This article evaluates the epidemiological evidence for a relationship between vaccination and neurological disease, specifically multiple sclerosis, Guillain-Barré syndrome and narcolepsy. The statistical methods used to test vaccine safety hypotheses are described and the merits of different study designs evaluated; these include the cohort, case-control, case-coverage and the self-controlled case-series methods. For multiple sclerosis, the evidence does not support the hypothesized relationship with hepatitis B vaccine. For Guillain-Barré syndrome, the evidence suggests a small elevated risk after influenza vaccines, though considerably lower than after natural influenza infection, with no elevated risk after human papilloma virus vaccine. For narcolepsy, there is strong evidence of a causal association with one adjuvanted vaccine used in the 2009/10 influenza pandemic. Rapid investigation of vaccine safety concerns, however biologically implausible, is essential to maintain public and professional confidence in vaccination programmes.

中文翻译：

---

疫苗会引发神经系统疾病吗？以多发性硬化症，格林-巴利综合征和嗜睡症为例，对疫苗接种和神经系统疾病进行流行病学评估。

本文评估了疫苗接种与神经系统疾病之间的关系的流行病学证据，特别是多发性硬化症，格林-巴利综合征和发作性睡病。描述了用于检验疫苗安全性假设的统计方法，并评估了不同研究设计的优点；这些包括队列，案例控制，案例覆盖和自控案例系列方法。对于多发性硬化症，证据不支持与乙型肝炎疫苗的假设关系。对于Guillain-Barré综合征，有证据表明，流感疫苗接种后的风险升高幅度很小，尽管比自然流感感染后的风险要低得多，而人乳头瘤病毒疫苗接种后风险却没有升高。发作性睡病 有强有力的证据表明，与2009/10流感大流行中使用的一种辅助疫苗有因果关系。对疫苗安全性问题进行快速调查（无论从生物学上讲是不可行的）对于维持公众和专业人士对疫苗接种计划的信心至关重要。