Hepatitis B Vaccine Not Associated With Childhood Multiple Sclerosis

Vaccinating against the hepatitis B virus does not appear to be associated with the risk of developing multiple sclerosis in childhood, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals1.

Several studies have evaluated a possible association between the hepatitis B vaccine and the autoimmune neurological disease multiple sclerosis (MS) in adults, according to background information in the article. Most have found no significant increase in the risk of MS in the short or long term, although one identified a potentially increased risk within three years of vaccination. “Some of these epidemiologic studies have been criticized for methodological limitations,” including how vaccination status was confirmed, the authors write. “This controversy created public misgivings about hepatitis B vaccination. Hepatitis B vaccination in children remained low in several countries despite vaccination campaigns supporting early vaccination against hepatitis B in children as a means of inducing strong and long-lasting immunity and despite high levels of hepatitis B–related morbidity and mortality worldwide.”

Yann Mikaeloff, M.D., Ph.D., of Hôpital Bicêtre, Le Kremlin Bicêtre, France, and colleagues studied 143 children who developed MS before age 16, with a first episode of the disease occurring between 1994 and 2003. Each patient was matched to an average of eight control participants from the general French population who were the same age and sex and lived in the same location but did not have MS. Telephone interviews and questionnaires were used to collect vaccination records and information about family history of MS or other autoimmune diseases.

In the three years before the first episode of MS, approximately 32 percent of both the 143 patients and the 1,122 controls were vaccinated against hepatitis B. “Vaccination against hepatitis B within the three-year study period was not associated with an increased rate of a first episode of MS,” the authors write. “The rate was also not increased for hepatitis B vaccination within six months of the index date or at any time since birth or as a function of the number of injections or the brand of hepatitis B vaccine.”

“Vaccination against hepatitis B does not seem to increase the risk of a first episode of MS in childhood,” they conclude.

It can sometimes be difficult to tell whether a new study represents a significant medical advance or flawed research, write Frederick P. Rivara, M.D., M.P.H., and Dimitri A. Christakis, M.D., M.P.H., of the University of Washington, Seattle, in an accompanying editorial. Dr. Rivara is editor and Dr. Christakis an associate editor of Archives of Pediatrics & Adolescent Medicine.2

“In this issue of the Archives, Mikaeloff and colleagues conducted a large well-done study to examine a link between hepatitis B vaccine and multiple sclerosis,” they write. “We have published it both because of the rigor of the research and because of the need to reassure a public that is increasingly wary of vaccination. Going forward, we hope that the process of scientific discovery proceeds in a rigorous and thoughtful way that will increase the public’s health and not harm it.”


1. Arch Pediatr Adolesc Med. 2007; 161(12):1176-1182. 

2. Arch Pediatr Adolesc Med. 2007; 161(12):1214-1215.