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Biologicals. 2019 Jul;60:1-7. doi: 10.1016/j.biologicals.2019.05.005. Epub 2019 May 23.

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.

Author information

1
Medical Center North, Vanderbilt University School of Medicine, Nashville, TN, D7227, USA. Electronic address: Kathryn.edwards@vumc.org.
2
Brussels, and Antwerp University, Universiteitsplein 1, 2610, Antwerp, Belgium. Electronic address: ghanquet@skynet.be.
3
Cincinnati Children's Hospital, Cincinnati, OH, USA.
4
Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA.
5
Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
6
Immunization Safety Office, Centers for Disease Control and Prevention (CDC), 1600, Clifton Road, Atlanta, GA, USA. Electronic address: TShimabukuro@cdc.gov.
7
Public Health England, London, United Kingdom.
8
National Institute for Health and Welfare THL Department of Health Security, Infectious Disease Control and Vaccinations Unit Helsinki, Finland.
9
IABS, Rue de la Vallée 3, 1204, Genève, Switzerland. Electronic address: pieter.neels@vaccine-vaccine.be.

Abstract

A group of scientific and public health experts and key stakeholders convened to discuss the state of knowledge on the relationship between adjuvanted monovalent inactivated 2009 influenza A H1N1 vaccines used during the 2009 influenza pandemic and narcolepsy. There was consensus that an increased risk of narcolepsy was consistently observed after Pandemrix (AS03-adjuvanted) vaccine, but similar associations following Arepanrix (AS03-adjuvanted) or Focetria (MF59-adjuvanted) vaccines were not observed. Whether the differences are due to vaccine composition or other factors such as the timing of large-scale vaccination programs relative to H1N1pdm09 wild-type virus circulation in different geographic regions is not clear. The limitations of retrospective observational methodologies could also be contributing to some of the differences across studies. More basic and epidemiologic research is needed to further elucidate the association between adjuvanted influenza vaccine and narcolepsy and its mechanism and to inform planning and preparation for vaccination programs in advance of the next influenza pandemic.

KEYWORDS:

Adjuvants; Antigen system 03 (AS03); H1N1pdm09 influenza vaccines; Narcolepsy; Pandemic influenza; Pandemrix vaccine

PMID:
31130313
PMCID:
PMC6668612
[Available on 2020-07-01]
DOI:
10.1016/j.biologicals.2019.05.005
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