Relapse of Polymyalgia Rheumatica Following Adjuvanted Influenza Vaccine: A Case-based Review

Overview

Journal Eur J Rheumatol

Publisher Aves

Specialty Rheumatology

Date 2020 Jan 11

PMID 31922479

Citations 6

Authors

Margaret F Bassendine

Simon H Bridge

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Polymyalgia rheumatica following COVID-19 vaccination: Case series of 3 patients and literature review on polymyalgia rheumatica induced by various vaccines.

Irani L, Bou Karroum M, Chehab Y, Abi Saad N, Al Dailaty A, Husni R Medicine (Baltimore). 2024; 103(43):e40204.

PMID: 39470514 PMC: 11521047. DOI: 10.1097/MD.0000000000040204.

Polymyalgia Rheumatica Following Respiratory Syncytial Virus (RSV) Vaccination.

El Labban M, Oluic S, Guleid H, Hassan M, Diab R, Rida M Eur J Case Rep Intern Med. 2024; 11(7):004636.

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Rare Cases of Polymyalgia Rheumatica After Receiving COVID-19 Vaccinations.

Furr T, Garg M Cureus. 2023; 15(4):e37782.

PMID: 37091488 PMC: 10115741. DOI: 10.7759/cureus.37782.

An Unusual Side Effect of the COVID-19 Vaccine: A Possible Trigger of Polymyalgia Rheumatica.

Ahmad A, Baker D Cureus. 2022; 14(7):e26617.

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Polymyalgia rheumatica and polymyalgia-like syndromes as adverse events following COVID-19 vaccines: working notes from a narrative review of published literature.

Manzo C, Castagna A, Isetta M Reumatologia. 2022; 60(2):142-147.

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