Elsevier

Vaccine

Volume 23, Issue 30, 10 June 2005, Pages 3876-3886
Vaccine

Analytical Review
Consequence or coincidence?: The occurrence, pathogenesis and significance of autoimmune manifestations after viral vaccines

https://doi.org/10.1016/j.vaccine.2005.03.005Get rights and content

Abstract

Background:

Viruses and virus-induced lymphokines may have an important role in the pathogenesis of autoimmunity (Schattner A. Clin Immunol Immunopathol; 1994). The occurrence and significance of autoimmune manifestations after the administration of viral vaccines remain controversial.

Methods:

Medline search of all relevant publications from 1966 through June 2004 with special emphasis on search of each individual autoimmune manifestation and vaccination, as well as specifically searching each viral vaccine for all potential autoimmune syndromes reported. All relevant publications were retrieved and critically analyzed.

Results:

The most frequently reported autoimmune manifestations for the various vaccinations, were: hepatitis A virus (HAV) — none; hepatitis B virus (HBV) — rheumatoid arthritis, reactive arthritis, vasculitis, encephalitis, neuropathy, thrombocytopenia; measles, mumps and rubella vaccine (MMR) — acute arthritis or arthralgia, chronic arthritis, thrombocytopenia; influenza — Guillain–Barre syndrome (GBS), vasculitis; polio — GBS; varicella — mainly neurological syndromes. Even these ‘frequent’ associations relate to a relatively small number of patients. Whenever controlled studies of autoimmunity following viral vaccines were undertaken, no evidence of an association was found.

Conclusions:

Very few patients may develop some autoimmune diseases following viral vaccination (in particular — arthropathy, vasculitis, neurological dysfunction and thrombocytopenia). For the overwhelming majority of people, vaccines are safe and no evidence linking viral vaccines with type 1 diabetes, multiple sclerosis (MS) or inflammatory bowel disease can be found.

Section snippets

Methods

All Medline records from 1966 through June of 2004 have been scanned and all articles relevant to vaccines (or immunizations) and safety, adverse reactions, autoimmune diseases or autoimmunity have been identified and all reports relating to viral vaccines were selected and retrieved. Additional searches were performed separately on each autoimmune disease or potentially autoimmune syndrome (e.g. SLE, arthritis, vasculitis, uveitis, thrombocytopenia, Guillain–Barre syndrome, etc.) and each one

Results

The findings regarding varied autoimmune manifestations reported in association with viral vaccines will be discussed separately for each of the vaccines studied.

Discussion

Vaccination can undoubtedly be counted among the most impressive achievements of modern medicine, saving millions of lives each year with relatively little cost and much safety [5]. Nevertheless, compliance has often been found to be very poor [90] and concern about adverse effects remains an important cause of noncompliance [91], though by no means the only one. Fuelled by the media and by groups of partially-informed activists [25], [92], the impression that viral vaccines may lead to the

Acknowledgments

The help of Professor Patrick Sissons, Head of the Department of Medicine at Addenbrooke's Hospital, whose advice and support were invaluable to me throughout this work — is gratefully acknowledged.

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