| How to cite this article: Wiwanitkit S, Wiwanitkit V. Psychiatric comorbidity, cognitive profile, narcolepsy, and H1N1 influenza vaccination. Ann Trop Med Public Health 2015;8:147 |
| How to cite this URL: Wiwanitkit S, Wiwanitkit V. Psychiatric comorbidity, cognitive profile, narcolepsy, and H1N1 influenza vaccination. Ann Trop Med Public Health [serial online] 2015 [cited 2021 Apr 14];8:147. Available from: https://www.atmph.org/text.asp?2015/8/4/147/162404 |
Dear Sir,
The problem of adverse effects due to the H1N1 influenza vaccination is very interesting.
The neuropsychiatric complication is not widely mentioned. Szakács et al. evaluated “psychiatric comorbidity and the cognitive profile in children and adolescents with narcolepsy” and found that “the most frequent psychiatric symptom was temper tantrums, which occurred in 94% of the patients in the PHV group and 71% of the patients in the nPHV narcolepsy group.” [1] Considering that study, [1] it can be seen that the problem was evident in both post-H1N1 vaccination (PHV) and non-post-H1N1 vaccination (nPHV) groups; however, Szakács et al. did not further statistically analyze whether there was any difference between the two groups. The relationship between narcolepsy and H1N1 influenza vaccination is an interesting topic. Duffy et al. recently reported no association between narcolepsy and H1N1 influenza vaccination. [2] However, Montplaisir et al. mentioned that there might be increased risk but that the increase might be due to the “confounding effect of the influenza infection.” [3] In the previous reports, [1],[2],[3] the possible higher rate of psychiatric symptoms in the PHV group may have some implications that should be further studied. Some hypothesized about immunopathogenesis leading to cognitive impairment and narcolepsy. [4] However, this is not approved for PHV cases. [5] The problem of the confounding effect of influenza infection is thus widely mentioned in the present day. Van der Most et al. wrote that “evidence of a mimicry-based mechanism could also explain the association between narcolepsy and A(H1N1)pdm09 influenza infection.” [6] However, Melén et al. noted “No serological evidence of influenza A H1N1pdm09 virus infection as a contributing factor in childhood narcolepsy after Pandemrix vaccination campaign in Finland.” [7] Hence, the effect of the possible “confounding effect of the influenza infection” should also be further assessed.
| References |
| 1. |
Szakács A, Hallböök T, Tideman P, Darin N, Wentz E. Psychiatric comorbidity and cognitive profile in children with narcolepsy with or without association to the H1N1 influenza vaccination. Sleep 2015;38:615-21.
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| 2. |
Duffy J, Weintraub E, Vellozzi C, DeStefano F; Vaccine Safety Datalink. Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States. Neurology 2014;83:1823-30.
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| 3. |
Montplaisir J, Petit D, Quinn MJ, Ouakki M, Deceuninck G, Desautels A, et al. Risk of narcolepsy associated with inactivated adjuvanted (AS03) A/H1N1 (2009) pandemic influenza vaccine in Quebec. PLoS One 2014;9:e108489.
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| 4. |
Partinen M, Kornum BR, Plazzi G, Jennum P, Julkunen I, Vaarala O. Narcolepsy as an autoimmune disease: The role of H1N1 infection and vaccination. Lancet Neurol 2014;13:600-13.
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| 5. |
Fugger L, Steinman L. A scientific sequel to Stieg Larsson: Relationship between Pandemrix – pandemic influenza vaccine – and the subsequent development of narcolepsy. J Intern Med 2014;275: 195-7.
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| 6. |
van der Most R, Van Mechelen M, Destexhe E, Wettendorff M, Hanon E. Narcolepsy and A(H1N1)pdm09 vaccination: Shaping the research on the observed signal. Hum Vaccin Immunother 2014;10:572-6.
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| 7. |
Melén K, Partinen M, Tynell J, Sillanpää M, Himanen SL, Saarenpää-Heikkilä O, et al. No serological evidence of influenza A H1N1pdm09 virus infection as a contributing factor in childhood narcolepsy after Pandemrix vaccination campaign in Finland. PLoS One 2013;8:e68402.
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Source of Support: None, Conflict of Interest: None
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DOI: 10.4103/1755-6783.162404
