I think it is a good question and one worth considering. We know that certain infections can contribute to autoimmune disease and that there has been some talk about whether vaccines may also contribute.
I’ll share the facts we have at this point. The decision will be yours.
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Good to be Skeptical
I don’t consider myself pro-vaccine. I am anti-COVID, and I am pro-science. If the best evidence points toward a vaccine, so be it. If it suggests another option, then things change.
The year has been one full of surprises, few of them good. People are entirely reasonable for being wary and wanting to know more before deciding on vaccination.
As recently as June of 2020, I doubted that a safe and effective vaccine could be available by the end of the year. I shared this doubt with vaccine development experts. Over the following months, there was more progress made than I thought possible.
I did not understand how scientists could make a vaccine so quickly when it took 5-10 years in the past. I was worried that key safety steps must have been skipped or rushed.
I’m thankful our government took steps to expedite the research, but I think the title ‘Warp Speed’ was terrible! It implies a rushed job full of compromises and cut corners.
It turned out that it took longer in the past because vaccine production had to wait for one step to complete before starting the next. In the past, vaccines were also delayed from countless delays of months or years waiting for funding. None of that applied to the COVID vaccines. This time the scientists could do many of the steps simultaneously, and there were no funding delays.
Vaccines as a Category
One concern I have is that our critics may be quick to label us as anti-vaxxers or vaccine-hesitant. It is OK to be cautious and think things through. You don’t have to think that all vaccines are good or that all are bad. You can judge each vaccine on its own merits.
In doing so, one needs to take into account from what it is protecting you.
Fair questions include how common is the infection? How well does the vaccine prevent it? How likely would one be to catch the disease? How dangerous would it be if one did? What are the odds of spreading it to loved ones?
The answers to those questions would not be the same for COVID vaccines as they would for flu shots or childhood illnesses.
Correlation or Causation
When we talk about risk, it is essential to distinguish correlation from causation. Things that follow one another are not always related. People get out their umbrellas before a downpour, but umbrellas don’t cause rain!
People who receive the COVID vaccines will have bad things happen afterward. There will be countless stories of people who die. There will be countless stories of others who have real health problems that come on after getting vaccinated.
Everyone who suffers in these ways deserves to be listened to and deserves to help. We also need to determine if the vaccine causes any bad things that happen after receiving the vaccine. If they are, the vaccine needs to be discontinued or modified. If they are not, efforts need to go into finding the actual cause of the symptoms.
There were roughly 44,000 participants in the Pfizer Biotech study. Half of them received the vaccine; half received a salt-water shot as a placebo.
In the following months, there were two deaths in those who received the vaccine. On its own, this was startling. Yet, there were six deaths in those who received the placebo. Is it dangerous to receive a salt-water shot? Perhaps just being in a study is dangerous?
Analysts found that neither was the case. In a group that size, that many people would be expected to die at random.
It could have gone differently. Imagine that way more people died in the group getting the vaccine. If this were the case, it would have been reasonable to consider the vaccine as the cause.
The question is not whether people will feel ill in the days, weeks, or months after getting vaccinated. The question is will more people feel ill than would have otherwise.
Vaccines and Autoimmunity
We do know that infections can cause or worsen autoimmune diseases.
- Strep throat can lead to autoimmune damage of the heart lining later in life1
- Lyme disease can lead to lasting arthritis2
- Influenza can cause flare-ups of MS3
- Influenza can also cause Guillain barre syndrome4
If an infection can cause autoimmunity, what about the vaccine? How do the related vaccines compare?
We don’t have a vaccine for the streptococcal bacteria that cause strep throat. There is nothing to compare.
We did have a vaccine for Lyme disease. It did not cause autoimmune Lyme arthritis.5 To be more precise, many people did develop arthritis after receiving the Lyme vaccine, but the rates of arthritis were no higher than those in the general population.
People do get arthritis. Rarely is there an apparent reason. Imagine that if one adult per 10,000 gets arthritis in a given year. Say 100,000 people got the Lyme vaccine, and 10 of them got arthritis.
