Can vaccine administration trigger autoimmune diseases, such as autoimmune (autoimmune) disorders?

From the Guidelines

There is limited evidence suggesting that vaccines may rarely trigger autoimmune diseases in genetically predisposed individuals, but the overall risk is extremely low, as indicated by the most recent and highest quality study 1. Most scientific research indicates that vaccines are safe for the vast majority of people, with the benefits of disease prevention far outweighing potential risks. Some case reports have documented temporal associations between vaccine administration and the onset of conditions like Guillain-Barré syndrome (particularly with certain influenza vaccines), immune thrombocytopenia, and narcolepsy (associated with a specific H1N1 influenza vaccine used in Europe). However, these events are exceptionally rare, occurring in fewer than 1 in 100,000 vaccine recipients. The biological mechanism potentially involved relates to molecular mimicry, where vaccine components might share structural similarities with self-antigens, potentially triggering an autoimmune response in susceptible individuals. People with existing autoimmune conditions or strong family histories of such disorders should discuss their specific situation with healthcare providers before vaccination, but for most people, routine vaccination remains strongly recommended without special precautions, as supported by the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases 1.

Key Considerations

• The risk of autoimmune diseases triggered by vaccines is extremely low, and the benefits of vaccination outweigh the risks, as stated in the 2019 EULAR recommendations 1.
• Certain individuals, such as those with existing autoimmune conditions or strong family histories, should discuss their specific situation with healthcare providers before vaccination.
• Routine vaccination is strongly recommended for most people without special precautions, according to the EULAR recommendations 1.
• The safety and efficacy of vaccines in patients with autoimmune diseases have been assessed in several studies, including a systematic review and meta-analysis on anti-pneumococcal vaccination in systemic lupus erythematosus patients 1.
• The Canadian Association of Gastroenterology clinical practice guideline for immunizations in patients with inflammatory bowel disease (IBD) also recommends influenza vaccine for adult patients with IBD, with a strong recommendation and moderate certainty of evidence 1.

Recommendations

• Vaccination should be administered during stable disease, preferably prior to the initiation of immunosuppression, as recommended by the EULAR guidelines 1.
• Non-live vaccines can be safely provided to patients with autoimmune inflammatory rheumatic diseases regardless of underlying therapy.
• Live-attenuated vaccines may be considered with caution in certain situations, as stated in the EULAR recommendations 1.
• Influenza and pneumococcal vaccination should be strongly considered for the majority of patients with autoimmune inflammatory rheumatic diseases, according to the EULAR guidelines 1.

From the Research

Autoimmune Diseases and Vaccine Administration

• The relationship between vaccine administration and the triggering of autoimmune diseases has been studied in various research papers 2, 3, 4, 5, 6.
• According to a study published in 2021, epidemiological studies do not support the hypothesis that vaccines cause systemic autoimmune diseases, although rare associations have been found between certain vaccines and specific conditions, such as Guillain-Barré syndrome and thrombocytopenia 2.
• Another study from 2016 highlights the importance of vaccination for patients with autoimmune diseases, who are at high risk for infections, and discusses the potential of vaccine therapy for treating autoimmune disorders 3.
• A 2015 review of the literature found evidence of vaccine-induced autoimmunity and adjuvant-induced autoimmunity in both experimental models and human patients, although the number of cases is limited and epidemiological studies have failed to establish a connection 4.
• A 2010 review presents evidence for the association between vaccinations and the development of autoimmune diseases, including systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis, although these cases are infrequently reported 5.
• A 2021 review addresses the safety and effectiveness of anti-viral vaccines in patients with autoimmune and autoinflammatory diseases, highlighting the importance of vaccination in these high-risk populations and providing recommendations for safe use 6.

Key Findings

• Vaccines are generally safe, but adverse events can occur, including rare cases of autoimmune diseases 2.
• The mechanisms underlying the potential correlation between vaccination and autoimmune disease development are not well understood 2, 4.
• Vaccination is crucial for preventing infections in patients with autoimmune diseases, who are often immunocompromised 3, 6.
• Further research is needed to understand the relationship between vaccine administration and autoimmune disease development, particularly in the context of new vaccine types and immunomodulating therapies 2, 4, 6.