[Hepatitis B vaccination and multiple sclerosis: from medical uncertainty to compensation for victims]

Cases of multiple sclerosis appearing after a mass hepatitis B vaccination program can lead to claims for compensation. The legal jurisdiction under which such claims will be examined depends on whether the vaccination was carried out as part of a mandatory program (implying liability of the State or employers) or in application of recommendations (implying responsibility of the vaccine manufacturer). In the literature, there is no evidence demonstrating a statistically significant relationship between anti-hepatitis B vaccination and the onset or exacerbation of multiple sclerosis, questioning even the notion of compensation. The analysis of the jurisprudence shows that, in a first period, the scientific uncertainty of a link between vaccination and onset of multiple sclerosis precluded any compensation to victims. Subsequently, judicial and administrative courts ignored this scientific uncertainty, which enabled them to examine claims for compensation by adopting a presumptive reasoning based on specific criteria and different regulations depending on the legal jurisdiction. According to the French high courts (Cour de cassation and Conseil d'État) scientific causality and legal causality do not necessarily have to be consistent, such that medical uncertainty should not be an obstacle to compensation for victims.