Multiple sclerosis &
David A Geier,
Mark R Geier MD PhD.
Chronic adverse reactions associated with hepatitis B vaccination.
The Annals of Pharmacotherapy 2002: Vol. 36,
No. 12, pp. 1970–1971.
In conclusion, our study demonstrates that adult HBV is statistically associated not only with acute neuropathy, neuritis, myelitis, vasculitis, thrombocytopenia, gastrointestinal disease, multiple sclerosis, and arthritis, but some of these patients go on to develop chronic adverse reactions that persist for at least 1 year following HBV. These types of chronic adverse reactions following adult HBV should be discussed with patients contemplating being immunized with HBV and should be included in the differential diagnosis of those who develop them following adult HBV.
Begaud B, Alperovitch A. Vaccinations and multiple sclerosis.N Engl J Med. 2001 Jun 7;344(23):1793; discussion 1795. No abstract available.PMID: 11396452 [PubMed - indexed for MEDLINE]
Buttinelli C, Salvetti M, Ristori G. Vaccinations and multiple sclerosis.N Engl J Med. 2001 Jun 7;344(23):1794; discussion 1795-6. No abstract available.PMID: 11396455 [PubMed - indexed for MEDLINE]
Campins Marti M, Moraga Llop FA. [Hepatitis B vaccine and multiple sclerosis] An Esp Pediatr. 1998 Dec;49(6):555-7. Review. Spanish. No abstract available.PMID: 9972614 [PubMed - indexed for MEDLINE]
Diego Nunez MA, Gonzalez Menendez AE. [Vaccination against hepatitis B and multiple sclerosis]An Esp Pediatr. 1999 Jan;50(1):97. Spanish. No abstract available.PMID: 10083655 [PubMed - indexed for MEDLINE]
Gout O. Vaccinations and multiple sclerosis.N Engl J Med. 2001 Jun 7;344(23):1794; discussion 1795. No abstract available.PMID: 11396453 [PubMed - indexed for MEDLINE]
Hall A, Kane M, Roure C, Meheus A. Multiple sclerosis and hepatitis B vaccine?Vaccine. 1999 Jun 4;17(20-21):2473-5. No abstract available.PMID: 10418891 [PubMed - indexed for MEDLINE]
Halsey NA, Duclos P, Van Damme P, Margolis H. Hepatitis B vaccine and central nervous system demyelinating diseases. Viral Hepatitis Prevention Board.Pediatr Infect Dis J. 1999 Jan;18(1):23-4. Review. No abstract available.PMID: 9951975 [PubMed - indexed for MEDLINE]
Hanslik T, Viboud C, Flahault A. Vaccinations and multiple sclerosis.N Engl J Med. 2001 Jun 7;344(23):1793-4; discussion 1795-6. No abstract available.PMID: 11396451 [PubMed - indexed for MEDLINE]
L, de Keyser J, Ebinger G. Central-nervous-system demyelination after
immunisation with recombinant hepatitis B vaccine. Lancet. 1991 Nov
9;338(8776):1174-5. PMID: 1682594 [PubMed - indexed for MEDLINE]
2 patients had neurological symptoms and signs, with evidence of central-nervous-system demyelination, 6 weeks after administration of recombinant hepatitis B vaccine. 1 had known multiple sclerosis but the other had no history of neurological disease; both had HLA haplotypes DR2 and B7, which are associated with multiple sclerosis. A causal link between vaccination and demyelination cannot be established from these 2 case-reports, but the time interval would fit a proposed immunological mechanism.
Ono F. Possible relation of small pox vaccination to multiple sclerosis-like disease. A personal note. Med Hypotheses. 1986 Jul;20(3):339-40. PMID: 3638479; UI: 86310423.
Hostetler L. Vaccinations and multiple sclerosis.N Engl J Med. 2001 Jun 7;344(23):1795. No abstract available.PMID: 11396456 [PubMed - indexed for MEDLINE]
Kaplanski G, Retornaz F, Durand J, Soubeyrand J.Central nervous system demyelination after vaccination against hepatitis B and HLA haplotype.J Neurol Neurosurg Psychiatry. 1995 Jun;58(6):758-9. No abstract available.PMID: 7608688 [PubMed - indexed for MEDLINE]
Monteyne P, Andre FE. Is there a causal link between hepatitis B vaccination and multiple sclerosis?Vaccine. 2000 Apr 3;18(19):1994-2001.PMID: 10706960 [PubMed - indexed for MEDLINE]
Nadler JP. Multiple sclerosis and hepatitis B vaccination.Clin Infect Dis. 1993 Nov;17(5):928-9. No abstract available.PMID: 8286645 [PubMed - indexed for MEDLINE]
Poch GF, et al. [Antidiphtheria vaccination as a factor precipitating multiple sclerosis]. Prensa Med Argent. 1966 Jul 29;53(30):1639-41. Spanish. No abstract available.PMID: 5989091; UI: 68120593.