For each of those 10 cases and their loved ones, it would be easy to think that the vaccine caused it. Yet, the rate was the same as it was in those who were not vaccinated.
Influenza (flu) shots do not cause MS or make it flare-up.6
Flu shots may cause Guillan barre syndrome. This condition is a big deal as it causes temporary paralysis and possible breathing problems.
Why do I say may? Here are the numbers. Roughly one person per million who gets a flu shot gets Guillain barre syndrome. The rate of the condition for those who have influenza is about 17 per million. Those who don’t have flu and did not get a flu shot, about 0.5 to 1 person per million, get Guillain barre syndrome.
Does the vaccine cause it or protect against it? You could make a reasonable argument either way.
There was a type of vaccine used in Europe that seemed to cause narcolepsy, which was considered autoimmune. The immunization was called Pandemrix and was only used in Europe and only in 2009.
The initial impression was that it was causing narcolepsy and that an adjuvant called squalene was the possible culprit. The sight of a possible link was enough, and the vaccine was discontinued. It was never used again.
Later evaluations found that some versions of the vaccine without squalene may still have been a problem. The sole adjuvant common to all versions in question was vitamin e (dl-alpha-tocopherol).7
Does vitamin e cause narcolepsy? The later evaluation showed that seasonal increases in narcolepsy also relate to influenza. There was no longer a clear pattern that the vaccine was the culprit. Nonetheless, it was still retired.8
There was also a suspicion that Pandemrix caused organ rejection in those receiving organ transplants. This case again turned out to be an issue of correlation and causation. The vaccine was not a factor.9
The Pandemrix story is the closest I’ve seen to a vaccine indeed causing autoimmunity even though, on final analysis, it likely did not. (12)
Probably the most referenced evidence for vaccines causing autoimmunity comes from the ASIA theory.
A 2011 paper claimed that aluminum in vaccines causes autoimmune disease. They called the reaction Autoimmune inflammatory Syndrome Induced by Adjuvants (ASIA).10
The theory included adverse events that showed up as long as 23 years after vaccination. The authors of the criteria for ASIA did not base it on the diagnosis of an autoimmune disease. Instead, it was said to be present whenever someone had any combination of a broad set of symptoms.
In the last 23 years, have you ever felt tired? Had a dry mouth or sore muscles? Maybe you had unrefreshing sleep or memory loss. Wow, I sure have.
Some people suffer from these symptoms to a greater degree or frequency than typical. Yet healthy people do have these symptoms on occasion. They are not clear signs of autoimmunity.
Subsequent critics argued that the inclusion criteria were far too broad to be useful. Nearly every adult has had exposure to infections or vaccines and has these symptoms in their life.
Furthermore, there is some strong evidence that counters the theory. If aluminum in vaccines causes autoimmunity, higher doses should do so even more clearly.
A 2017 study looked at the rate of autoimmune disease after allergy shots. Those receiving the allergy shots received 00-500 times more aluminum than expected from routine vaccines. Yet, the rate of autoimmune disease in those treated was lower than in control groups.
Another study compared whether hepatitis b vaccines caused disease flares in those with lupus. It turned out that those who received the vaccine had fewer disease flares than similar lupus patients who did not.
The ASIA paper has been rebuked by several follow up reports and is no longer considered a valid theory.11
As we talk about COVID vaccines, it is worth noting that none have aluminum.
COVID Vaccines and Autoimmunity
The past circumstances, some thought vaccines caused autoimmunity when:
- the infection itself caused autoimmunity and
- the vaccine contained a weakened version of the infection
The first point does apply. We have seen that COVID can trigger autoimmune disease. The second point does not apply in this case.
The COVID vaccines do not contain the infection. They contain a signal that teaches your cells to make antibodies against the spike protein. Your DNA is not part of this reaction. However, active viral infections often can cause changes to our DNA. We think much of our DNA is leftover from past viral illnesses.
These DNA remnants are why many viral infections are associated with later cancer risk. The DNA concern is a valid concern for the virus, but not for the vaccine.
