[Hepatitis vaccines]


Alexander Dorozynski – Paris  (BMJ Vol 317 17 Oct 1998)

The World Health Organisation and French paediatricians have condemned the French government’s decision to suspend hepatitis B vaccinations in schools.

Dr Bernard Kouchner, secretary of state for health, made the decision earlier this month as a temporary measure, pending the possibility that hepatitis B vaccine could cause multiple sclerosis or other forms of demyelination in the central nervous system. Vaccination of infants and adults at risk will continue.

Dr Kouchner based his decision on studies in France and Britain hinting at an increased risk of demyelination reactions in the central nervous system during the two months after vaccination of school age children. Most experts maintain that the results of these studies are not significant, and vaccination is known to prevent infection and its possible consequences – cirrhosis and liver cancer.

The World Health Organisation warned that the French government’s decision may lead to a loss of public confidence in the hepatitis B vaccine, leading to other countries abandoning its use or deciding not to introduce such a programme. According to the organisation, the use of more than a billion doses of the vaccine since 1989 has shown an exceptional record of safety and efficacy.

In France the National Union of School and University Physicians stated last week that it was "extremely surprised" by the decision that may discredit a vaccination whose usefulness has not been questioned by the scientific community. The National Union of Paediatricians followed suit and denounced the "total incoherence" of the decision. "How can we explain to mothers that infants, who have little risk of contracting hepatitis B by sexual contact, should be vaccinated but that…vaccination campaigns should be stopped in schools?" said Professor Jean Grunberg, president of the union.