Hepatitis B : stimulus for vaccination

While laboratories have marketed the vaccine against hepatitis B have been investigated there is exactly one year, a new document from the Ministry of Health is preparing the resumption of immunization coverage, in the context of hepatitis plane 2009-2012.

Even though justice has been seized, This plan was launched Tuesday by the Ministry of Health, by reaffirming its full commitment and faith in vaccination, including that of infants. Sending and forgotten the precautionary principle requested by the victims of the vaccine against hepatitis B, including many cases of multiple sclerosis.

For the record : the context of the scandal hepatitis B is summarized in one of my previous articles : http://priskaducoeurjoly.blogsudouest.com/files/2008/06/hepatiteb.pdf

Here are some selected pieces of the document from the Department for the plan guide 2009-2012.

In brief :

"The interest to vaccinate children against hepatitis B is not properly perceived by doctors. The results of recent scientific studies in children show no link and increased risk between vaccination against hepatitis B and a push of demyelinating disease were not sufficiently disseminated and explained. It is therefore important, Firstly, to provide the press and opinion scientific and factual information relays on the health impact of hepatitis B and C and on vaccination against hepatitis B. This information can be relayed in a differentiated manner to professionals and the public ".

Numbers

On the merits of a new plan to fight against viral hepatitis B and C :

« Hepatitis B :

-touch five times more men women

2.500 to 3.000 acute hepatitis B with or without symptoms occur annually (estimation 2005),

-can be in a so-called fulminant acute form which can be fatal in the absence of liver transplantation : among 20 acute fulminant hepatitis B reported between 2004 and 2006 (DO), 8 died, 9 have benefited from a liver transplant and 3 healed spontaneously,

-represents a major potential risk for theChildren born to infected mothers car l’infection

transmitted may become chronic even in 90 % cases, in the absence of treatment

Preventive birth

-may be prevented by vaccine : half the cases of symptomatic acute hepatitis notified

could have been avoided if testing around a case had been made (or family environment

Sexually) and if the current vaccination recommendations were

respected "

On note que les 2 to 3000 case are based on estimates (Conditional use) and that the number of deaths is not mentioned in these cases of acute hepatitis. On the other hand, concerning cases fulminant, alone 20 deaths were recorded between 2004 and 2006. This is enough for the steering group to boost the generalization of vaccination which the risk / benefit ratio is far from proven, except perhaps for pharmaceutical companies…

According to the document, Hepatitis B and C " trained in 2001, around 4.000 death, 1.330 Hepatitis B, about one and half times the level of declared AIDS mortality and 2.640 Hepatitis C, twice that of the cervical cancer mortality ".

Goal : more vaccinations

"Currently, la vaccination, Available for over 20 years, is the measure of

The most effective prevention against infection with HBV. The hypothesis of an association between risk of multiple sclerosis (SEP) and vaccination against hepatitis B has been widely publicized since 1993. Until 2004, no studying, among a dozen publications, had shown a statistically significant result in favor of an association between vaccination and the onset of a central demyelinating disease.

In 2004, a case-control study8 found a significant association, adult, within three years after vaccination. However, according to the expert bodies consulted9, the result of this study does not question the current vaccine recommendations.

Otherwise, the results of a study published in 2003 did not show this association10.

8 Hernan M et al. Neurology 2004; 63: 838-42.

9 Commission Nationale de Pharmacovigilance du 29/09/2004 and Public Hearing on vaccination against

HBV and September ; Paris ; 9/11/2004.

10 DeStefano F et al. Arch Neurol 2003; 60: 504-9. »

Here we are therefore fully reassured and confident about the absence of risk of vaccination, even for infants :

« In 2007 and 2008, the results of three studies on a French cohort “KIDSEP”

(Children 0-16 years), have been published. They found no association between exposure to vaccination against hepatitis B and the risk of developing multiple sclerosis11. They do not

September show no recurrence risk, and no increased risk of acute episode

demyelinating central nervous system in children vaccinated. In the most recent study12, the authors conclude that there is no link between vaccination against hepatitis B in children and the risk of subsequent onset of demyelinating central nervous system, including multiple sclerosis, regardless of the number of injections, the time and the brand of the vaccine. Continuing the analysis in several subgroups, the authors reported, in one of the subgroups, defined by children who have completed the immunization schedule and vaccinated more than three years Engerix B® by the vaccine, a statistical association between a history of vaccination against hepatitis B and the observation of a demyelinating disease. But the different bodies of expertise consulted on this result13 concluded that there was no need to modify the vaccine recommendations. Analysis of the World Health Organization (8 October 2008) reaches the same conclusion.

The benefits of vaccination against hepatitis appear obvious (assessment of the benefit-risk balance). A simulation carried out by InVS it was estimated that vaccinating children 11-16 years performed from 1994 currently prevents more 1.000 acute hepatitis, close to 3.000 infections, plus de 100 chronic infections and about 5 fulminant hepatitis a year. It also allowed to estimate that about 8.000 acute hepatitis, 20.000 infections, 800 chronic infections and 40 fulminant hepatitis were avoided since 1994. These figures likely underestimate the impact of vaccination strategies implemented since 1994. En effet, this simulation did not take into account the reduction of incidence of hepatitis B among unvaccinated, due to the decrease of the circulation of the virus-induced B reached the coverage in the population.

11 And Mikaeloff, Charity G, Rossier M, Suissa S, Tardieu M. Hepatitis B vaccination and the risk of childhoodonset

multiple sclerosis. Arch. Pediatrician. Adolesc. With. 2007; 161 :1176-82

The results of the first study on neuropediatric cohort showed no KIDSEP

increased risk of relapse (SEP) in children vaccinated against HBV and has submitted a first

demyelinating episode (Mikaeloff Yet al. Brain 2007;130 : 1105-10).

12 And Mikaeloff, et al.Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood Neurology

2008 Oct. [Epub ahead of print ».

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