Sleep Care

Flu Vaccine Eyed for Narcolepsy Link

Back in 2009-2010, there was an outbreak of the influenza strain H1N1, which came to be known as “swine flu”. Fortunately, the flu turned out to be one of the least lethal modern pandemics, killing only one out of about every 2,000 people. In the United States, a vaccine called Tamiflu was used to combat the spread of the flu. The most frequent side effects of Tamiflu, nausea, vomiting, and diarrhea, were

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occur in only 10% or less of patients thirteen years or older in studies assessing the safety and side effects of Tamiflu in response to naturally acquired influenza. Sick_in_BedOther countries used different vaccines to guard against H1N1. In Finland, Sweden, and other European countries, a vaccine called Pamdemrix was made available. It was produced by GlaxoSmithKline in Europe specifically for combating the H1N1 influenza strain. Notably, the drug contains an oil-in-water emulsion adjuvant called ASO3. Adjuvants are substances

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that boost the body’s immune response to a vaccine through a variety of methods, such as stimulating the activity of certain immune cells or becoming involved in the chemical pathways responsible for the production of the body’s immune defenses. Pandemrix, like other adjuvanted influenza vaccines,

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was not licensed for use in the United States by the Centers for Disease Control and Prevention (CDC). Pandemrix and Narcolepsy In May 2010, researchers in Finland began reporting an apparent link between narcolepsy in children and the administration of the Pandemrix vaccine. In some cases, the narcolepsy was accompanied by cataplexy, a condition in which the individual loses muscle composure. Narcolepsy was not observed in adults who were also given the vaccine. The link became apparent in part due to the rarity of narcolepsy in Finnish children: on average, about one child younger than ten is diagnosed with narcolepsy each year. A variety of factors were initially offered as reasons for this finding: genetics, an unknown environmental factor unique to Finland, pre-existence of narcolepsy that was “enhanced” by the vaccine. Since Pandemrix was issued to several European countries but cases were only initially reported from Finland, it was thought that perhaps Finland received a bad batch of the vaccine. However, reports of an association between the vaccine and narcolepsy eventually came from other European countries, including the United Kingdom. For its part, GlaxoSmithKline reported having details of 900 people across 14 countries who had received the vaccine and had narcolepsy. Pamdemrix has not been used since the 2009-2010 flu season. Perhaps one lesson that could be learned from this case study is that even when receiving something like a flu vaccine, be sure to be aware of the potential side effects or adverse symptoms, and consult with a physician if any unexpected ones seem to develop.

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