Hepatitis B Vaccine and Multiple Sclerosis

In 1998, some research caused concern that hepatitis B vaccination might be linked with multiple sclerosis (MS), a progressive nerve disease. Numerous studies have evaluated a possible relationship between hepatitis B vaccination and MS. A large body of scientific evidence now shows that hepatitis B vaccination does not cause or worsen MS.

What is multiple sclerosis (MS)?

Multiple sclerosis (MS)external icon is an autoimmune disease that affects the brain and spinal cord (central nervous system). In many cases, MS can cause permanent disability and even death.

It is unknown what exactly causes MS. The most common thought is that a virus or gene defect- or both- are to blame. Environmental factors may also play a role.

Multiple sclerosis (MS) affects women more than men. The disorder is most commonly diagnosed between ages 20 and 40, but it can be seen at any age. You are slightly more likely to develop this condition if you have a family history of MS or you live in a part of the world where MS is more common.

Does hepatitis B vaccination cause MS?

No. Hundreds of millions of people worldwide have received hepatitis B vaccine without developing MS or any other autoimmune disease.   As with all vaccines and any disease, due to the large number of vaccinations administered worldwide, surveillance systems that monitor health concerns after vaccination do expect to receive reports of MS occurring after vaccination that happen by chance alone.

To further explore any possible connection between hepatitis B vaccination and MS, many scientific studies have been conducted, and have concluded that hepatitis B vaccination does not cause MS.

Examples of this scientific evidence are:

  • A study conducted in France from 1994 to 2003 (Mikaeloff, 2007) compared children with MS to children without. The study did not find a relationship between vaccination for hepatitis B and the development of childhood-onset MS.
  • In the United States, a study (Verstraeten et al., 2001) compared 422 adults with demyelinating diseasesexternal icon, including MS, and 921 matched controls (people similar in age, gender, and enrollment in a healthcare system, but who did not have demyelinating disease). The researchers concluded that hepatitis B vaccination was not associated with demyelinating disease in the study population.
  • Other studies conducted in the US (Ascherio and colleagues, 2001), in Europe (Confavreaux, 2001) and in British Columbia (Sadovnick and Scheifele, 2000) also evaluated the possible link between hepatitis B vaccination and MS, and also found no association between hepatitis B vaccination and MS.
  • In 2002, the Institute of Medicine (IOM) reviewed published and unpublished research to determine if there was a link 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.

What research has been conducted on vaccines and other autoimmune diseases?

CDC takes concerns about vaccines and immune system diseases and disorders very seriously. Researchers at CDC and elsewhere have conducted studies to examine the possible link between vaccines and autoimmune conditions like MS, diabetes, and asthma. These studies have been reassuring, providing no evidence to suggest a link between vaccines and autoimmune conditions.

As part of ongoing vaccine safety surveillance, CDC continues to conduct research to examine the effects vaccines may have on the immune system.

References

Ascherio A, Zhang SM, Hernán MA, Olek MJ, Coplan PM, Brodovicz K, et al. Hepatitis B vaccination and the risk of multiple sclerosisexternal icon. N Engl J Med. 2001 Feb 1;344(5):327-32.

Confavreux C, Suissa S, Saddier P, Bourdès V, Vukusic S; Vaccines in Multiple Sclerosis Study Group. Vaccinations and the risk of relapse in multiple sclerosisexternal icon. N Engl J Med. 2001 Feb 1;344(5):319-26.

Institute of Medicine. Immunization Safety Review: Hepatitis B Vaccine and Demyelinating Neurological Disordersexternal icon. Washington DC; 2002.

Mikaeloff Y, Caridade G, Rossier M, Suissa S, Tardieu M. Hepatitis B vaccination and the risk of childhood-onset multiple sclerosisexternal icon. Arch Pediatr Adolesc Med. 2007 Dec;161(12):1176-82.

Sadovnik AD, Scheifele DW. School-based hepatitis B vaccination programme and adolescent multiple sclerosisexternal icon. Lancet. 2000;355(9203):549–550.

Verstraeten T, DeStefano F, Jackson L, Benson P, Okoro C, et al. 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.