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The road to universal immunization against hepatitis B has been bumpy.1 The hepatitis B vaccine (HBV) has been anecdotally linked to multiple sclerosis (MS), systemic lupus erythematosus, rheumatoid arthritis, diabetes mellitus, leukemia, and chronic fatigue syndrome. The possibility that the vaccine could induce MS prompted temporary halting of the universal HBV program in France in 1998 based on surveillance reports. In 2000, a French court awarded damages to three people with MS who had received the HBV, in a decision that was later highly criticized.2–5⇓⇓⇓ Subsequently, numerous studies, commissions, and hearings have not corroborated the association. The report by Hernán et al.6 in this issue of Neurology has potential to reopen the debate.
The Hernán paper used the General Practice Research Database (GPRD) of the United Kingdom to ascertain 163 cases of confirmed MS, and performed a case-controlled analysis for the association of first MS symptoms with HBV. The authors identified 11 people who developed first symptoms of MS within 3 years of the vaccine, producing an odds …
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