https://scholars.lib.ntu.edu.tw/handle/123456789/548506
標題: | Narcolepsy and 2009 H1N1 pandemic vaccination in Taiwan | 作者: | Huang W.-T. Huang Y.-S. Hsu C.-Y. HSI-CHUNG CHEN Lee H.-C. Lin H.-C. Hsieh C.-F. Wu M.-N. Yang C.-H. |
關鍵字: | Epidemiology; H1N1; Influenza vaccine; MF59; Narcolepsy; Taiwan | 公開日期: | 2020 | 卷: | 66 | 起(迄)頁: | 276-281 | 來源出版物: | Sleep Medicine | 摘要: | Background: Several European countries have observed an association between narcolepsy and H1N1 vaccines containing AS03? adjuvant in children/adolescents. In Taiwan, a nationwide campaign starting November 2009 administered H1N1 vaccines without adjuvant or with MF59? adjuvant to 67% of children and 12% of adults. Methods: For those registered in the 2000–2012 National Health Insurance (NHI) databases, we compared age-stratified (0–4, 5–18, 19–59, and ?60 years) incidence of first referral for a diagnostic MSLT for the pre-pandemic, pandemic/pre-vaccination, and vaccination/post-pandemic period. We also compared the odds of H1N1 vaccination in each chart-ascertained narcolepsy patient, whoever had an onset of excessive daytime sleepiness between April 2009 and December 2012, with 10 population-based controls from the NHI databases on year of birth, sex, and index date, using conditional logistic regressions. Results: Incidence of MSLT referral for narcolepsy was highest and significantly increased in the pandemic/pre-vaccination period in the age group 5–18 (IRR 3.40, 95% confidence intervals (CI) 2.12–5.45) and 19–59 (IRR 2.90, 95% CI 1.62–5.02) years. Among 137 confirmed narcolepsy cases (86 adults and 51 children), the odds ratios (ORs) were 1.67 (95% CI 0.81–3.45) (adults) and 1.22 (95% CI 0.62–2.39) (children) for H1N1 vaccination without adjuvant, and 1.39 (95% CI 0.17–11.48) (adults) and 3.66 (95% CI 0.37–36.02) (children) with MF59? adjuvant. Conclusion: No substantial association between the use of H1N1 vaccines and narcolepsy was identified in Taiwan. Instead, the H1N1 infection itself could have played a role in triggering narcolepsy in children and young adults. ? 2018 Elsevier B.V. |
URI: | 2-s2.0-85058669515 https://scholars.lib.ntu.edu.tw/handle/123456789/548506 |
ISSN: | 13899457 | DOI: | 10.1016/j.sleep.2018.10.036 | SDG/關鍵字: | antibiotic agent; antivirus agent; immunological adjuvant; influenza vaccine; immunological adjuvant; influenza vaccine; 2009 H1N1 influenza; adolescent; adult; Article; asthma; case control study; cataplexy; child; controlled study; daytime somnolence; depression; disease association; drug use; epilepsy; female; flu like syndrome; human; ICD-9-CM; incidence; influenza vaccination; major clinical study; male; migraine; narcolepsy; priority journal; risk factor; sleep latency; Taiwan; upper respiratory tract infection; adverse event; complication; immunology; infant; influenza; Influenza A virus (H1N1); isolation and purification; middle aged; narcolepsy; newborn; pandemic; preschool child; vaccination; young adult; Adjuvants, Immunologic; Adolescent; Adult; Child; Child, Preschool; Female; Humans; Incidence; Infant; Infant, Newborn; Influenza A Virus, H1N1 Subtype; Influenza Vaccines; Influenza, Human; Male; Middle Aged; Narcolepsy; Pandemics; Taiwan; Vaccination; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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