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No Link Between Vaccination and Multiple Sclerosis

Among the objections that patients sometimes raise to routine vaccination is the rumor that vaccines may cause or exacerbate multiple sclerosis (MS). (The French government temporarily suspended a nationwide hepatitis B immunization program for this reason in 1998.) Now, the findings of 2 large-scale studies debunk the idea of an association.

Investigators searched a large European database, identified MS patients who had suffered at least 1 neurologic relapse between 1993 and 1997, and obtained their vaccination histories; 94 percent of reported vaccinations (which included diphtheria-tetanus, tetanus, hepatitis B, and influenza) were subsequently confirmed by medical records. Of 643 patients interviewed, the proportion vaccinated during several relapse-free 2-month intervals ranged from 2.8 percent to 4.0 percent, not significantly different from the 2.3 percent who received a vaccination during the 2 months before a relapse. The relative risk for relapse did not vary with specific vaccines or with different assigned "danger" intervals after vaccine administration.

In a U.S. case-control study, researchers used data from 2 Nurses' Health Study cohorts to examine the specific association between hepatitis B vaccination and MS. They matched 192 women who had newly diagnosed MS with 645 controls who either were completely healthy or had breast cancer. Vaccination records confirmed that the age-adjusted relative risk for MS was not affected by hepatitis B vaccination.

Comment: Despite case reports, and even small controlled studies, that hint at an association between vaccination and multiple sclerosis, 2 large, well-designed studies have failed to show any evidence of a link. The editorialists react to the sequence of events by quoting Jonathan Swift: "Falsehood flies and the truth comes limping after...."

— A Zuger

Published in Journal Watch General Medicine February 13, 2001

Citation(s):

Confavreux C et al. Vaccinations and the risk of relapse in multiple sclerosis. N Engl J Med 2001 Feb 1 344 319-326.

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• Medline abstract (Free)

Ascherio A et al. Hepatitis B vaccination and the risk of multiple sclerosis. N Engl J Med 2001 Feb 1 344 327-332.

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• Medline abstract (Free)

Gellin BG and Schaffner W. The risk of vaccination -- The importance of "negative" studies. N Engl J Med 2001 Feb 1 344 372-373.

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• Medline abstract (Free)