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Vaccines and the risk of acute disseminated encephalomyelitis
Institution:1. Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, China;2. Department of Neurology, Nanjing Brain Hospital, China;3. Department of Neurology, Jiangsu Provincial People''s Hospital, China;1. Department of functional investigations, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France;2. Inserm, U965, hôpital Lariboisière, 41, boulevard de la Chapelle, 75010 Paris, France;3. Department of abdominal imaging, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France;4. Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France;1. MOH Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, People''s Republic of China;2. Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang 050017, Heibei Province, People''s Republic of China;3. Capital Medical University Affiliated Beijing You’an Hospital, Beijing Institute of Hepatology, Beijing 100069, People''s Republic of China;4. School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, People''s Republic of China;5. National Institute of Biological Sciences, Beijing 102206, People’s Republic of China
Abstract:BackgroundIt is important to examine the risk of Acute disseminated encephalomyelitis (ADEM) after vaccination.MethodsWe conducted a nested case–control study between January 2011 and December 2015. Four controls per case were matched for age, gender, address. An independent expert committee validated the diagnoses of cases and controls. Data on vaccinations were obtained from computerized vaccination records. The analyses were conducted with the use of conditional logistic regression.ResultsThe analyses include 272 cases of ADEM and 1096 controls. No increase in the risk of ADEM was observed for vaccination against hepatitis B, influenza, polio(live), diphtheria, pertuss(acellular), tetanusis, measles, mumps, rubella, Japanese Encephalitis, meningitis, hepatitis A, varicella and rabies vaccines. Vaccine was associated with a statistically significant increase in risk in the 31–60-day exposure interval (OR, 4.04 95% CI, 1.07–12.69]), but not the 0–30 and 61–180-day interval. There was no association between vaccine received and the recurrence of ADEM.ConclusionsFindings from the present study do not demonstrate an association of vaccines with an increased risk of ADEM and its recurrence among either paediatric (≤18 years) or adult (>18 years) individuals within the 180 days after vaccinations. The finding in children in the 31–60 day risk interval is likely coincidental and was not confirmed in separate self-control analyses.
Keywords:Vaccines  Acute disseminated encephalomyelitis
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