Tourbah A, Gout O, Liblau R, Lyon-Caen O, Bougniot C, Iba-Zizen MT, Cabanis EA
Neurology 1999 Jul 22;53(2):396-40. Encephalitis after hepatitis B vaccination: recurrent
disseminated encephalitis or MS? Federation de Neurologie, Hopital de la Salpetriere and
Faculte de Medecine Pitie-Salpetriere (Paris VI) France.
OBJECTIVE: To describe clinical and MRI features of patients with a disease suggestive of CNS inflammation after hepatitis B vaccination. METHODS: Eight patients with confirmed CNS inflammation occurring less than 10 weeks after hepatitis B vaccination are described. They received follow-up clinically and on MRI for a mean period of 18 months. RESULTS: Clinical and MRI findings were compatible with acute disseminated encephalomyelitis. However, clinical follow-up, repeated MRI, or both showed the persistence of inflammatory activity, which makes this encephalitis more suggestive of MS than of acute disseminated encephalomyelitis. CONCLUSION: The persistent inflammatory activity observed clinically and on MRI in these patients is comparable with that usually observed in MS. Epidemiologic studies are currently testing the hypothesis of a triggering role of hepatitis B vaccination in CNS demyelination. PMID: 10430433, UI: 99357502
JL, Guillamo JS, Ramirez JM, Taillia H, Felten D, Buisson Y. Presse Med 1999 Jul
3-10;28(24):1290-2 [No title available].[Article in French] Clinique de neurologie, HIA
Val-de-Grace, Paris. [Medline record in process]
BACKGROUND: The cause and effect relationship between anti-HBV immunization using recombinant vaccine and the development of a neurological event, including flare-ups of multiple sclerosis, is a widely debated issue.
CASE REPORT: A previously asymptomatic 16-year-old girl was a hyper-responder to anti-HBV vaccine. Subsequent to a booster shot of anti-HBV recombinant vaccine, she developed regressive acute cervical transverse myelitis with intrathecal oligochonal IgG secretion and a hypersignal on the MRI T2 sequences of the cord.
DISCUSSION: The distinction between a first episode of multiple sclerosis or post-vaccinal acute myelitis in this case will depend upon subsequent course, but this observation points out the very high level of persistent post-vaccinal immunization which can be acquired by a hyper-responder. PMID: 10442059, UI: 99370647
Sturkenboom MC, Fourrier A. Vaccinations and multiple sclerosis.N Engl J Med. 2001 Jun 7;344(23):1794; discussion 1795. No abstract available.PMID: 11396454 [PubMed - indexed for MEDLINE]
Tosti ME, et al. Multiple sclerosis and vaccination against hepatitis B: analysis of risk benefit profile. Ital J Gastroenterol Hepatol. 1999 Jun-Jul;31(5):388-91. PMID: 10470598; UI: 99399619.
Zintchenko (1965) has reported 12 patients in whom multiple sclerois first became evident after a course of anti-rabies vaccination--British Medical Journal 2:210-213, 1967.
Multiple sclerosis has been reported to become clinical apparent or be exacerbated following immunization with a variety of vaccines (Paffy & Merei, 1961); (Miller et al., 1967).
Multiple Sclerosis References (http://www.vaccines.net/multiple.htm )
3A. British Medical Journal 1967, April 22, 210-213
The authors present 9 cases of multiple sclerosis, 5 cases first occurred after vaccination and 4 cases had exacerbations after immunization. They say (p. 212 second column last paragraph) "That vaccination and inoculation sometimes provoke exacerbations seems certain, and they are clearly better avoided by the patient except in circumstances that render the hazard preferable to the alternative (page 212, column 2 last paragraph)"
3B. Lancet 338:1174-1175. 1991
The authors report 2 cases of demyelination after hepatitis B vaccination.
3C. World Neurology 2:167-171, 1961
The paper reviews several cases of vaccine associated multiple sclerosis. " In 6 of 8 cases reported, neurologic syndromes first manifested as complications of the administration of a serum or vaccine and later development corresponded to that of multiple sclerosis (summary page 170)"
3D. Lancet September 16, 1978, p636
The author reports 5 cases of multiple sclerosis occurring after swine flu vaccination.
3E. J. Neurological Sciences 26:259-270, 1975
The authors describe three cases of multiple sclerosis associated with vaccination.
"The attention needs to be drawn to the 3 cases in this series in which there was some relationship to vaccination (page 268 last paragraph)."
3F. Arch. Neurol 35: 693, 1978
Arch. Neurol 35: 693, 1978. The authors describe a multiple sclerosis like illness occurring 4 years after rabies immunization. It references a paper describing similar cases presenting 2-20 years after immunization with the rabies vaccine.
3G. Jama 225:63-64, 1973
The authors report a case of multiple sclerosis induced/exacerbated vaccination.