Hepatitis B vaccine and risk of autoimmune thyroid disease: a Vaccine Safety Datalink study.
OBJECTIVE
Hepatitis B vaccine has been postulated as a possible cause of autoimmune disorders, including autoimmune thyroid diseases (ATD). Cases of Graves' disease and Hashimoto's thyroiditis, following hepatitis B vaccine have been reported to the Vaccine Adverse Events Reporting System (VAERS). To test the hypothesis that hepatitis B vaccine increases the risk of ATD, we conducted a case-control study, within the Vaccine Safety Datalink project.


METHODS
We identified potential cases of Graves' disease and Hashimoto's thyroiditis, among persons aged 18-69 years from administrative data recorded by three health maintenance organizations (HMOs) and verified cases by medical record review. Controls were frequency-matched to cases by birth year, sex, and study site. Vaccine information was collected from administrative records, chart review, and telephone interviews with study subjects. We enrolled 355 Graves' disease cases, 418 Hashimoto's thyroiditis cases, and 1102 controls. We assessed the association between ever-receipt of hepatitis B vaccine, as well as receipt of hepatitis B vaccine less than 1 year, 1-5 years and at least 5 years prior to the index date, and the risk of ATD.


RESULTS
Ever-receipt of hepatitis B vaccine was not associated with risk of Graves' disease (odds ratio (OR), 0.90; 95% confidence interval (CI), 0.62-1.32) or Hashimoto's thyroiditis (OR, 1.23; 95%CI, 0.87-1.73). There was also no association between the time interval since receipt of hepatitis B vaccination and either outcome.


CONCLUSIONS
We did not observe an increased risk of Graves' disease or Hashimoto's thyroiditis, following receipt of hepatitis B vaccine.
Yu
Onchee
O
Group Health Center for Health Studies, Seattle, WA 98101-1448, USA. yu.o@ghc.org
Bohlke
Kari
K
Hanson
Christi A
CA
Delaney
Kristin
K
Rees
Thomas G
TG
Zavitkovsky
Ann
A
Ray
Paula
P
Mullooly
John
J
Black
Steven B
SB
Benson
Patti
P
Thompson
William W
WW
Davis
Robert L
RL
Jackson
Lisa A
LA
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D006111:Graves Disease / Q000139:chemically induced* / Q000453:epidemiology; D050031:Hashimoto Disease / Q000139:chemically induced* / Q000453:epidemiology; D017325:Hepatitis B Vaccines / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors
D017325:Hepatitis B Vaccines