Vaccinating against the hepatitis B virus does not appear to be associated with the risk of developing
multiple sclerosis in childhood, according to a new article.
　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. Journal reference: Arch Pediatr Adolesc Med. 2007;161(12):1176-1182.
　Editorial: Medical Journals Bear Responsibility for Disseminating Accurate Findings
　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.
　"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."
　Reference for editorial: Arch Pediatr Adolesc Med. 2007;161(12):1214-1215.
　Adapted from materials provided by JAMA and Archives Journals.