Stowe J, Andrews N, Gringras P, et al. - Given the correlation of the AS03-adjuvanted H1N1 pandemic vaccine Pandemrix with an excess of cases of narcolepsy, researchers sought to determine the duration of elevated risk postvaccination and examine the risk in children aged under 5 years who may not present until much older. From hospital notes at 3 large pediatric sleep centers in England, they obtained clinical information and sleep test results, for narcolepsy cases aged 4–19 years with symptom onset since January 2009. Comparison was performed of the proportion of cases vaccinated before onset with that in the age-matched population at the time of symptom onset in each case. After Pandemrix, 7-fold elevated risk of onset of narcolepsy was noted. This elevated risk was confined to the first year after vaccination, with the highest risk within 6 months. They identified no evidence suggesting a compensatory drop in risk to below one between 1 and 8 years after vaccination. Children vaccinated under 5 years or at an older age were noted to be at similar vaccine-associated risk.