Paul A. Offit, MD, addresses concerns about vaccines and autoimmune diseases, such as arthritis, rheumatic fever and multiple sclerosis, and explains how we know vaccines are not the cause.
Do vaccines cause autoimmune or chronic disorders?
Paul Offit, MD:
Hi, my name is Paul Offit. I’m talking to you today from the Vaccine Education Center at the Children’s Hospital of Philadelphia.
One question that parents reasonably ask is, “Is it possible that vaccines could cause autoimmune diseases or chronic diseases?” And by autoimmune disease I mean a disease where the body reacts against itself. Now, it’s certainly true that certain viruses or bacteria can cause autoimmune diseases. So, for example, Lyme disease is caused a bacteria. When you’re infected with that bacteria, you generally rid yourself of it, but it can cause chronic, or long-term, arthritis, meaning inflammation of the joints. Because when the body reacts to the bacteria, it’s also reacting against itself; essentially reacting against its joints. Similarly, strep throat can set up for rheumatic fever. So, while you’re reacting to the bacteria that causes strep throat, you’re also reacting to the lining of your own heart that can cause symptoms and signs of rheumatic fever. So, we know that bacteria can do it. We know that viruses can do it. The question is, can vaccines do it? Now, there are few examples that I think help to answer that question. One is that there was a Lyme vaccine; it was used in the United States between 1998 and 2002. And while it was clear that Lyme bacteria could cause chronic, or long-term, arthritis, the Lyme vaccine couldn’t do it because it didn’t have what it took to drive the immune response to cause autoimmunity. Similarly, if you look at people who have multiple sclerosis, when they’re infected with natural, or so-called wild type, influenza virus, they have a worsening of their multiple sclerosis — that’s clear. However, when they’re given the vaccine, they don’t have that. So, again, in many ways then, the influenza vaccine prevents the exacerbation, or worsening, of multiple sclerosis in someone who has multiple sclerosis.
Now, there are a couple of very rare examples where a vaccine could cause autoimmunity, or said another way, the vaccine could cause the body to react against itself. One is influenza virus. It is possible that roughly 1 per million people who get an influenza vaccine can have a disease called Guillain-Barré syndrome, where the body essentially reacts against itself and causes this sort of ascending paralysis; it starts at the legs and then works its way up the body and can affect breathing. Now of interest, influenza virus, the natural virus, also causes Guillain-Barré syndrome at a rate roughly 17 times greater than that that’s caused by the vaccine, or said another way then, the influenza vaccine then, arguably, prevents Guillain-Barré syndrome.
There’s one other isolated example where a vaccine could cause autoimmune disease. It occurred in Europe; it occurred in 2009; it was associated with a squalene-adjuvanted influenza vaccine, called Pandemrix®. Now, the rate of narcolepsy, which is a permanent disease of wakefulness, that was caused by that vaccine was, depending on the country you looked at, between 1 in 15,000 to 1 in 50,000. We never used that vaccine in this country, the United States; it was never used again, and so I don’t think that’s ever gonna be a problem again.
So, I think that we can feel comfortable that for all the diseases that are associated with autoimmunity, and frankly for all the diseases that are just sort of chronic diseases that are not associated with autoimmunity, there have been study after study after study showing that vaccines don’t do that. And vaccines really, frankly, are the safest best tested things we put in our bodies because ounce they’re licensed, regulatory agencies and academic institutions look very hard to see whether it’s at all possible that vaccines are doing more harm than good, that vaccines might be causing autoimmune or chronic diseases, and clearly and consistently that’s been shown not to be true with the exception of the couple rare instances I mentioned.
So, again, vaccines are safe and effective, and a choice not to get them is not a risk-free choice, it’s just a choice to take a different and more serious risk.
Related Centers and Programs: Vaccine Education Center
Last Reviewed on Mar 26, 2020