{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:54:50Z","timestamp":1792076090622,"version":"4.4.0"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"Importance<\/jats:title>Scientific literature is sparse about the association of vaccination with the onset of multiple sclerosis (MS) flare-ups. Immunization by vaccines of the entire population is crucially important for public health.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the risk of hospitalization for severe MS flare-ups after vaccination in patients with MS.<\/jats:p><\/jats:sec>Design, Setting, Participants<\/jats:title>This cohort study included patients diagnosed with MS between January 1, 2007, and December 31, 2017, who were included in the System of National Health Databases, a national health claims database in France. In a nested case-crossover analysis, cases were defined by vaccine exposure prior to the onset of hospitalization due to an MS flare-up, and flare-up rates were compared with those that occurred prior to vaccine exposure in up to 4 control time windows immediately preceding the at-risk time window (ie, the MS flare-up) for each patient. Data were analyzed from January 2022 to December 2022.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Receipt of at least 1 vaccination, including the diphtheria, tetanus, poliomyelitis, pertussis, or Haemophilus influenzae<\/jats:italic> (DTPPHi) vaccine, influenza vaccine, and pneumococcal vaccine, during follow-up.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was the risk of hospitalization for an MS flare-up after receipt of a vaccine. Adjusted odds ratios (AORs) and 95% CIs were derived using conditional logistic regression to measure the risk of hospitalization for an MS flare-up associated with vaccination.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 106\u202f523 patients constituted the MS cohort (mean [SD] age, 43.9 [13.8] years; 76 471 females [71.8%]; 33\u202f864 patients [31.8%] had incident MS and 72\u202f659 patients [68.2%] had prevalent MS) and were followed up for a mean (SD) of 8.8 (3.1) years. Of these patients, 35 265 (33.1%) were hospitalized for MS flare-ups during the follow-up period for a total of 54 036 MS-related hospitalizations. The AORs of hospitalization for an MS flare-up and vaccine exposure in the 60 days prior to the flare-up were 1.00 (95% CI, 0.92-1.09) for all vaccines, 0.95 (95% CI, 0.82-1.11) for the DTPPHi, 0.98 (95% CI, 0.88-1.09) for the influenza vaccine, and 1.20 (95% CI, 0.94-1.55) for the pneumococcal vaccine.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>A nationwide study of the French population found no association between vaccination and the risk of hospitalization due to MS flare-ups. However, considering the number of vaccine subtypes available, further studies are needed to confirm these results.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2023.2968","type":"journal-article","created":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T15:01:48Z","timestamp":1693926108000},"page":"1098","source":"Crossref","is-referenced-by-count":17,"title":["Vaccines and the Risk of Hospitalization for Multiple Sclerosis Flare-Ups"],"prefix":"10.1001","volume":"80","author":[{"given":"Lamiae","family":"Grimaldi","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Hospital Group Paris-Saclay, Assistance Publique-H\u00f4pitaux de Paris, Paris, France"},{"name":"Anti-Infective Evasion and Pharmacoepidemiology, Centre for Epidemiology and Population Health, INSERM U1018, Villejuif, France"},{"name":"Department of Pharmacoepidemiology, Faculty of Medicine and Health Science, University Versailles Saint-Quentin\/Paris-Saclay, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Papeix","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Foundation Adolphe de Rothschild, Paris, France"},{"name":"Department of Neurology, Faculty of Medicine, Paris-Cit\u00e9 University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Hamon","sequence":"additional","affiliation":[{"name":"[RE]MEDs, Rueil Malmaison, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Buchard","sequence":"additional","affiliation":[{"name":"[RE]MEDs, Rueil Malmaison, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yola","family":"Moride","sequence":"additional","affiliation":[{"name":"[RE]MEDs, Rueil Malmaison, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Benichou","sequence":"additional","affiliation":[{"name":"Department of 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