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agate
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 Posted: Thu Jun 15, 2006 1:55 pm Post subject: (Article) No link found between ON and vaccines |
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From Medscape:
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Optic Neuritis Not Linked to Anthrax, Hepatitis B, Influenza, or Smallpox Vaccines
News Author: Laurie Barclay, MD
CME Author: Hien T. Nghiem, MD
June 14, 2006 — Anthrax, hepatitis B, influenza, and/or smallpox vaccination is not linked to the development of optic neuritis, according to the results of a postmarketing surveillance of military personnel reported in the June issue of the Archives of Neurology.
"Numerous case reports have suggested a possible association between optic neuritis and receipt of several different vaccines," write Daniel C. Payne, PhD, MSPH, from the Centers for Disease Control and Prevention in Atlanta, Ga, and colleagues. "The most frequently identified vaccines associated with optic neuritis in the literature are influenza and hepatitis B, and a report describing 2 US military cases suggests an association with the currently used anthrax vaccine (anthrax vaccine adsorbed)."
Using the Defense Medical Surveillance System, the investigators conducted a matched case-control study in US military personnel from January 1, 1998, through December 31, 2003. They estimated statistical associations between vaccine exposures and optic neuritis within 6-, 12-, and 18-week study intervals using multivariable conditional logistic regression analyses. The 1131 cases of optic neuritis were matched by sex, military component, and deployment status to 3393 controls.
There were no statistically significant associations between optic neuritis and anthrax vaccine for any of the 3 study intervals: 6-week interval (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.74 - 1.87); 12-week interval (OR, 0.92; 95% CI, 0.63 - 0.35); and 18-week interval (OR, 0.81; 95% CI, 0.58 - 1.14). Comparing those who received no dose, 1 dose, and 2 doses of anthrax vaccine, there was no difference in optic neuritis risk. For all study intervals, there were no statistically significant associations between optic neuritis and smallpox, hepatitis B, or influenza vaccines, and no vaccine-to-vaccine interactions were statistically significant.
Study limitations include lack of medical record review to confirm the diagnosis of optic neuritis; inability to rule out an infectious cause for a minority of cases; and age imbalance between cases and controls.
"The results from this vaccine postmarketing surveillance investigation suggest that there is no association between optic neuritis and receipt of anthrax, smallpox, hepatitis B, or influenza vaccinations in the US military, whether these vaccines are administered alone or in combination," the authors write. "The negative findings presented here are important to the continuing discussions regarding the safety of these vaccines."
Arch Neurol. 2006;63:871-875
Study Highlights
From January 1, 1998, through December 31, 2003, a matched case-control study was conducted among US military personnel, using the Defense Medical Surveillance System. A total of 1131 cases of optic neuritis and 3393 controls were matched by sex, military component, and deployment status.
Statistically significant differences between studied group and control were found for race, age, service branch, and occupational category.
Statistical associations between vaccine exposures and optic neuritis within 6-, 12-, and 18-week study intervals were estimated through multivariable conditional logistic regression analyses.
Optic neuritis was defined as those having a first-time diagnosis of the following International Classification of Diseases, Ninth Edition, Clinical Modification, codes: optic neuritis, unspecified (377.30); optic papillitis (377.31); retrobulbar neuritis, acute (377.32); and optic neuritis, other (377.39).
Findings revealed no statistically significant associations between optic neuritis and anthrax vaccine for any of the 3 study intervals: 6-week interval (OR, 1.18; 95% CI, 0.74 - 1.87), 12-week interval (OR, 0.92; 95% CI, 0.63 - 0.35), and 18-week interval (OR, 0.81; 95% CI, 0.58 - 1.14).
Furthermore, no difference in optic neuritis risk was detected when comparing those who received no dose, 1 dose, and 2 doses of anthrax vaccine during the 18-week study.
Similarly, no statistically significant associations were observed between optic neuritis and smallpox, hepatitis B, or influenza vaccines within any of the study intervals.
No vaccine-to-vaccine interactions were statistically significant.
A possible limitation to this study includes the omission of medical record review to confirm the diagnosis of optic neuritis.
Authors and Disclosures
As an organization accredited by the ACCME, Medscape, LLC requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.
Medscape, LLC encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
News Author
Laurie Barclay, MD
is a freelance writer for Medscape.
Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.
Clinical Reviewer
Gary Vogin, MD
Senior Medical Editor, Medscape
Disclosure: Gary Vogin, MD, has disclosed no relevant financial relationships.
CME Author
Hien T. Nghiem, MD
Writer for Medscape Medical News
Disclosure: Hien T. Nghiem, MD, has disclosed no relevant financial relationships.
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