In the Pfizer Biontech study, neither onset of new autoimmune disease nor flares of existing autoimmune disease were reported side effects.
The following table lists the initial side effects and the delayed complications from the Pfizer vaccine and compares them against risks for the same complications from COVID.12
COVID and Autoimmune Disease
If you choose not to get the vaccine, what about your risks for COVID and autoimmunity?
It is worth considering that the COVID infection can raise the risk for developing autoimmune diseases and has caused flares for those who already have autoimmune diseases.
It can cause Guillain Barre syndrome, Acute Disseminated Encephalomyelitis (ADE), and rheumatoid arthritis.13,14
ADE is horrific. Some have described it as the immune system turning the brain to jello.
Future developments – mRNA Vaccines to Combat Autoimmunity
You may have heard that mRNA vaccine technology may have many other helpful applications.
Researchers have shown that mRNA vaccines can calm the unwanted immune responses of autoimmunity. They are working on ways autoantigens may be delivered to immune cells to help those with autoimmunity recovery.15
We must not compare the possible harm of a vaccine against no vaccine. We are comparing the potential harm of a vaccine against the probable harm of COVID.
The numbers involved make this comparison less silly than it might sound. By bizarre coincidence, as I’m writing this, America has had 25.6 million cases of COVID, and we have administered 25.6 million doses of COVID vaccines. I could not have asked for a better comparison.
The CDC just summarized the vaccine tolerance with the following statement.
“With 23.5 million doses of the Pfizer and Moderna vaccines now
given, there have been very few serious side effects. In addition,
deaths reported after people got the vaccine do not seem to be
related to it.”18
Tragically, 429,000 people have died from COVID. People have died after receiving the vaccine, but all deaths appear to be unrelated. The comparison is 429,000 to zero.
It is safe to say for adults, the COVID vaccine is safer than the COVID infection.
COVID is a severe condition that can cause autoimmune disease and cause flares for those who have autoimmune diseases. Some people with autoimmune diseases may be more at risk than others for complications from COVID.
The COVID vaccines do not have any adjuvants suspected of causing autoimmunity, nor do they have live organisms that could harmfully activate the immune system. There are no cases of autoimmune disease or flare-ups of autoimmune disease attributed to the vaccines.
The decision to vaccinate or not is yours personally.
Please know that my only agenda in this matter is you have the best data available to make your own decision.
1. Karthikeyan G, Guilherme L. Acute rheumatic fever. Lancet. 2018 Jul 14;392(10142):161-174. doi: 10.1016/S0140-6736(18)30999-1. Epub 2018 Jun 29. Erratum in: Lancet. 2018 Sep 8;392(10150):820. PMID: 30025809.
2. Arvikar SL, Steere AC. Diagnosis and treatment of Lyme arthritis. Infect Dis Clin North Am. 2015 Jun;29(2):269-80. doi: 10.1016/j.idc.2015.02.004. PMID: 25999223; PMCID: PMC4443866.
3. Nguyen J, Hardigan P, Kesselman MM, Demory Beckler M. Immunogenicity of The Influenza Vaccine in Multiple Sclerosis Patients: A Systematic Review and Meta-Analysis. Mult Scler Relat Disord. 2020 Dec 15;48:102698. doi: 10.1016/j.msard.2020.102698. Epub ahead of print. PMID: 33385826.
4. Vellozzi C, Iqbal S, Broder K. Guillain-Barre syndrome, influenza, and influenza vaccination: the epidemiologic evidence. Clin Infect Dis. 2014 Apr;58(8):1149-55. doi: 10.1093/cid/ciu005. Epub 2014 Jan 9. PMID: 24415636.
5. Nigrovic LE, Thompson KM. The Lyme vaccine: a cautionary tale. Epidemiol Infect. 2007;135(1):1-8. doi:10.1017/S0950268806007096
6. Mailand MT, Frederiksen JL. Vaccines and multiple sclerosis: a systematic review. J Neurol. 2017 Jun;264(6):1035-1050. doi: 10.1007/s00415-016-8263-4. Epub 2016 Sep 7. PMID: 27604618.
