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Vaccination and the risk of multiple sclerosis

There is no association between hepatitis B vaccination and the development of multiple sclerosis.

By | February 2, 2001

Reports of multiple sclerosis (MS) developing after hepatitis B vaccination raised the concern that this vaccine can cause MS in previously healthy subjects. Two studies published in the 1 February issue of the New England Journal of Medicine indicate no association between this vaccine and the development of MS.

Christian Confavreux from Hôpital Neurologique, Lyons, France, and colleagues from the Vaccines in Multiple Sclerosis Study Group, investigated 643 European patients with multiple sclerosis. They found a 0.71 relative risk of relapse associated with exposure to any vaccination during the previous two months (95% confidence interval, 0.40 – 1.26). There was no increase in the specific risk of relapse associated with tetanus, hepatitis B, or influenza vaccination (range of relative risks, 0.22 – 1.08). Analyses based on risk periods of one and three months yielded similar results (N Engl J Med 2001, 344:319-326).

Meanwhile, in a case-control study, Alberto Ascherio and colleagues from Harvard Medical School, Boston reviewed the cases of 192 nurses in the US with multiple sclerosis and 645 matched controls. They found a 0.9 (95% confidence interval, 0.5 – 1.6) relative risk of multiple sclerosis associated with exposure to the hepatitis B vaccine at any time before the onset of the disease (N Engl J Med 2001, 344:327-332).

These negative studies also serve to illustrate how hypotheses can become 'facts' long before the critical data are in.

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