To the Editor We read with interest the work by Langer-Gould et al1 about the risk for demyelinating diseases after vaccinations. The major points of the article (no long-term risk for multiple sclerosis [MS] and short-term risk for neuroinflammation for any type of vaccination in younger individuals) suggest various levels of complexities.
Time (that is, age and time of vaccine administration) is important in the interplay between susceptible hosts and environmental factors.2 Previous work on the modeling of nondeterministic processes in MS development (random perturbations and time can amplify the effects of weak genetic and environmental factors)3 may provide a conceptual framework to interpret a timing effect of vaccines on neuroinflammation.