Hepatitis B vaccine

The hepatitis B vaccine is widely considered to be safe and effective at preventing the occurence of hepatitis B, a disease which can cause scarring and subsequent cancer of the liver if left untreated. In the UK, it was recently added to the schedule of vaccinations offered to babies. Hepatitis B vaccine was introduced in its current form in 1986, and rolled out as a major public health improvement in many countries through the 1990s. 

However, a study published in 2004 caused concern. The study suggested that people who had had a hepatitis B vaccination in the previous three years were slightly more likely to develop MS than those who did not. Out of 163 people with MS, 11 (6.7%) had had the hepatitis B vaccination compared with 1,604 people without MS, of whom 39 (2.4%) had been vaccinated.

Although this research suggests a possible role for the vaccine in the onset of multiple sclerosis, the vast majority of people who developed MS had not had the hepatitis B vaccination.

Because vaccinations are so common, even a small increase in risk of MS could have a significant effect on public health. As such, the claims made by this single study have been repeatedly checked. There has been no further evidence found for a link between hepatitis B vaccination and the onset of multiple sclerosis.

In brief, an analysis of all the published research on demyelinating diseases and Hepatitis B vaccination in 2018 found no evidence of an association. Other studies on people who already have MS showed no link between having the Hepatitis B vaccination and having a relapse. In children who had had one episode of neurological symptoms, receiving the Hepatitis B vaccination made no difference to whether or not they went on to develop MS. 

One explanation of the 2004 study results is that it picked up a few people who had underlying MS, and the Hepatitis B vaccine brought on their symptoms a little sooner. Given the serious and at times fatal nature of hepatitis B, the recommendation is to have the vaccination if necessary.

Find out more

DeStefano F, et al.
Vaccinations and risk of central nervous system demyelinating diseases in adults.
Archives of Neurology 2003;60(4):504-509.
Summary (link is external)
Hernan MA, et al.
Recombinant hepatitis B vaccine and the risk of multiple sclerosis: a prospective study.
Neurology 2004;63(5):838-842.
Summary (link is external)
Ozakbas S, et al.
Development of multiple sclerosis after vaccination against hepatitis B: a study based on human leucocyte antigen haplotypes.
Tissue Antigens 2006;68(3):235-238.
Summary (link is external)
Mikaeloff Y, et al
Hepatitis B vaccine and risk of relapse after a first childhood episode of CNS inflammatory demyelination.
Brain 2007;130(4):1105-1110.
Full article (link is external)
Langer-Gould A, et al.
Vaccines and the risk of multiple sclerosis and other central nervous system demyelinating diseases.
JAMA Neurology 2014;71(12):1506-1513.
Summary (link is external)
Confavreux C, et al.
Vaccinations and the risk of relapse in multiple sclerosis. Vaccines in Multiple Sclerosis Study Group.
New England Journal of Medicine 2001;344(5):319-326.
Summary (link is external)