ArticlePloS one2014
Risk of narcolepsy associated with inactivated adjuvanted (AS03) A/H1N1 (2009) pandemic influenza vaccine in Quebec.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01394614 (Risk of Narcolepsy Associated With Administration of Inactivated Adjuvanted), which is not on this map. Cited by 35 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Risk of Narcolepsy Associated With Administration of Inactivated Adjuvanted (AS03) A/H1N1 Pandemic Influenza Vaccine in Quebec
Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Safety of Influenza A H1N1pdm09 Vaccines: An Overview of Systematic Reviews.Frontiers in immunology · 2021Pooled it
- Oil-in-water emulsion adjuvants for pediatric influenza vaccines: a systematic review and meta-analysis.Nature communications · 2020Pooled it
- Vaccines for preventing influenza in healthy adults.The Cochrane database of systematic reviews · 2018Pooled it
- A phase 3 randomized controlled trial of a COVID-19 recombinant vaccine S-268019-b versus ChAdOx1 nCoV-19 in Japanese adults.Scientific reports · 2024Trial
- Persistent sleep symptoms in post-COVID syndrome: a Brazilian prospective clinical study.Arquivos de neuro-psiquiatria · 2025Observational
- The immunopathogenesis of narcolepsy type 1.Nature reviews. Immunology · 2024Review
- Long COVID: neurological manifestations - an updated narrative review.Dementia & neuropsychologia · 2024Review
- What respiratory physicians should know about narcolepsy and other hypersomnias.Breathe (Sheffield, England) · 2022Review
- Autoimmune conditions following mRNA (BNT162b2) and inactivated (CoronaVac) COVID-19 vaccination: A descriptive cohort study among 1.1 million vaccinated people in Hong Kong.Journal of autoimmunity · 2022Article
- Narcolepsy and H1N1 influenza immunology a decade later: What have we learned?Frontiers in immunology · 2022Review
- Novel vaccine safety issues and areas that would benefit from further research.BMJ global health · 2021Review
- Article
- Retrospective in silico HLA predictions from COVID-19 patients reveal alleles associated with disease prognosis.medRxiv : the preprint server for health sciences · 2020Article
- Mass Spectrometric Characterization of Narcolepsy-Associated Pandemic 2009 Influenza Vaccines.Vaccines · 2020Article
- Reassessment of the risk of narcolepsy in children in England 8 years after receipt of the AS03-adjuvanted H1N1 pandemic vaccine: A case-coverage study.PLoS medicine · 2020Article
- No evidence of autoimmunity to human OXJournal of translational autoimmunity · 2020Article
- Meeting report narcolepsy and pandemic influenza vaccination: What we know and what we need to know before the next pandemic? A report from the 2nd IABS meeting.Biologicals : journal of the International Association of Biological Standardization · 2019Article
- Neurobiological and immunogenetic aspects of narcolepsy: Implications for pharmacotherapy.Sleep medicine reviews · 2019Review
- Autoimmunity to hypocretin and molecular mimicry to flu in type 1 narcolepsy.Proceedings of the National Academy of Sciences of the United States of America · 2018Article
- Narcolepsy and adjuvanted pandemic influenza A (H1N1) 2009 vaccines - Multi-country assessment.Vaccine · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextAn association between an adjuvanted (AS03) A/H1N1 pandemic vaccine and narcolepsy has been reported in Europe.
objectiveTo assess narcolepsy risk following administration of a similar vaccine in Quebec.
designRetrospective population-based study.
settingNeurologists and lung specialists in the province were invited to report narcolepsy cases to a single reference centre. POPULATION: Patients were interviewed by two sleep experts and standard diagnostic tests were performed. Immunization status was verified in the provincial pandemic influenza vaccination registry.
main outcome measuresConfirmed narcolepsy with or without cataplexy with onset of excessive daytime sleepiness between January 1st, 2009, and December 31st, 2010. Relative risks (RRs) were calculated using a Poisson model in a cohort analysis, by a self-controlled case series (SCCS) and a case-control method.
resultsA total of 24 cases were included and overall incidence rate was 1.5 per million person-years. A cluster of 7 cases was observed among vaccinated persons in the winter 2009-2010. In the primary cohort analysis, 16-week post-vaccination RR was 4.32 (95% CI: 1.50-11.12). RR was 2.07 (0.70-6.17) in the SCCS, and 1.48 (0.37-7.03) using the case-control method. Estimates were lower when observation was restricted to the period of pandemic influenza circulation, and tended to be higher in persons <20 years old and for cataplexy cases.
conclusionsResults are compatible with an excess risk of approximately one case per million vaccine doses, mainly in persons less than 20 years of age. However, a confounding effect of the influenza infection cannot be ruled out.
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