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Hepatitis B Vaccine and Concerns about Multiple Sclerosis (MS)Numerous studies have evaluated a possible relationship between hepatitis B vaccination and multiple sclerosis (MS). The weight of the available scientific evidence does not support the suggestion that hepatitis B vaccine causes or worsens MS.
What is multiple sclerosis (MS)? MS is a progressive and usually fluctuating disease with exacerbations (patients feeling worse) and remissions (patients feeling better) over many decades. In many patients with MS, permanent disability and even death can occur. The cause of MS is unknown. The most widely held hypothesis is that MS occurs in patients with a genetic susceptibility and is "triggered" by certain environmental factors. MS is 3 times more common in women than men, with diagnosis usually made as young adults; however, it has been estimated that between 2 to 5% of cases begin before age 16. Since MS is not widely recognized as a childhood disorder, diagnosis is often missed or delayed. In addition, many of its symptoms are similar to those of other pediatric neurological conditions, leukodystrophies and metabolic disorders. Diagnosis in childhood is difficult due to the lack of universally accepted diagnostic criteria. Does hepatitis B vaccination cause MS?
What has been done to examine the suggested association between hepatitis B vaccine and neurological disorders? In 2002, the IOM reviewed the evidence of a possible causal association between hepatitis B vaccine and demyelinating neurological disorders, including MS in adults. The committee found that the epidemiological evidence does not support a causal relationship between hepatitis B vaccine in adults and multiple sclerosis. Should I delay hepatitis B vaccination until more is known? What research has been conducted to look at the possible link between vaccines and autoimmune diseases? As part of ongoing vaccine safety surveillance, CDC will continue to conduct research to examine the effects vaccines may have on the immune system. Related Publications Ascherio A, Zhang SM, Hernan MA, et al. Hepatitis B vaccination and the risk of multiple sclerosis.* New England Journal of Medicine 2001;344(5):327–332. Confavreux C, Suissa S, Saddier P et al. Vaccinations and the risk of relapse in multiple sclerosis.* New England Journal of Medicine 2001;344(5):319–326. DeStefano F, Weintraub ES, Chen RT. Hepatitis B vaccine and risk of multiple sclerosis [letter]. Pharmacoepidemiology and Drug Safety 2007;16(6):705–707. Fourrier A, Touze E, Alperovitch A, Begaud B. Association between hepatitis B vaccine and multiple sclerosis: a case-control study. Pharmacoepidemiology & Drug Safety 1999;8:S140–141. Herrolen L, DeKeyser J, Ebinger G. Central nervous system demyelination after immunisation with recombinant hepatitis B vaccine. Lancet 1991;338(8776):1174–1175. Lewis E, Shinefield HR, Woodruff BA, Black SB, DeStefano F, Chen RT, Ensor R. Safety of neonatal hepatitis B vaccine administration. Pediatric Infectious Disease Journal 2001;20: 10489-1054. Mikaeloff Y, Caridade G, Rossier M, Suissa S, Tardieu M. Hepatitis B vaccination and the risk of childhood-onset multiple sclerosis. Arhcilves of Pediatricks and Adolescent Medicine 2007: 161(12): 1214-15. Niu MT, Rhodes P, Salive M, Davis DM, Black S, Shinefield H, Chen RT, Ellenberg SS. Comparative safety of two recombinant hepatitis B vaccines in children: data from the Vaccine Adverse Event Reporting System (VAERS) and Vaccine Safety Datalink (VSD). Journal of Clinical Epidemiology 1998; 51(6):503-510. Quast U, Herder C, Zwisler O. Vaccination of patients with encephalomyelitis disseminata. Vaccine 1991;9(4):228–230. Sadovnik AD, Scheifele DW. School-based hepatitis B vaccination programme and adolescent multiple sclerosis. Lancet 2000;355(9203):549–550. Sturkenboom MCJM, Abenhaim L, Wolfson C, Roulet E, Heinzelf O, Gout O. Vaccinations, demyelination, and multiple sclerosis study (VDAMS). Pharmacoepidemiology & Drug Safety 1999;8:S170–171. Touzé E, Gout O, Verdier-Taillefer MH, Lyon-Caen O, Alpérovitch A. The first episode of central nervous system demyelinization and hepatitis B vaccination. Revue Neurologique 2000;156(3):242–246. Verstraeten T, DeStefano F, Jackson L, Benson P, Okoro C, Black S, Shinefield H., Mullooly J, Chen R.; VSD Team. Risk of demyelinating disease after hepatitis B vaccination—West Coast, United States, 1995–1999. Paper presented at the 50th Annual Epidemic Intelligence Service Conference, 2001, Atlanta GA. Yu O, Bohlke K, Hanson CA, Delaney K, Rees TG, Zavitkovsky A, Ray P, Mullooly J, Black SB, Benson P, Thompson WW, Davis RL, Jackson LA. Hepatitis B vaccine and risk of autoimmune thyroid disease: a Vaccine Safety Datalink study. Pharmacoepidemiology and Drug Safety 2007;16(7a):736-745. Zipp F, Weil JG, Einhaupl KM. No increase in demyelinating diseases after hepatitis B vaccination. Nature Medicine 1999;5(9):964–965. *Links to non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.
Page last reviewed: October 14, 2008
Page last updated: October 14, 2008 Content source: Immunization Safety Office |
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