Bioethics Blogs

Journal retracts paper linking vaccine and narcolepsy

A paper that once promised to help unravel a medical mystery — why some children developed narcolepsy after receiving an influenza vaccine — has been retracted.

Narcolepsy is a disorder that causes extreme sleepiness, sometimes inducing uncontrollable ‘sleep attacks’ that can strike at any time of day. In 2010, a puzzling cluster of sudden-onset narcolepsy cases was reported in Europe among children vaccinated with GlaxoSmithKline’s Pandemrix flu vaccine against the H1N1 ‘swine flu’ that had caused a pandemic in 2009.

On 18 December 2013, researchers reported a possible connection between the vaccine and narcolepsy. In a paper published in Science Translational Medicine, they showed that people with narcolepsy produce immune cells called T cells that recognize hypocretin, a neurotransmitter that regulates wakefulness. People with narcolepsy tend to have low levels of hypocretin in neurons that control wakefulness, and the results supported the notion that autoimmune responses could be destroying the neurotransmitter.

The authors, led by immunologist Elizabeth Mellins and narcolepsy researcher Emmanuel Mignot of the Stanford School of Medicine in Palo Alto, California, went on to demonstrate that pieces of a flu protein often used in vaccines stimulated immune cells that recognize hypocretin. This suggested a mechanism by which the vaccine could contribute to narcolepsy in some people.

But on 31 July, the authors announced that they have been unable to repeat a key finding: that immune cells from people with narcolepsy respond to hypocretin more so than immune cells from people who do not have narcolepsy. “Because the validity of the conclusions reported in the study cannot be confirmed, we are retracting the article,” the team wrote.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.