Narcolepsy after A/H1N1 vaccination

Comparison of Pandemrix and Arepanrix, two pH1N1 AS03-adjuvanted vaccines differentially associated with narcolepsy development

“…Pandemrix was used in Europe, whereas Arepanrix was used in Canada and South America. Interestingly, although convincing case reports of narcolepsy following Arepanrix have been published (Dauvilliers et al, 2010;Mendes et al, 2012), a recent analysis of data in Quebec suggests only a modest increased relative risk of 1.48-2.07 in a small sample size (Montplaisir et al, 2014).…”

La narcolepsie avec cataplexie : une maladie auto-immune ?

“…Narcolepsy type 1 (also named narcolepsy-cataplexy or hypocretin deficiency syndrome) is a rare sleep disorder dans d'autres pays utilisant également le vaccin, comme l'Irlande, le Royaume-Uni et la France [42,[44][45][46]. Curieusement, une telle augmentation de l'incidence de la narcolepsie n'a pas été observée en Amérique du Nord ou dans certains pays d'Amérique du Sud où Arepanrix (GSK, Canada), un vaccin très similaire à Pandemrix, a été utilisé [47][48][49] …”

Is narcolepsy a classical autoimmune disease?

“…In particular, vaccinated patients had a shorter delay in diagnosis and the MSLT analysis showed higher number of sleep onset REM periods [86]. Moreover, genotypification of Narcolepsy/Cataplexy post vaccination cases from Switzerland, United States, the United Kingdom, France, and Brazil found that all the patients were carriers of DQB1*06:02 [61,76,87], and one particular case with an additional diagnosis of multiple sclerosis was also DRB1*15:01 positive [88].…”

“…There is no evidence of narcolepsy in other adjuvanted or nonadjuvanted H1N1 vaccines [90][91][92][93]. Just one case has been reported in Brazil, where a 19 year old women carrier of the DQB1*06:02 allele developed narcolepsy after she was vaccinated with Arepanrix (AS03 adjuvanted vaccine manufactured in Canada -Table 1) [4,87]. Recently, the hypothesis that the manufacturing process of the vaccines can be the culprit of this situation has been emerged, since they vary in composition as well as in the production process (Table 1) [4,23].…”