Mrs. X. brought her 9 month old son to the office for his routine well-check. He was thriving quite nicely--his growth and development were excellent for age, and he was well on his way to eating solid foods. He was up to date with his immunizations, all that he needed today was his third, and last, hepatitis B vaccine. He had received the first hepatitis B vaccine shortly after he was born, and the second one two months later. He tolerated these along with all of the other vaccines just fine.
I could sense Mrs. X.’s uneasiness as we came to the part of the visit where we go over the shots that he needs. When I brought up the fact that he would only need the remaining hepatitis B vaccine, she squirmed uncomfortably in her chair and folded her arms in a defensive posture. "I’m afraid I don’t want him to get the shot," she said in a somewhat unconvincing voice. She went on to explain that a friend had given her an article that she had downloaded from the Internet that said that the hepatitis B vaccine could cause Multiple Sclerosis (MS). This prompted her to look further and she found other articles on the Internet that linked the vaccine to not only MS, but also other demyelinating diseases of the central nervous system. What really concerned her was a news report that said the French health authorities had suspended the school-based adolescent hepatitis B vaccine programs because of such reports.
Needless to say, Mrs. X. was frightened by these reports, and rightfully so, when taken at their face value. The problem however, was the source of the reporting. None were from reputable scientific or medical journals, and none had undergone the scrutiny of proper scientific methodology or testing to even be considered for publication in respected journals. Many of these "reports" were anecdotal accounts that simply appeared on the Internet.
With the ease with which information is passed and shared from continent to continent, it was no time at all before these reports about the vaccine caused much concern in the medical community. A panel of experts was convened by the World Health Organization in September 1998. They reviewed all the current data that supposedly linked the hepatitis B vaccine with MS; they reviewed the national reporting systems in the U.S., Canada, and Italy; they reviewed all published studies of the hepatitis B vaccine safety as well as post-marketing surveillance studies.
Their conclusion was that there was NO tangible evidence to even suggest a relationship between receiving the hepatitis B vaccine and coming down with MS or any other central nervous system demyelinating disease. Most of the anecdotal accounts that are circulating around the Internet are most likely coincidental happenings. It is important to remember that a large number of vaccine recipients are in the age group in which most of the symptoms of MS first occur.
At a recent conference, a pediatrician whose specialty is pediatric infectious diseases was lecturing on the status of vaccines in the U.S. in 1999. He talked about "coincidence" and related a story that was told to him by a private practice general pediatrician. This pediatrician was doing a 6 month well-check on a healthy baby boy. After determining that all was just fine with the baby, he told the parents that he would need to get his third set of immunizations. They were very comfortable with this. As the nurse was in another room, drawing up the vaccines, the baby had a generalized grand-mal seizure while in mom’s arms. It lasted around two minutes. An exhaustive work up to find the cause of the seizures was all negative. This included a CT scan of the head, a brain wave test, and a spinal tap. It was determined that the baby had "idiopathic" seizures, unrelated to fever, which meant that there was no explanation as to how or why it happened. The important point is that had the seizure occurred AFTER the vaccines had been given, there is no doubt that the vaccines would have been blamed. In the eyes of the parents, they could not have been convinced otherwise...and chances are that the baby would not have received any future vaccines because of this. Timing and coincidence. It is very curious how these shape the way we perceive things.
After a lengthy discussion and many questions, Mrs. X. felt much more comfortable about her baby receiving the last hepatitis B shot. He tolerated this just fine. She did, however, let out a deep sigh when I informed her that he would need to receive THREE shots at his one year visit--the measles mumps and rubella vaccine (MMR), the chicken pox vaccine, and the fourth and final Hemophilus influenza vaccine. She just laughed and said, "We’ll just cross that bridge when we get to it!"