Global estimates of vaccine-associated narcolepsy from 1967 to 2023, 2025, Jeong et al.

[SNT Gatchaman]

Global estimates of vaccine-associated narcolepsy from 1967 to 2023

Spoiler: Authors

Jeong, Yi Deun; Jo, Hyesu; Yim, Yesol; Lee, Sooji; Park, Jaeyu; Lee, Jinseok; Kang, Jiseung; Jacob, Louis; Smith, Lee; Rahmati, Masoud; López Sánchez, Guillermo F; Lee, Hayeon; Yon, Dong Keon

Regional evidence on the signal detection between narcolepsy and vaccines is scarcely available and insufficiently understood, thus impeding a comprehensive understanding of this relationship on a global scale. Therefore, this study aimed to evaluate the global estimates of vaccine-associated narcolepsy, discern its association with specific vaccines, and thereby contribute to the advancement of more efficient vaccination protocols.

This study utilized data from the international pharmacovigilance database concerning vaccine-associated narcolepsy from 1967 to 2023. Global reporting counts, reported odds ratios (ROR), and information components (IC) were analyzed to identify the signal detection between the 16 vaccines and the occurrence of vaccine-associated narcolepsy across 140 countries.

We identified 2,183 reports (male, n = 870 [39.85%]) of vaccine-associated narcolepsy from 5,291 reports of narcolepsy. Vaccine-associated narcolepsy has been reported since 2009. The highest disproportionality signals for narcolepsy were observed with influenza vaccines (ROR, 156.53 [95% CI, 147.62-165.97]; IC, 6.72 [IC0.25, 6.63]), followed by papillomavirus and encephalitis vaccines. Concerning age and sex-specific signals, reports of vaccine-associated narcolepsy were associated with age groups between 12 and 17 years and males. Most of these adverse events had a long time to onset (mean: 115 days).

Although our findings do not permit any inference of causality, influenza vaccines showed highest signal detection between vaccines and narcolepsy followed by papillomavirus and encephalitis vaccines. COVID-19 mRNA vaccines, despite large number of reports, showed no evidence of signal detection with narcolepsy.

Web | DOI | PDF | Nature Scientific Reports | Open Access

 

[SNT Gatchaman]

In our study, vaccine-associated narcolepsy exhibited the strongest signal detection with the age group between 12 and 17 years. However, it is noteworthy that the age group exhibiting the highest signal detection varies for each vaccine. Narcolepsy has been reported to occur most frequently between the ages of 10 and 30 years, with previous suggesting a first peak around age 15 years and a second peak around age 35 years.

This aligns with our research findings indicating a high signal detection between the influenza vaccine and these age groups. Additionally, our results are consistent with studies showing a 5 to 14-fold increase in narcolepsy occurrence when children and adolescents receive the vaccine and a 2 to 7-fold increase in the adult group.

Referencing Age at onset of narcolepsy in two large populations of patients in France and Quebec (2001)

Edit: corrected to link to ScoutB's initial thread.

 

[Hoopoe]

previous suggesting a first peak around age 15 years and a second peak around age 35 years.

Very interesting.

 

[ScoutB]

According to the paper the vaccine most associated with Narcolepsy was an influenza vaccine called Pandemrix. I googled it and apparently it's not news that this vaccine might cause narcolepsy, the entire wikipedia page on Pandemrix is pretty much about that.

From wiki:

In February 2011, [The Finnish National Institute for Health and Welfare] concluded that there is a clear connection between the Pandemrix vaccination campaign of 2009 and 2010 and the narcolepsy epidemic in Finland. The probability of developing narcolepsy was determined to be nine times higher in those who received the Pandemrix vaccination than those who didn't. A total of 152 cases of narcolepsy have been found in Finland during 2009–2010, and ninety percent of them had received the Pandemrix vaccination.

(Apparently the background vaccination coverage was 70%, this was a swine flu vaccine during that pandemic)
Also:

"Results from a Swedish registry based cohort study indicate a 4-fold increased risk of narcolepsy in children and adolescents below the age of 20 vaccinated with Pandemrix, compared to children of the same age that were not vaccinated." The same study found no increased risk in adults who were vaccinated with Pandemrix.

A 2018 CDC study was less sure of a connection, saying:

Other than elevated narcolepsy incidence rates 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.