FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 344:327-332 February 1, 2001 Number 5 Next

	Full Text PDF Editorial by Gellin, B. G. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Reports of multiple sclerosis developing after hepatitis B vaccination have led to the concern that this vaccine might be a cause of multiple sclerosis in previously healthy subjects.

Methods We conducted a nested case–control study in two large cohorts of nurses in the United States, those in the Nurses' Health Study (which has followed 121,700 women since 1976) and those in the Nurses' Health Study II (which has followed 116,671 women since 1989). For each woman with multiple sclerosis, we selected as controls five healthy women and one woman with breast cancer. Information about hepatitis B vaccination was obtained by means of a mailed questionnaire and was confirmed by means of vaccination certificates. The analyses included 192 women with multiple sclerosis and 645 matched controls (534 healthy controls and 111 with breast cancer) and were conducted with the use of conditional logistic regression.

Results The multivariate relative risk of multiple sclerosis associated with exposure to the hepatitis B vaccine at any time before the onset of the disease was 0.9 (95 percent confidence interval, 0.5 to 1.6). The relative risk associated with hepatitis B vaccination within two years before the onset of the disease was 0.7 (95 percent confidence interval, 0.3 to 1.8). The results were similar in analyses restricted to women with multiple sclerosis that began after the introduction of the recombinant hepatitis B vaccine. There was also no association between the number of doses of vaccine received and the risk of multiple sclerosis.

Conclusions These results indicate no association between hepatitis B vaccination and the development of multiple sclerosis.

Source Information

From the Departments of Epidemiology (A.A., M.A.H., A.M.W.) and Nutrition (A.A., S.M.Z.), Harvard School of Public Health, Boston; the Multiple Sclerosis Unit, Center for Neurological Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston (M.J.O.); and Merck Research Laboratories, West Point, Pa. (P.M.C., K.B.).

Address reprint requests to Dr. Ascherio at the Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115, or at alberto.ascherio{at}channing.harvard.edu.

Full Text of this Article

This article has been cited by other articles:

