Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood
AlainBraillon, Department of Public Health
Published December 05, 2008
Mikaeloff et al. assert that Engerix B® vaccine appears to increase the risk of CNS inflammatory demyelination in childhood. [1] This type of subgroup analysis and conclusion should be based on known mechanisms or made in response to previous findings. A subgroup analysis should also include the declaration of the number of analyses performed and adjustments should be made for multiple testing with tests for heterogeneity. Media coverage following the release of this article stated that "the children with MS were 1.74 times more likely to have received a certain type of hepatitis B vaccine called Engerix B®." [2] The repercussions from this type of claim may inhibit physicians from administering the vaccine.
France has the lowest rate for immunization against the Hepatitis B virus (HBV) among developed countries. In 2006, the percentage of one-year-old children immunized with three doses of Hepatitis B in France was 29%. When compared to countries such as Germany (86%), France's immunization record may worsen to the level of Dominica (7%)-one of the poorest countries in the world. [3] When applied carefully and self critically, epidemiological methods offer a way to improve a population's health.
References
1. Mikaeloff Y, Caridade G, Suissa S, Tardieu M. Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood. Neurology 2008; DOI: 10.1212/01.wnl.0000335762.42177.07.
2. Majority Of Children Vaccinated Against Hepatitis B Not At Increased Risk Of Multiple Sclerosis, Study Shows. Science Daily News, September 28, 2008. http://www.sciencedaily.com/releases/2008/09/080925144808.htm (accessed October 31 2008).
3. Data available at http://www.who.int/whosis/data (accessed November 14, 2008).
Disclosure: The authors report no disclosures.
Editor’s Note: The authors of the article were offered the opportunity to respond but declined.
Mikaeloff et al. assert that Engerix B® vaccine appears to increase the risk of CNS inflammatory demyelination in childhood. [1] This type of subgroup analysis and conclusion should be based on known mechanisms or made in response to previous findings. A subgroup analysis should also include the declaration of the number of analyses performed and adjustments should be made for multiple testing with tests for heterogeneity. Media coverage following the release of this article stated that "the children with MS were 1.74 times more likely to have received a certain type of hepatitis B vaccine called Engerix B®." [2] The repercussions from this type of claim may inhibit physicians from administering the vaccine.
France has the lowest rate for immunization against the Hepatitis B virus (HBV) among developed countries. In 2006, the percentage of one-year-old children immunized with three doses of Hepatitis B in France was 29%. When compared to countries such as Germany (86%), France's immunization record may worsen to the level of Dominica (7%)-one of the poorest countries in the world. [3] When applied carefully and self critically, epidemiological methods offer a way to improve a population's health.
References
1. Mikaeloff Y, Caridade G, Suissa S, Tardieu M. Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood. Neurology 2008; DOI: 10.1212/01.wnl.0000335762.42177.07.
2. Majority Of Children Vaccinated Against Hepatitis B Not At Increased Risk Of Multiple Sclerosis, Study Shows. Science Daily News, September 28, 2008. http://www.sciencedaily.com/releases/2008/09/080925144808.htm (accessed October 31 2008).
3. Data available at http://www.who.int/whosis/data (accessed November 14, 2008).
Disclosure: The authors report no disclosures.
Editor’s Note: The authors of the article were offered the opportunity to respond but declined.