7. Lodaya RN, Kanitkar AP, Friedrich K, Henson D, Yamagata R, Nuti S, Mallett CP, Bertholet S, Amiji MM, O’Hagan DT. Formulation Design, Optimization and In Vivo Evaluations of an α-Tocopherol-Containing Self-Emulsified Adjuvant System using Inactivated Influenza Vaccine. J Control Release. 2019 Dec 28;316:12-21. doi: 10.1016/j.jconrel.2019.10.042. Epub 2019 Oct 31. PMID: 31678654.
8. Sarkanen T, Alakuijala A, Julkunen I, Partinen M. Narcolepsy Associated with Pandemrix Vaccine. Curr Neurol Neurosci Rep. 2018 Jun 1;18(7):43. doi: 10.1007/s11910-018-0851-5. PMID: 29855798.
9. Cohet C, Haguinet F, Dos Santos G, et al. Effect of the adjuvanted (AS03) A/H1N1 2009 pandemic influenza vaccine on the risk of rejection in solid organ transplant recipients in England: a self-controlled case series. BMJ Open. 2016;6(1):e009264. Published 2016 Jan 28. doi:10.1136/bmjopen-2015-009264
10. Shoenfeld Y, Agmon-Levin N. ‘ASIA’ – autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun. 2011 Feb;36(1):4-8. doi: 10.1016/j.jaut.2010.07.003. Epub 2010 Aug 13. PMID: 20708902.
11. Ameratunga R, Gillis D, Gold M, Linneberg A, Elwood JM. Evidence Refuting the Existence of Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants (ASIA). J Allergy Clin Immunol Pract. 2017 Nov-Dec;5(6):1551-1555.e1. doi: 10.1016/j.jaip.2017.06.033. Epub 2017 Sep 6. PMID: 28888842.
12. The COVID Choice – NDs For Vaccines. https://ndsforvaccines.com/the-covid-choice/. Accessed January 28, 2021.
13. Ross W Paterson, Rachel L Brown, Laura Benjamin, Ross Nortley, Sarah Wiethoff, Tehmina Bharucha, Dipa L Jayaseelan, Guru Kumar, Rhian E Raftopoulos, Laura Zambreanu, Vinojini Vivekanandam, Anthony Khoo, Ruth Geraldes, Krishna Chinthapalli, Elena Boyd, Hatice Tuzlali, Gary Price, Gerry Christofi, Jasper Morrow, Patricia McNamara, Benjamin McLoughlin, Soon Tjin Lim, Puja R Mehta, Viva Levee, Stephen Keddie, Wisdom Yong, S Anand Trip, Alexander J M Foulkes, Gary Hotton, Thomas D Miller, Alex D Everitt, Christopher Carswell, Nicholas W S Davies, Michael Yoong, David Attwell, Jemeen Sreedharan, Eli Silber, Jonathan M Schott, Arvind Chandratheva, Richard J Perry, Robert Simister, Anna Checkley, Nicky Longley, Simon F Farmer, Francesco Carletti, Catherine Houlihan, Maria Thom, Michael P Lunn, Jennifer Spillane, Robin Howard, Angela Vincent, David J Werring, Chandrashekar Hoskote, Hans Rolf Jäger, Hadi Manji, Michael S Zandi, for the UCL Queen Square National Hospital for Neurology and Neurosurgery COVID-19 Study Group, The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings, Brain, Volume 143, Issue 10, October 2020, Pages 3104–3120, https://doi.org/10.1093/brain/awaa240
14. Gao ZW, Wang X, Lin F, Dong K. The correlation between SARS-CoV-2 infection and rheumatic disease. Autoimmun Rev. 2020;19(7):102557. doi:10.1016/j.autrev.2020.102557
15. Krienke, C. et al. A noninflammatory mRNA vaccine for treatment of experimental autoimmune encephalomyelitis. Science 371, 145–153 (2021).
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