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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 Type:	Article
Authors/Creators:	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
Keywords:	case-control study, demyelination, infections, multiple sclerosis, tonsillectomy, vaccinations
Journal or Publication Title:	Multiple Sclerosis and Related Disorders
Publisher:	Elsevier BV
ISSN:	2211-0348
DOI / ID Number:	10.1016/j.msard.2020.102062
Copyright Information:	© 2020 Elsevier B.V. All rights reserved.
Related URLs:	UTAS Profile: Taylor, BV Google Scholar: van der Mei, I UTAS Profile: van der Mei, I
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