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Letters Narcolepsy and pandemic A/H1N1 2009 influenza vaccine

Is the risk of narcolepsy also increased with non-adjuvanted flu vaccines?

BMJ 2013; 346 doi: (Published 13 May 2013) Cite this as: BMJ 2013;346:f2769
  1. Lennart Waldenlind, pharmacovigilance assessor1,
  2. Birgitta Grundmark, pharmacovigilance assessor12,
  3. Faranak Azarbayjani, pharmacovigilance assessor13,
  4. Andreas Börjesson, pharmacovigilance assessor1,
  5. Hans Olaisson, pharmacovigilance assessor1
  1. 1Department of Pharmacovigilance, Medical Products Agency, PO Box 26, SE-751 03 Uppsala, Sweden
  2. 2Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
  3. 3Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
  1. lennart.waldenlind{at}

In line with previous studies, Miller and colleagues find an increased risk of narcolepsy after vaccination with AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine (Pandemrix; odds ratio 16.2, 95% CI 3.1 to 84.5) and call for similar studies on other flu vaccines.1

Several flu vaccines are available in Europe, both adjuvanted and non-adjuvanted. All suspected adverse vaccine reactions must be reported to pan-European database EudraVigilance (, which will soon be fully publicly accessible. The first suspected case of narcolepsy associated with a non-adjuvanted flu …

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