There are so many anti-vaccine religious tropes about the safety of vaccines, that it is often hard to keep them all straight. One of the current ones is that vaccines cause autoimmune diseases such as multiple sclerosis. Does scientific evidence support the hypothesis that vaccines cause multiple sclerosis?
Well, I have written about whether vaccines cause multiple sclerosis before, and based on the scientific evidence (see here and here), there simply was no link between them. Of course, with the anti-vaccine religion, evidence be damned, they will stand by their claims. All I can do is repeat myself with more and more evidence, refuting their claims.
There is a new review of the evidence of whether vaccines cause multiple sclerosis, and once again, they found nothing. And once again, I will review the evidence to see if there is something to the claims of the anti-vaccine religion. I should give a spoiler alert, but you all know what’s coming.
A multiple sclerosis primer
Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord. It cause demyelination in which the insulating myelin sheaths of nerve cells in the brain and spinal cord are damaged. The demyelination leads to a disruption in the ability of the nervous stem to communicate with one another.
The signs and symptoms of MS include physical, mental, and, rarely, psychiatric problems. Some of the more specific symptoms can include double vision, blindness in one eye, muscle weakness, and other neuromuscular conditions.
There are several forms of MS, including a relapsing version where new symptoms occur in isolated attacks, and the progressive version, where the symptoms build up over time. The symptoms of MS may disappear completely for a period of time. Unfortunately, the underlying neurological conditions remain, especially as the disease progresses.
MS is caused by destruction of the myelin sheath by the immune system. It appears that a combination of genetics and environmental factors, such as a viral infection trigger, may cause the autoimmune attack.
There are no known cures for multiple sclerosis, despite some claims to the contrary in pseudoscience pushing websites, which are missing any real scientific evidence to support their outlandish claims. Evidence based clinical treatments include a large number of medications which are used to treat some of the symptoms, but have a number of significant side effects; and physical therapy.
Scientific research is exploring several directions in a hope to find an actual cure (outside of the pseudoscientific woo that has shown no efficacy). In time, we will see whether any of them are effective through clinical trials.
Multiple sclerosis is the most common autoimmune disease that affects the central nervous system. It afflicts about 2.3 million people worldwide (pdf), with about twice as many women compared to men that contract the disease.
Do vaccines cause multiple sclerosis? – the paper
An extensive review of the possible evidence of whether vaccines cause multiple sclerosis was recently published in Acta Neurologica Scandinavica by Jette Frederiksen, MD, Professor, Department of Neurology, Rigshospitalet Glostrup, and medical student Mia Mailand, University of Copenhagen, Copenhagen Denmark. This review found no evidence linking vaccines to multiple sclerosis, except for a possible (and very tiny) risk for MS relapse after a live yellow fever vaccine. Because the yellow fever vaccine is rarely given to those individuals included in these reviews, it’s really hard to determine if there is a causal risk.
The researchers included a review of 51 relevant studies on MS, along with 15 on optic neuritis, an autoimmune demyelinating disease of the optic nerve, similar to MS, to determine if there was a link between vaccines and multiple sclerosis. They excluded case reports, which rarely can establish correlation or causality between a medical procedure and a medical condition.
The authors described a lawsuit brought before the European Court of Justice where the justices found that a hepatitis B vaccine was linked to a case of MS. Professor Dorit Rubinstein Reiss wrote an in-depth review of this case. Frederiksen and Mailand wrote that the decision was based on “benefit of the doubt” for the safety of the patient.
Professor Reiss agreed with that assessment and concluded,
It’s important to reiterate, again, what the European court vaccine decision is not. It’s not a decision that says courts can ignore science. It’s not a decision that should allow anti-vaccine activists to bring counter-science claims, like the claim that vaccines cause autism.
And it’s not a decision that requires all member states to follow the French law. It is a decision that allows, even encourages, member states, in situations of scientific uncertainty in product liability – not just vaccines – to consider other factors, such as temporal proximity of harm to vaccine, and compensate a plaintiff even without clear scientific evidence supporting causation. It’s a break for the plaintiffs, certainly.
But European court vaccine decision is not a blank check to blame vaccines for any problem, and it’s not unreasonable to place the burden of scientific uncertainty, when there are other factors that can support causation, on large manufacturers over consumers.
Of course, I always like to make one point about legal cases on vaccines (or any scientific matter) – courts don’t decide science. The evidence, like what was presented in this article by Frederiksen and Mailand, overwhelmingly reject the hypothesis that vaccines, including hepatitis B, is linked to multiple sclerosis. The CDC states, with atypical and strong emphasis, that there is no link between hepatitis B vaccines and multiple sclerosis.
Do vaccines causes multiple sclerosis? – the summary
From their review of relevant studies, Frederiksen and Mailand found no increased risk of association between vaccines and multiple sclerosis. They examined hepatitis B, HPV, seasonal flu and H1N1, MMR (mumps, measles and rubella), smallpox, BCG (tuberculosis), polio, tetanus, diphtheria, chickenpox, rabies, pertussis (whooping cough), typhoid fever and cholera vaccines. That is a huge number of vaccines that show no causal relationship to MS.
Moreover, the researchers found that there was no increased risk of relapsing MS after hepatitis B, tetanus, seasonal flu and H1N1. This is important, because it is possible that vaccine preventable diseases could exacerbate MS, so reducing the risk of those diseases through vaccinations is important to reduce the acceleration of the progression of MS.
But it’s not just me that is positive about rejecting the idea that vaccines cause multiple sclerosis. The National Multiple Sclerosis Society states emphatically that vaccines are not only safe for those with MS, but are beneficial to their health:
The Academy of Neurology, in collaboration with the Immunization Panel of the Multiple Sclerosis Council for Clinical Practice Guidelines, published a summary of evidence and recommendations regarding immunizations and MS. They concluded that:
(1) The evidence supports strategies to minimize the risk of acquiring infectious diseases that may trigger MS relapses (also called attacks or exacerbations).
(2) The influenza, hepatitis B, varicella and tetanus vaccines are safe for people with MS.
I want to hope that this kind of overwhelming scientifically evidence will get rid of this one trope of the anti-vaccine religion. At least it will give confidence to those afflicted with multiple sclerosis to get vaccinated to prevent a serious infection that could make their condition worse.
- Frederiksen JL, Topsøe Mailand M. Vaccines and multiple sclerosis. Acta Neurol Scand. 2017 Nov;136 Suppl 201:49-51. doi: 10.1111/ane.12837. Review. PubMed PMID: 29068486.
- Langer-Gould A, Qian L, Tartof SY, Brara SM, Jacobsen SJ, Beaber BE, Sy LS, Chao C, Hechter R, Tseng HF. Vaccines and the risk of multiple sclerosis and other central nervous system demyelinating diseases. JAMA Neurol. 2014 Dec;71(12):1506-13. doi: 10.1001/jamaneurol.2014.2633. PubMed PMID: 25329096.
- Martínez-Sernández V, Figueiras A. Central nervous system demyelinating diseases and recombinant hepatitis B vaccination: a critical systematic review of scientific production. J Neurol. 2013 Aug;260(8):1951-9. doi: 10.1007/s00415-012-6716-y. Epub 2012 Oct 20. Review. PubMed PMID: 23086181.
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