ArticleVaccine2018
Narcolepsy and adjuvanted pandemic influenza A (H1N1) 2009 vaccines - Multi-country assessment.
Article in Vaccine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Minimum Data Set and Metadata for Active Vaccine Safety Surveillance: Systematic Review.JMIR public health and surveillance · 2025Pooled it
- Oil-in-water emulsion adjuvants for pediatric influenza vaccines: a systematic review and meta-analysis.Nature communications · 2020Pooled it
- Harmonizing Case Validation for Vaccine Safety in Real-World Data: The VAC4EU Experience.Clinical epidemiology · 2026Article
- Dispelling Vaccine Legal Myths.The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics · 2026Article
- Global estimates of vaccine-associated narcolepsy from 1967 to 2023.Scientific reports · 2025Article
- Review
- T cells responses after vaccination: a regulatory perspective.Frontiers in immunology · 2025Review
- Review
- Exploring the Literature on Narcolepsy: Insights into the Sleep Disorder That Strikes during the Day.NeuroSci · 2023Review
- Novel Influenza Vaccines: From Research and Development (R&D) Challenges to Regulatory Responses.Vaccines · 2023Review
- Neurologic Complications With Vaccines: What We Know, What We Don't, and What We Should Do.Neurology · 2023Article
- Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries.International journal of stroke : official journal of the International Stroke Society · 2023Article
- Narcolepsy risk loci outline role of T cell autoimmunity and infectious triggers in narcolepsy.Nature communications · 2023Article
- Vaccinomics: A scoping review.Vaccine · 2023Article
- Article
- Characterization of T cell receptors reactive to HCRTProceedings of the National Academy of Sciences of the United States of America · 2022Article
- Article
- Pediatric Narcolepsy-A Practical Review.Children (Basel, Switzerland) · 2022Review
- Narcolepsy and H1N1 influenza immunology a decade later: What have we learned?Frontiers in immunology · 2022Review
- All vials are not the same: Potential role of vaccine quality in vaccine adverse reactions.Vaccine · 2021Article
Corrections and comments
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Authors and funding
39 authors.
Funding
Abstract
backgroundIn 2010, a safety signal was detected for narcolepsy following vaccination with Pandemrix, an AS03-adjuvanted monovalent pandemic H1N1 influenza (pH1N1) vaccine. To further assess a possible association and inform policy on future use of adjuvants, we conducted a multi-country study of narcolepsy and adjuvanted pH1N1 vaccines.
methodsWe used electronic health databases to conduct a dynamic retrospective cohort study to assess narcolepsy incidence rates (IR) before and during pH1N1 virus circulation, and after pH1N1 vaccination campaigns in Canada, Denmark, Spain, Sweden, Taiwan, the Netherlands, and the United Kingdom. Using a case-control study design, we evaluated the risk of narcolepsy following AS03- and MF59-adjuvanted pH1N1 vaccines in Argentina, Canada, Spain, Switzerland, Taiwan, and the Netherlands. In the Netherlands, we also conducted a case-coverage study in children born between 2004 and 2009.
resultsNo changes in narcolepsy IRs were observed in any periods in single study sites except Sweden and Taiwan; in Taiwan incidence increased after wild-type pH1N1 virus circulation and in Sweden (a previously identified signaling country), incidence increased after the start of pH1N1 vaccination. No association was observed for Arepanrix-AS03 or Focetria-MF59 adjuvanted pH1N1 vaccines and narcolepsy in children or adults in the case-control study nor for children born between 2004 and 2009 in the Netherlands case-coverage study for Pandemrix-AS03.
conclusionsOther than elevated narcolepsy IRs in the period after vaccination campaigns in Sweden, we did not find an association between AS03- or MF59-adjuvanted pH1N1 vaccines and narcolepsy in children or adults in the sites studied, although power to evaluate the AS03-adjuvanted Pandemrix brand vaccine was limited in our study.
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