Multiple sclerosis incidence in the era of measles-mumps-rubella mass vaccinations.
Journal article, 2009
BACKGROUND: Viral childhood infections may be involved in the multiple sclerosis (MS) pathogenesis. Following national Swedish vaccination programs, measles sharply declined in the 1970s, and measles, mumps, and rubella were virtually eliminated in cohorts born from 1981. OBJECTIVES: To examine whether the vaccination induced reduction in these infections influences the MS incidence. In addition, the public health aspect justified an early evaluation of beneficial as well as harmful effects of mass vaccinations. MATERIALS AND METHODS: From an incidence material of 534 MS patients, born 1959-1990, we selected one unvaccinated cohort and four cohorts, each corresponding to a vaccination program (MS patients = 251). RESULTS: With the ability to detect a decrease by 30-35%, and an increase by 37-48% in the MS incidence in the first three cohorts, we found no vaccination related MS incidence changes. The background MS incidence showed a significant gradual age dependent increase. CONCLUSIONS: While the present follow-up provided limited power in the last cohort, there is no evidence as yet that the radical decline in three viral infections influenced the MS incidence. However, the increasing background MS incidence of unknown cause may have concealed a reduction in MS risk associated with mass vaccinations.
epidemiology
epidemiology
Measles
Multiple Sclerosis
Sweden
epidemiology
Proportional Hazards Models
therapeutic use
prevention & control
Sex Distribution
Risk Reduction Behavior
epidemiology
Measles-Mumps-Rubella Vaccine
Age Distribution
epidemiology
prevention & control
Cohort Studies
Incidence
Comorbidity
Mumps
Rubella
prevention & control
adverse effects
Author
Cecilia Ahlgren
University of Gothenburg
Anders Odén
University of Gothenburg
Chalmers, Mathematical Sciences, Mathematical Statistics
Kjell Torén
University of Gothenburg
Oluf Andersen
University of Gothenburg
Acta Neurologica Scandinavica
0001-6314 (ISSN) 1600-0404 (eISSN)
Vol. 119 5 313-20Subject Categories
Physiology
DOI
10.1111/j.1600-0404.2008.01131.x
PubMed
19154535