They also noted that if specific peptides of pandemic H1N1 are shown to interact with narcolepsy-associated genes, an understanding of the triggers of narcolepsy may begin to emerge, potentially leading to new approaches for prevention and treatment.
As for the emerging concerns about adjuvanted vaccine and narcolepsy risk, Dr. Hauser and Dr. Johnston noted that the findings of this study raise the possibility that narcolepsy following infection and vaccination might represent a common immune response to a similar antigenic challenge – a phenomenon seen with ADEM (acute disseminated encephalomyelitis) that can occur following both native infection with measles virus, or after administration of measles vaccine. In the case of ADEM, the risk is far greater with infection than with vaccination.
"Clearly we need to insure that all flu vaccines ... are as safe as possible; however, we need also to keep in mind that the risk of any adverse outcome related to vaccination must be balanced against the known risk of community-acquired infection," they wrote.
This study was supported by research grants from the National Science Foundation of China, the Sino-German Center for Research Promotion, the Beijing Municipal Science and Technology commission, and by the Veterans Administration Research Service. Dr. Emmanuel Mignot, one of the authors, reported serving as a consultant and/or providing expert testimony for Jazz Pharmaceuticals, Merck, Mead, and the Federal Trade Commission. Dr. Mignot also has been in discussion with GlaxoSmithKline, the maker of Pandemrix, regarding the funding of contractual research.