title: Systemic adverse effects of hepatitis B vaccines are rare.
abstract: (1) A few exceptional but serious cases have raised the possibility that hepatitis B vaccination could trigger or exacerbate demyelinating and autoimmune diseases. (2) Epidemiological data, i.e. three cohort studies and five case-control studies, showed no increased risk of demyelinating disease after hepatitis B vaccination. Another case-control study showed a significant link between multiple sclerosis and hepatitis B vaccination. Any increase in risk (if indeed there is one) probably affects only a small minority of vaccine recipients. But these few cannot be identified before vaccination. (3) Hepatitis B vaccination carries a very low risk of anaphylactic reactions (estimated incidence less than 1 case per 100 000 injections). (4) A few cases of haematological, rheumatological and autoimmune disturbance have been linked to hepatitis B vaccination. Appropriate epidemiological studies are needed to determine whether these links are causal. (5) In practice, hepatitis B vaccination has a favourable risk-benefit balance in non-immunised subjects who are at risk of contracting hepatitis B.
mesh_terms: D000707:Anaphylaxis / Q000209:etiology / Q000276:immunology; D001172:Arthritis, Rheumatoid / Q000209:etiology / Q000276:immunology; D001327:Autoimmune Diseases / Q000209:etiology* / Q000276:immunology; D016022:Case-Control Studies; D015331:Cohort Studies; D003711:Demyelinating Diseases / Q000209:etiology* / Q000276:immunology; D004311:Double-Blind Method; D005602:France; D006509:Hepatitis B / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000009:adverse effects*; D006801:Humans; D007938:Leukemia / Q000209:etiology / Q000276:immunology; D009103:Multiple Sclerosis / Q000209:etiology / Q000276:immunology; D011358:Product Surveillance, Postmarketing; D006113:United Kingdom; D014481:United States; D014611:Vaccination / Q000009:adverse effects*; D014612:Vaccines / Q000009:adverse effects*
chemical_list: D017325:Hepatitis B Vaccines; D014612:Vaccines