VACCINE

Archives Of Neurology • November 2007
Optic Neuritis and Vaccination Investigation:
Failure to Consider Significant Sex Differences
and Multiple Vaccine Combinations
Renata J. M. Engler, MD; Mary Klote, MD;
Michael R. Nelson, MD, PhD
Abstract
In follow-up to recent correspondence related to the study of vaccinations and subsequent
optic neuritis by the Centers for Disease Control and Prevention (CDC),1,2
we are deeply concerned regarding the lack of consideration of sex differences in
incidence of disease for the ICD-9 code 377.3, a common finding for autoimmune
disorders, particularly in young adults aged 18 to 39 years. The Defense Medical
Surveillance System (DMSS) demonstrates that in the population of service
members of greatest concern, there is a consistent pattern, regardless of year for
review, of increased disease incidence by first visit in women compared with men.
This sex difference is also independent of race. The Figure was extracted from the
remote access program to data contained within the DMSS offered by the Army
Medical Surveillance Activity.3 Similar sex differences were identified for ICD-9
codes for optic neuritis, unspecified (377.30); optic papillitis (377.31); retrobulbar
neuritis, acute (377.32); and optic neuritis, other (377.39) during the period between
January 1, 1998, and December 31, 2003. It is of increasing concern in the
context of medical evidence and research that sex differences are not adequately
considered in both research design and data analysis. Given the mandatory nature
of immunizations in the military health system and the fact that most visits involve
complex and sometimes new mixtures, concern for sex-based risk differences is
not a minor question and merits far more attention on the agenda of vaccine safety
surveillance.
“we are deeply concerned
regarding the lack of consideration
of sex differences in incidence of disease ...
there is a consistent pattern, regardless of year
for review, of increased disease incidence
by first visit in women compared with men ...”
http://archneur.jamanetwork.com/article.aspx?articleid=794738&resultClick=3