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Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study

Citation

Hughes, AM and Ponsonby, A-L and Dear, K and Dwyer, T and Taylor, BV and van der Mei, I and Valery, PC and Lucas, RM, Ausimmune Investigator Group, Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study, Multiple Sclerosis and Related Disorders, 42 Article 102062. ISSN 2211-0348 (2020) [Refereed Article]

Copyright Statement

2020 Elsevier B.V. All rights reserved.

DOI: doi:10.1016/j.msard.2020.102062

Abstract

Background: The association between childhood vaccinations and infections and risk of multiple sclerosis is unclear; few studies have considered age at vaccination/infection.

Objective: To explore age-related associations between childhood vaccinations, infection and tonsillectomy and risk of a first clinical diagnosis of CNS demyelination.

Methods: Data on case (n = 275, 76.6% female; mean age 38.6 years) and age- and sex-matched control (n = 529) participants in an incident population-based case-control study included self-reported age at time of childhood vaccinations, infections, and tonsillectomy. Conditional logistic regression models were used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI).

Results: Poliomyelitis vaccination prior to school-age was associated with increased risk of a first clinical diagnosis of CNS demyelination (AOR = 2.60, 95%CI 1.02-6.68), based on a very small unvaccinated reference group. Late (11-15 years) rubella vaccination (compared to none) was associated with lower odds of being a case (AOR = 0.47, 95%CI 0.27-0.83). Past infectious mononucleosis at 11-15 years (AOR = 2.84, 95%CI 1.0-7.57) and 16-20 years (AOR = 1.92, 95%CI 1.12-3.27) or tonsillectomy in adolescence (11-15 years: AOR = 2.45, 95%CI 1.12-5.35), including after adjustment for IM, were associated with increased risk of a first clinical diagnosis of CNS demyelination.

Conclusions: Age at vaccination, infection or tonsillectomy may alter the risk of subsequent CNS demyelination. Failing to account for age effects may explain inconsistencies in past findings.

Item Details

Item Type:Refereed Article
Keywords:case-control study, demyelination, infections, multiple sclerosis, tonsillectomy, vaccinations
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Taylor, BV (Professor Bruce Taylor)
UTAS Author:van der Mei, I (Professor Ingrid van der Mei)
ID Code:139223
Year Published:2020
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-06-02
Last Modified:2021-03-24
Downloads:0

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