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Published on: October 13, 2023
Tetanus vaccination and risk of multiple sclerosis: a systematic review
Miguel A Hernán1, Alvaro Alonso, Sonia Hernández-Díaz
1Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA. miguel_hernan@post.harvard.edu
Objective:
To conduct a systematic review on the association between tetanus vaccination and the risk of multiple sclerosis (MS).
Methods:
The authors searched the databases Medline, LILACS, EMBASE, and Science Citation Index including the period 1966 to September 1, 2005. Eligible studies had to meet the following inclusion criteria: presentation of original data, case-control or cohort design, physician-confirmed diagnosis of MS as the outcome of interest, attempt to ascertain vaccinations in a period before the diagnosis, and report of an association measure between tetanus vaccination and incidence of MS, and its 95% CI or enough information to compute it. Study specific log ORs were weighted by the inverse of their variances to obtain a pooled estimate and its 95% CI.
Results:
The OR of MS associated with history of tetanus vaccination was 0.67 (95% CI: 0.55 to 0.81). There was little indication of heterogeneity of results across studies.
Conclusion:
Tetanus vaccination is associated with a lower risk of multiple sclerosis.
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