Is there a causal link between hepatitis B vaccination and multiple sclerosis?

After the publication of case reports of hepatitis B vaccinees with onset o r relapse of multiple sclerosis (MS), followed by a media-driven scare camp aign in France, the perception that hepatitis B vaccine causes MS has devel oped. This has led to a Fall in the acceptance of hepatitis B vaccination p articularly in French-speaking communities which was accelerated by court d ecisions in favour of vaccination "victims" and the suspension of routine v accination of pre-adolescents in French schools as a "precautionary measure " This situation has arisen in spite of the absence of scientific data to s upport a causal link between vaccination and multiple sclerosis. in this ar ticle. initially written to inform and reassure employees of one of the vac cine manufacturers, the epidemiological importance of hepatitis B and curre nt knowledge on the aetiology of MS are described. All available data that may throw light on the hypothesis that hepatitis B vaccination is causally Linked to MS was reviewed. The conclusion reached an the basis of available data is that the most plausible explanation for the observed temporal asso ciation between vaccination and MS is that it is a coincidental association . It is now important to rebuild public confidence in hepatitis B vaccine a s well as in vaccination in general. (C) 2000 Elsevier Science Ltd. All rig hts reserved.