Though declared as generally “harmless,” fears about vaccines are universal. Over the years, vaccines’ short- and long-term effects have been studied, with fear of autoimmune diseases as one of the biggest concerns. Vaccines like those for COVID-19 have caused flares in some people with autoimmune disease – but could it also cause autoimmune disease in the susceptible population?
Despite the high mortality and morbidity associated with the Covid 19 pandemic, there is significant opposition to the widespread vaccination. Almost 30% of American adults in 2020 stated fears over the effects and safety of vaccines as the primary reason for not getting a vaccine. In Japan, a staggering 66% feared side effects. This reservation is not limited to COVID vaccines. In England, 29% of parents in England were worried about side effects, while 23% were worried about long-term effects.
Is there indeed a link – and what could be done about it?
Vaccines And The Immune Response
A vaccine is a preparation of dead or weakened pathogens, such as bacteria or viruses, that are introduced into the body to stimulate the immune system to recognize and fight the pathogen. When the immune system encounters a pathogen, it produces specific proteins called antibodies that can identify and neutralize the virus.
The immune system also produces memory cells that “remember” how to recognize and fight the pathogen if it is reencountered in the future. This way, if the person is exposed to the pathogen in the future, the immune system can respond quickly and effectively to prevent infection. When a person has an autoimmune disease, the body’s immune system, designed to protect the body from harmful invaders such as bacteria and viruses, mistakenly attacks healthy cells and tissues.
The belief that one can get autoimmune disorders from vaccines persists. Years before COVID-19 became a worldwide concern, a study confirmed that those who received the Hepatitis B vaccine were more likely to develop lupus, an autoimmune disease, than those who didn’t.
New-Onset Symptoms After Vaccination
The government response to the COVID threat was three-fold: screening, monitoring, and vaccination. Though vaccines are envisioned to play a crucial role in reducing the burden of disease globally, there have been reports of autoimmune incidents after COVID-19 vaccination. A study supported by the National Natural Science Foundation of China and published in 2021 reported a possible connection between vaccination and new-onset symptoms of rheumatoid arthritis, Guillain–Barré syndrome, autoimmune liver disease, and others. With that said, more studies are needed to confirm the causal relationship.
People with autoimmune diseases may respond differently to vaccines than those without autoimmune diseases. This is because their immune system is already overactive and may not respond to the vaccine similarly as someone with a healthy immune system. However, the evidence is mixed, and the extent to which people with autoimmune diseases respond to vaccines can vary depending on the specific condition and the individual.
Autoimmune Disease: Could Vaccines Cause it?
Autoimmune diseases are the third most prevalent disease classification in the US, which affects 5-8% of the population, 78% of them women. There is evidence that supports the following:
- Vaccines can cause flare-ups in patients with autoimmune diseases, and
- Animal studies have confirmed that infections can cause autoimmune diseases.
Both findings lead to the logical question of whether the attenuated version of the virus, as found in vaccines, can cause new cases of autoimmune disease. There are sporadic reports that some patients developed multiple sclerosis after vaccination with the HPV vaccine, but this finding has yet to be supported by extensive studies.
Alopecia or hair loss was observed in genetically predisposed patients or those with thyroid hormonal dysfunction after SARS-CoV-2 vaccination worldwide and in the US. Hair loss was experienced as early as 2-10 weeks after the first vaccination to four months after the last dose.
One theory was that the antibody-mediated response to the messenger RNA in the Moderna and Pfizer vaccines led to an autoimmune reaction, with alopecia as a manifestation. A search through the Centers for Disease Control (CDC) database also revealed alopecia from Japanese encephalitis, influenza, tetanus toxoid, and childhood diseases vaccines.
Though 80% would eventually grow back hair spontaneously, it is unknown whether other autoimmune diseases, such as arthritis and lupus, would eventually manifest. Vaccine injuries are not that rare, and there are ways to report such for possible compensation.
Some general precautions that healthcare providers may recommend for people with autoimmune diseases include:
- Timing of vaccines: Some vaccines may need to be administered during disease quiescence or when immunosuppressive medications are at their lowest dose.
- Additional monitoring: People with autoimmune diseases may need to be monitored more closely for side effects after receiving vaccines, especially if they are taking immunosuppressive medications.
- Vaccine type: Certain live vaccines, such as the MMR (measles, mumps, rubella) and varicella (chickenpox) vaccines, may not be recommended for people with certain autoimmune diseases, as these vaccines may pose a risk of triggering disease activity.
- Individualized care: Vaccine recommendations may need to be individualized based on the specific autoimmune disease, the individual’s medication regimen, and other factors.
People with autoimmune diseases need to discuss their vaccine options and any concerns with their healthcare provider, who can help determine the best course of action for each individual.
Vaccines are designed to increase immunity to pathogens. However, these could cause flare-ups in those with autoimmune diseases. It can potentially trigger autoimmune diseases in genetically predisposed individuals and those with thyroid hormone imbalances.