. Chart review was done to confirm the diagnosis and determine the date of symptom onset. Cases were patients who met the International Classification of Sleep Disorders, 2nd edition, narcolepsy diagnostic criteria. We compared the observed number of cases after vaccination to the number expected to occur by chance alone.
RESULTS:The number vaccinated with 2009 pandemic vaccine was 650,995 and with 2010–2011 seasonal vaccine was 870,530. Among these patients, 70 had a first-ever narcolepsy diagnosis code after vaccination, of which 16 had a chart-confirmed incident diagnosis of narcolepsy. None had their symptom onset during the 180 days after receipt of a 2009 pandemic vaccine compared with 6.52 expected, and 2 had onset after a 2010–2011 seasonal vaccine compared with 8.83 expected.
CONCLUSIONS:Influenza vaccines containing the A(H1N1)pdm09 virus strain used in the United States were not associated with an increased risk of narcolepsy. Vaccination with the influenza A(H1N1)pdm09 vaccine viral antigens does not appear to be sufficient by itself to increase the incidence of narcolepsy in a population.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000000987</identifier><identifier>PMID: 25320099</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: American Academy of Neurology</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Child ; Cohort Studies ; Community Health Planning ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Female ; General aspects ; Human viral diseases ; Humans ; Infectious diseases ; Influenza A Virus, H1N1 Subtype - immunology ; Influenza Vaccines - adverse effects ; Influenza, Human - epidemiology ; Influenza, Human - immunology ; Influenza, Human - therapy ; International Classification of Diseases ; Male ; Medical sciences ; Narcolepsy - diagnosis ; Narcolepsy - epidemiology ; Narcolepsy - etiology ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Pharmacology. Drug treatments ; United States - epidemiology ; Viral diseases ; Viral diseases of the respiratory system and ent viral diseases ; Young Adult</subject><ispartof>Neurology, 2014-11, Vol.83 (20), p.1823-1830</ispartof><rights>2014 American Academy of Neurology</rights><rights>2015 INIST-CNRS</rights><rights>2014 American Academy of Neurology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5207-2e0727edc08e735937f9af6c5c66149d878fb4359009381fbf07aea76a6ea88e3</citedby><cites>FETCH-LOGICAL-c5207-2e0727edc08e735937f9af6c5c66149d878fb4359009381fbf07aea76a6ea88e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28961456$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25320099$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duffy, Jonathan</creatorcontrib><creatorcontrib>Weintraub, Eric</creatorcontrib><creatorcontrib>Vellozzi, Claudia</creatorcontrib><creatorcontrib>DeStefano, Frank</creatorcontrib><creatorcontrib>Vaccine Safety Datalink</creatorcontrib><title>Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States</title><title>Neurology</title><addtitle>Neurology</addtitle><description>OBJECTIVE:To assess the occurrence of narcolepsy after influenza vaccines used in the United States that contained the influenza A(H1N1)pdm09 virus strain.
METHODS:A population-based cohort study in the Vaccine Safety Datalink with an annual population of more than 8.5 million people. All persons younger than 30 years who received a 2009 pandemic or a 2010–2011 seasonal influenza vaccine were identified. Their medical visit history was searched for a first-ever occurrence of an ICD-9 narcolepsy diagnosis code through the end of 2011. Chart review was done to confirm the diagnosis and determine the date of symptom onset. Cases were patients who met the International Classification of Sleep Disorders, 2nd edition, narcolepsy diagnostic criteria. We compared the observed number of cases after vaccination to the number expected to occur by chance alone.
RESULTS:The number vaccinated with 2009 pandemic vaccine was 650,995 and with 2010–2011 seasonal vaccine was 870,530. Among these patients, 70 had a first-ever narcolepsy diagnosis code after vaccination, of which 16 had a chart-confirmed incident diagnosis of narcolepsy. None had their symptom onset during the 180 days after receipt of a 2009 pandemic vaccine compared with 6.52 expected, and 2 had onset after a 2010–2011 seasonal vaccine compared with 8.83 expected.
