Role of vaccinations as risk factors for ill health in veterans of the Gulf war: cross sectional study

Objectives To explore the relation between ill health after the Gulf war an d vaccines received before or during the conflict To test the hypothesis th at such ill health is limited to military personnel who received multiple v accines during deployment and that pesticide use modifies any effect. Design Cross sectional study of Gulf war veterans followed for six to eight years after deployment Setting UK armed forces. Participants Military personnel who served in the Gulf and who still had th eir vaccine records. Main outcome measures Multisymptom illness as classified by the Centers for Disease Control and Prevention; fatigue; psychological distress; post-trau matic stress reaction; health perception; and physical functioning Results The response rate for the original survey was 70.4% (n = 3284). Of these, 28% (923) had vaccine records. Receipt of multiple vaccines before d eployment was associated with only one of the six health outcomes (post-tra umatic stress reaction). By contrast five of the six outcomes tall but post -traumatic stress reaction) were associated with multiple vaccines received during deployment. The strongest association was for the multisymptom illn ess (odds ratio 5.0; 95% confidence interval 2.5 to 9.8). Conclusion Among veterans of the Gulf war there is a specific relation betw een multiple vaccinations given during deployment and later ill health. Mul tiple vaccinations in themselves do not seem to be harmful but combined wit h the "stress" of deployment they may be associated with adverse health out comes. These results imply that every effort should be made to maintain rou tine vaccines during peacetime.