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dc.contributor.authorHughes, A.M.en
dc.contributor.authorPonsonby, A.L.en
dc.contributor.authorDear, K.en
dc.contributor.authorDwyer, T.en
dc.contributor.authorTaylor, B.V.en
dc.contributor.authorvan der Mei, I.en
dc.contributor.authorValery, P.C.en
dc.contributor.authorLucas, R.M.en
dc.identifier.citationMultiple Sclerosis and Related Disorders, 2020; 42:1-8en
dc.description.abstractBackground: The association between childhood vaccinations and infections and risk of multiple sclerosis is unclear; few studies have considered age at vaccination/infection. Objective: To explore age-related associations between childhood vaccinations, infection and tonsillectomy and risk of a first clinical diagnosis of CNS demyelination. Methods: Data on case (n = 275, 76.6% female; mean age 38.6 years) and age- and sex-matched control (n = 529) participants in an incident population-based case-control study included self-reported age at time of childhood vaccinations, infections, and tonsillectomy. Conditional logistic regression models were used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results: Poliomyelitis vaccination prior to school-age was associated with increased risk of a first clinical diagnosis of CNS demyelination (AOR = 2.60, 95%CI 1.02–6.68), based on a very small unvaccinated reference group. Late (11–15 years) rubella vaccination (compared to none) was associated with lower odds of being a case (AOR = 0.47, 95%CI 0.27–0.83). Past infectious mononucleosis at 11–15 years (AOR = 2.84, 95%CI 1.0–7.57) and 16–20 years (AOR = 1.92, 95%CI 1.12–3.27) or tonsillectomy in adolescence (11–15 years: AOR = 2.45, 95%CI 1.12–5.35), including after adjustment for IM, were associated with increased risk of a first clinical diagnosis of CNS demyelination. Conclusions: Age at vaccination, infection or tonsillectomy may alter the risk of subsequent CNS demyelination. Failing to account for age effects may explain inconsistencies in past findings.en
dc.description.statementofresponsibilityA.M.Hughes, A.-L.Ponsonby, K.Dear, T.Dwyer, B.V.Taylor, I.van der Mei ... et al.en
dc.rights© 2020 Elsevier B.V. All rights reserved.en
dc.subjectMultiple sclerosis; infections; vaccinations; tonsillectomy; case-control study; demyelinationen
dc.titleChildhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Studyen
dc.typeJournal articleen
dc.identifier.orcidDear, K. [0000-0002-0788-7404]en
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