• Mikaeloff, Y., Caridade, G., Rossier, M., Suissa, S., Tardieu, M. (2007). Hepatitis B Vaccination and the Risk of Childhood-Onset Multiple Sclerosis. Arch Pediatr Adolesc Med 161: 1176-1182 [Abstract] [Full Text]  
• Mikaeloff, Y., Caridade, G., Assi, S., Tardieu, M., Suissa, S., on behalf of the KIDSEP study group of the French, (2007). Hepatitis B vaccine and risk of relapse after a first childhood episode of CNS inflammatory demyelination. Brain 130: 1105-1110 [Abstract] [Full Text]  
• Hawkes, C.H. (2005). Are multiple sclerosis patients risk-takers?. QJM 98: 895-911 [Abstract] [Full Text]  
• Poland, G. A., Jacobson, R. M. (2004). Prevention of Hepatitis B with the Hepatitis B Vaccine. NEJM 351: 2832-2838 [Full Text]  
• Naismith, R. T., Cross, A. H. (2004). Does the hepatitis B vaccine cause multiple sclerosis?. Neurology 63: 772-773 [Full Text]  
• Hernan, M. A., Jick, S. S., Olek, M. J., Jick, H. (2004). Recombinant hepatitis B vaccine and the risk of multiple sclerosis: A prospective study. Neurology 63: 838-842 [Abstract] [Full Text]  
• Karayiannis, P., Main, J., Thomas, H. C. (2004). Hepatitis vaccines. Br Med Bull 70: 29-49 [Full Text]  
• Bale, J. F. JR (2004). Topical Review: Neurologic Complications of Immunization. J Child Neurol 19: 405-412 [Abstract]  
• Riise, T. (2003). Can we contract multiple sclerosis from our working environment?. Mult Scler 9: 217-218  
• Stenager, E., Bronnum-Hansen, H., Koch-Henriksen, N. (2003). The risk of multiple sclerosis in nurses: a population-based epidemiological study. Mult Scler 9: 299-301 [Abstract]  
• DeStefano, F., Verstraeten, T., Jackson, L. A., Okoro, C. A., Benson, P., Black, S. B., Shinefield, H. R., Mullooly, J. P., Likosky, W., Chen, R. T. (2003). Vaccinations and Risk of Central Nervous System Demyelinating Diseases in Adults. Arch Neurol 60: 504-509 [Abstract] [Full Text]  
• Offit, P. A., Hackett, C. J. (2003). Addressing Parents' Concerns: Do Vaccines Cause Allergic or Autoimmune Diseases?. Pediatrics 111: 653-659 [Abstract] [Full Text]  
• Lorber, B. (2002). Update in Infectious Diseases. ANN INTERN MED 137: 974-980 [Full Text]  
• Havinga, W., Offit, P. A., Gerber, M. A., Hackett, C., Marcuse, E., Gellin, B. (2002). Too Many Vaccinations?. Pediatrics 110: 648-649 [Full Text]  
• Belloni, C., Avanzini, M. A., De Silvestri, A., Martinetti, M., Pasi, A., Coslovich, E., Autelli, M., Masanti, M. L., Cuccia, M., Tinelli, C., Rondini, G., Lorini, R. (2002). No Evidence of Autoimmunity in 6-Year-Old Children Immunized at Birth With Recombinant Hepatitis B Vaccine. Pediatrics 110: e4-4 [Abstract] [Full Text]  
• Sibilia, J, Maillefert, J F (2002). Vaccination and rheumatoid arthritis. Ann Rheum Dis 61: 575-576 [Full Text]  
• Abramson, J. S., Pickering, L. K. (2002). US Immunization Policy. JAMA 287: 505-509 [Full Text]  
• Ascherio, A., Munger, K. L., Lennette, E. T., Spiegelman, D., Hernan, M. A., Olek, M. J., Hankinson, S. E., Hunter, D. J. (2001). Epstein-Barr Virus Antibodies and Risk of Multiple Sclerosis: A Prospective Study. JAMA 286: 3083-3088 [Abstract] [Full Text]  
• Millichap, J. G., Rathore, M. H. (2001). Increased Risk of Seizures Following DTP and MMR Vaccine Is Not Associated with Any Long-Term Adverse Consequences. AAP Grand Rounds 6: 54-55 [Full Text]  
• Dennehy, P. H. (2001). Active Immunization in the United States: Developments over the Past Decade. Clin. Microbiol. Rev. 14: 872-908 [Abstract] [Full Text]  
• Begaud, B., Alperovitch, A., Hanslik, T., Viboud, C., Flahault, A., Gout, O., Sturkenboom, M. C.J.M., Fourrier, A., Buttinelli, C., Salvetti, M., Ristori, G., Hostetler, L., Ascherio, A., Zhang, S. M., Walker, A. M., Confavreux, C., Suissa, S., Saddier, P. (2001). Vaccinations and Multiple Sclerosis. NEJM 344: 1793-1796 [Full Text]  
• Hartung, H.-P. (2001). ADEM: Distinct disease or part of the MS spectrum?. Neurology 56: 1257-1260 [Full Text]  
• Rathore, M. H. (2001). Guillain-Barre Syndrome Not Related to MMR. AAP Grand Rounds 5: 46-47 [Full Text]  
• (2001). No Significant Risk to Vaccination in MS. JWatch Neurology 2001: 1-1 [Full Text]  
• (2001). From Rumor to Reality: Vaccinations Not Associated with MS Onset or Relapse. JWatch Infect. Diseases 2001: 1-1 [Full Text]  
• (2001). No Link Between Vaccination and Multiple Sclerosis. JWatch General 2001: 1-1 [Full Text]  
• Gellin, B. G., Schaffner, W. (2001). The Risk of Vaccination -- The Importance of "Negative" Studies. NEJM 344: 372-373 [Full Text]  
• DeStefano, F., Verstraeten, T., Newman, J.P., Noseworthy, J. H., Poland, G. A. (2001). Multiple Sclerosis. NEJM 344: 381-382 [Full Text]