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

Bassendine, Margaret F. and Bridge, Simon (2020) Relapse of polymyalgia rheumatica following adjuvanted influenza vaccine: A case-based review. European Journal of Rheumatology, 7 (1). pp. 37-40. ISSN 2147-9720

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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.

Item Type: Article
Uncontrolled Keywords: Polymyalgia rheumatic, B-lymphocytes, vaccines, autoimmune inflammatory syndrome induced by adjuvants/ASIA syndrome, adjuvants, squalene
Subjects: A300 Clinical Medicine
A900 Others in Medicine and Dentistry
B200 Pharmacology, Toxicology and Pharmacy
C100 Biology
C900 Others in Biological Sciences
Department: Faculties > Health and Life Sciences > Applied Sciences
Depositing User: Rachel Branson
Date Deposited: 26 Mar 2020 10:39
Last Modified: 31 Jul 2021 18:48

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