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Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study

Hughes, AM, Ponsonby, A-L, Dear, K, Dwyer, T, Taylor, BV, van der Mei, I ORCID: 0000-0001-9009-7472, Valery, PC and Lucas, RM 2020 , 'Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study' , Multiple Sclerosis and Related Disorders, vol. 42 , pp. 1-8 , doi: 10.1016/j.msard.2020.102062.

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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
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© 2020 Elsevier B.V. All rights reserved.

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