CONCLUSIONS:Influenza vaccines containing the A(H1N1)pdm09 virus strain used in the United States were not associated with an increased risk of narcolepsy. Vaccination with the influenza A(H1N1)pdm09 vaccine viral antigens does not appear to be sufficient by itself to increase the incidence of narcolepsy in a population.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Community Health Planning</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Female</subject><subject>General aspects</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Influenza A Virus, H1N1 Subtype - immunology</subject><subject>Influenza Vaccines - adverse effects</subject><subject>Influenza, Human - epidemiology</subject><subject>Influenza, Human - immunology</subject><subject>Influenza, Human - therapy</subject><subject>International Classification of Diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Narcolepsy - diagnosis</subject><subject>Narcolepsy - epidemiology</subject><subject>Narcolepsy - etiology</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>United States - epidemiology</subject><subject>Viral diseases</subject><subject>Viral diseases of the respiratory system and ent viral diseases</subject><subject>Young Adult</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UE1PGzEQtSqqEkL_QYV8QYLDUtub9ccFCSFokKJwKKi9WRNnTNxuvJG9AYVfX6MApRw6F0vzPub5EfKFsxMuuPj6Yzo5YW_HaPWBDHgjZCVr8XOHDBgTuqq10rtkL-dfjBVQmU9kVzS1KAIzINdTSK5rcZU3FOKchujbNcZHoGdHYz7lx3RV1rgMjj4p6D04FyL0oYuFS_sF0tsYepzT7z30mPfJRw9txs_P75DcXl7cnI-ryfW3q_OzSeUawVQlkCmhcO6YRlU3plbegJeucVLykZmXzH42KkC5WWvuZ54pQFASJILWWA_J6dZ3tZ4tiw_GPkFrVyksIW1sB8H-i8SwsHfdvZWNrA03xWC0NXCpyzmhf9VyZp8KtqVg-77gIjt4e_dV9NJoIRw-EyA7aH2C6EL-y9OmfLBkGBK95T10bY8p_27XD5jsAqHtF__P8AdZBZP5</recordid><startdate>20141111</startdate><enddate>20141111</enddate><creator>Duffy, Jonathan</creator><creator>Weintraub, Eric</creator><creator>Vellozzi, Claudia</creator><creator>DeStefano, Frank</creator><general>American Academy of Neurology</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20141111</creationdate><title>Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States</title><author>Duffy, Jonathan ; Weintraub, Eric ; Vellozzi, Claudia ; DeStefano, Frank</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5207-2e0727edc08e735937f9af6c5c66149d878fb4359009381fbf07aea76a6ea88e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Community Health Planning</topic><topic>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</topic><topic>Female</topic><topic>General aspects</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Influenza A Virus, H1N1 Subtype - immunology</topic><topic>Influenza Vaccines - adverse effects</topic><topic>Influenza, Human - epidemiology</topic><topic>Influenza, Human - immunology</topic><topic>Influenza, Human - therapy</topic><topic>International Classification of Diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Narcolepsy - diagnosis</topic><topic>Narcolepsy - epidemiology</topic><topic>Narcolepsy - etiology</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>United States - epidemiology</topic><topic>Viral diseases</topic><topic>Viral diseases of the respiratory system and ent viral diseases</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duffy, Jonathan</creatorcontrib><creatorcontrib>Weintraub, Eric</creatorcontrib><creatorcontrib>Vellozzi, Claudia</creatorcontrib><creatorcontrib>DeStefano, Frank</creatorcontrib><creatorcontrib>Vaccine Safety Datalink</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duffy, Jonathan</au><au>Weintraub, Eric</au><au>Vellozzi, Claudia</au><au>DeStefano, Frank</au><aucorp>Vaccine Safety Datalink</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2014-11-11</date><risdate>2014</risdate><volume>83</volume><issue>20</issue><spage>1823</spage><epage>1830</epage><pages>1823-1830</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>OBJECTIVE:To assess the occurrence of narcolepsy after influenza vaccines used in the United States that contained the influenza A(H1N1)pdm09 virus strain.
METHODS:A population-based cohort study in the Vaccine Safety Datalink with an annual population of more than 8.5 million people. All persons younger than 30 years who received a 2009 pandemic or a 2010–2011 seasonal influenza vaccine were identified. Their medical visit history was searched for a first-ever occurrence of an ICD-9 narcolepsy diagnosis code through the end of 2011. Chart review was done to confirm the diagnosis and determine the date of symptom onset. Cases were patients who met the International Classification of Sleep Disorders, 2nd edition, narcolepsy diagnostic criteria. We compared the observed number of cases after vaccination to the number expected to occur by chance alone.
RESULTS:The number vaccinated with 2009 pandemic vaccine was 650,995 and with 2010–2011 seasonal vaccine was 870,530. Among these patients, 70 had a first-ever narcolepsy diagnosis code after vaccination, of which 16 had a chart-confirmed incident diagnosis of narcolepsy. None had their symptom onset during the 180 days after receipt of a 2009 pandemic vaccine compared with 6.52 expected, and 2 had onset after a 2010–2011 seasonal vaccine compared with 8.83 expected.
CONCLUSIONS:Influenza vaccines containing the A(H1N1)pdm09 virus strain used in the United States were not associated with an increased risk of narcolepsy. Vaccination with the influenza A(H1N1)pdm09 vaccine viral antigens does not appear to be sufficient by itself to increase the incidence of narcolepsy in a population.</abstract><cop>Hagerstown, MD</cop><pub>American Academy of Neurology</pub><pmid>25320099</pmid><doi>10.1212/WNL.0000000000000987</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Biological and medical sciences Child Cohort Studies Community Health Planning Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Female General aspects Human viral diseases Humans Infectious diseases Influenza A Virus, H1N1 Subtype - immunology Influenza Vaccines - adverse effects Influenza, Human - epidemiology Influenza, Human - immunology Influenza, Human - therapy International Classification of Diseases Male Medical sciences Narcolepsy - diagnosis Narcolepsy - epidemiology Narcolepsy - etiology Nervous system (semeiology, syndromes) Neurology Neuropharmacology Pharmacology. Drug treatments United States - epidemiology Viral diseases Viral diseases of the respiratory system and ent viral diseases Young Adult |
| title | Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States |
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