Relapse of polymyalgia rheumatica following adjuvanted influenza vaccine: A case-based review

Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatological condition affecting individuals aged >50 years. There have been rare reports of PMR and other vasculitides developing within 3 months of influenza vaccination. Influenza is a major public health issue associated with sea...

Full description

Saved in:
Bibliographic Details
Published in:European journal of rheumatology 2020-01, Vol.7 (1), p.37-40
Main Authors: Bassendine, Margaret F, Bridge, Simon H
Format: Article
Language:English
Subjects:
B cells
Case-based Review
Health aspects
Health care industry
Homeostasis
Immune response
Influenza
Influenza vaccines
Lymphocytes
Polymyalgia rheumatica
Precision medicine
Prevention
Public health
Public health movements
Socialized medicine
T cells
Therapeutics
Vaccination
Vaccines
Vasculitis
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatological condition affecting individuals aged >50 years. There have been rare reports of PMR and other vasculitides developing within 3 months of influenza vaccination. Influenza is a major public health issue associated with seasonal increased mortality and intensified health care service use. Annual vaccination is the most effective intervention to prevent influenza, especially in elderly individuals. We report a severe "flare" of PMR in a 70-year-old patient after receiving the adjuvanted trivalent influenza vaccine, as recommended by the Joint Committee on Vaccination and Immunisations for this age group in the UK National Health Service in 2018-2019. The adverse event (AE) could be interpreted as the newly described autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome) as both PMR and ASIA display hyperactive immune responses. Caution is warranted in the use of vaccine adjuvants in patients with PMR with pre-existing imbalance of B and T cell homeostasis. Rare AEs are important to individuals, and personalized medicine means we should move away from "one size fits all" for vaccines, as well as for therapeutics.
ISSN:2147-9720
2148-4279
DOI:10.5152/eurjrheum.2019.19152