A large case-control study on vaccination as risk factor for multiple sclerosis.

Hapfelmeier, Alexander; Gasperi, Christiane; Donnachie, Ewan; Hemmer, Bernhard

doi:10.1212/WNL.0000000000008012

2019

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Title:: A large case-control study on vaccination as risk factor for multiple sclerosis.
Document type:: Article
Author(s):: Hapfelmeier, Alexander; Gasperi, Christiane; Donnachie, Ewan; Hemmer, Bernhard
Abstract:: OBJECTIVE: To investigate the hypothesis that vaccination is a risk factor for multiple sclerosis (MS) by use of German ambulatory claims data in a case-control study. METHODS: Using the ambulatory claims data of the Bavarian Association of Statutory Health Insurance Physicians covering 2005-2017, logistic regression models were used to assess the relation between MS (n = 12,262) and vaccinations in the 5 years before first diagnosis. Participants newly diagnosed with Crohn disease (n = 19,296) or psoriasis (n = 112,292) and participants with no history of these autoimmune diseases (n = 79,185) served as controls. RESULTS: The odds of MS were lower in participants with a recorded vaccination (odds ratio [OR] 0.870, p < 0.001 vs participants without autoimmune disease; OR 0.919, p < 0.001 vs participants with Crohn disease; OR 0.973, p = 0.177 vs participants with psoriasis). Lower odds were most pronounced for vaccinations against influenza and tick-borne encephalitis. These effects were consistently observed for different time frames, control cohorts, and definitions of the MS cohort. Effect sizes increased toward the time of first diagnosis. CONCLUSIONS: Results of the present study do not reveal vaccination to be a risk factor for MS. On the contrary, they consistently suggest that vaccination is associated with a lower likelihood of being diagnosed with MS within the next 5 years. Whether this is a protective effect needs to be addressed by future studies.
Journal title abbreviation:: Neurology
Year:: 2019
Journal volume:: 93
Journal issue:: 9
Pages contribution:: e908-e916
Fulltext / DOI:: doi:10.1212/WNL.0000000000008012
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/31363057
Print-ISSN:: 0028-3878
TUM Institution:: Institut für Medizinische Statistik und Epidemiologie; Neurologische Klinik und Poliklinik
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