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Immunization with common vaccines is not associated with an increased risk for rheumatoid arthritis, nor does it trigger the autoimmune disease in individuals who have established risk factors, according to an analysis of data that was presented by Camilla Bengtsson at the annual European Congress of Rheumatology on June 16.
Although anecdotal reports have suggested that common vaccinations might be inciting agents for rheumatoid arthritis, no sufficiently powered epidemiologic studies have addressed this concern, according to Ms. Bengtsson, a doctoral candidate at the Karolinska Institute in Stockholm.
Using data on 1,851 people with RA from the Swedish population-based EIRA (Epidemiological Investigation of Rheumatoid Arthritis) data set and 1,984 healthy matched controls, Ms. Bengtsson and her associates investigated the possible association between vaccinations that are commonly used in industrialized societies (influenza; tetanus; diphtheria; tick-borne encephalitis; hepatitis A, B, and C; polio; and pneumococcus) and the risk for RA, as well as the impact of vaccinations on two subsets of RA patients: those with and without antibodies to citrullinated peptides. Ms. Bengtsson discussed their findings on potential interactions between vaccination and smoking and between vaccination and the presence of HLA-DRB1 SE alleles with respect to RA risk, both of which have been implicated anecdotally as possible catalysts for the disease.
To evaluate these potential associations, the investigators compared the 582 individuals in the EIRA data set who had been vaccinated in the 5 years prior to disease onset with the 1,269 RA patients who had not been vaccinated within 5 years prior to disease onset. Among the control subjects, 617 had been vaccinated and 1,367 had not been vaccinated within the preceding 5 years.
Vaccine by vaccine, the odds ratio for developing RA after influenza vaccination was 1.1 (252 RA patients and 279 controls had received the flu vaccine during the period of interest). The OR for RA after tetanus vaccination was 1.0 (170 cases and 179 controls had received that vaccination). The OR was 1.0 for diphtheria vaccination (71 cases/71 controls). For tick-borne encephalitis, the OR was 0.8 (91 cases/122 controls). The OR for hepatitis A, B, and C was 0.9 (105 cases/124 controls). The OR for polio vaccination was 1.1 (29 cases/31 controls). The OR for pneumococcus was 1.0 (22 cases/22 controls). The RA OR for the unvaccinated was 1.0 (1,269 cases/1,367 controls).
There was no statistically significant difference among the outcomes. Based on the analysis, vaccinations did not increase the risk of RA overall. Being negative or positive for antibodies to citrullinated peptides did not alter the risk for RA among the vaccinated or unvaccinated subjects, according to Ms. Bengtsson. Additionally, there was no association between any specific vaccine and the risk of RA, nor did vaccinations increase the risk of RA among smokers or among carriers of HLA-DRB1 SE alleles, she said.
The results indicate that “immunological provocation with common vaccines given to adults in their present form is not a major risk factor for RA, at least not vaccines administered [within 5 years] before onset of disease,” Ms. Bengtsson noted, suggesting that clinicians point to these findings to encourage patients to follow recommended immunization guidelines.
No conflicts of interest were reported.
Immunization with common vaccines is not associated with an increased risk for rheumatoid arthritis, nor does it trigger the autoimmune disease in individuals who have established risk factors, according to an analysis of data that was presented by Camilla Bengtsson at the annual European Congress of Rheumatology on June 16.
Although anecdotal reports have suggested that common vaccinations might be inciting agents for rheumatoid arthritis, no sufficiently powered epidemiologic studies have addressed this concern, according to Ms. Bengtsson, a doctoral candidate at the Karolinska Institute in Stockholm.
Using data on 1,851 people with RA from the Swedish population-based EIRA (Epidemiological Investigation of Rheumatoid Arthritis) data set and 1,984 healthy matched controls, Ms. Bengtsson and her associates investigated the possible association between vaccinations that are commonly used in industrialized societies (influenza; tetanus; diphtheria; tick-borne encephalitis; hepatitis A, B, and C; polio; and pneumococcus) and the risk for RA, as well as the impact of vaccinations on two subsets of RA patients: those with and without antibodies to citrullinated peptides. Ms. Bengtsson discussed their findings on potential interactions between vaccination and smoking and between vaccination and the presence of HLA-DRB1 SE alleles with respect to RA risk, both of which have been implicated anecdotally as possible catalysts for the disease.
To evaluate these potential associations, the investigators compared the 582 individuals in the EIRA data set who had been vaccinated in the 5 years prior to disease onset with the 1,269 RA patients who had not been vaccinated within 5 years prior to disease onset. Among the control subjects, 617 had been vaccinated and 1,367 had not been vaccinated within the preceding 5 years.
Vaccine by vaccine, the odds ratio for developing RA after influenza vaccination was 1.1 (252 RA patients and 279 controls had received the flu vaccine during the period of interest). The OR for RA after tetanus vaccination was 1.0 (170 cases and 179 controls had received that vaccination). The OR was 1.0 for diphtheria vaccination (71 cases/71 controls). For tick-borne encephalitis, the OR was 0.8 (91 cases/122 controls). The OR for hepatitis A, B, and C was 0.9 (105 cases/124 controls). The OR for polio vaccination was 1.1 (29 cases/31 controls). The OR for pneumococcus was 1.0 (22 cases/22 controls). The RA OR for the unvaccinated was 1.0 (1,269 cases/1,367 controls).
There was no statistically significant difference among the outcomes. Based on the analysis, vaccinations did not increase the risk of RA overall. Being negative or positive for antibodies to citrullinated peptides did not alter the risk for RA among the vaccinated or unvaccinated subjects, according to Ms. Bengtsson. Additionally, there was no association between any specific vaccine and the risk of RA, nor did vaccinations increase the risk of RA among smokers or among carriers of HLA-DRB1 SE alleles, she said.
The results indicate that “immunological provocation with common vaccines given to adults in their present form is not a major risk factor for RA, at least not vaccines administered [within 5 years] before onset of disease,” Ms. Bengtsson noted, suggesting that clinicians point to these findings to encourage patients to follow recommended immunization guidelines.
No conflicts of interest were reported.
Immunization with common vaccines is not associated with an increased risk for rheumatoid arthritis, nor does it trigger the autoimmune disease in individuals who have established risk factors, according to an analysis of data that was presented by Camilla Bengtsson at the annual European Congress of Rheumatology on June 16.
Although anecdotal reports have suggested that common vaccinations might be inciting agents for rheumatoid arthritis, no sufficiently powered epidemiologic studies have addressed this concern, according to Ms. Bengtsson, a doctoral candidate at the Karolinska Institute in Stockholm.
Using data on 1,851 people with RA from the Swedish population-based EIRA (Epidemiological Investigation of Rheumatoid Arthritis) data set and 1,984 healthy matched controls, Ms. Bengtsson and her associates investigated the possible association between vaccinations that are commonly used in industrialized societies (influenza; tetanus; diphtheria; tick-borne encephalitis; hepatitis A, B, and C; polio; and pneumococcus) and the risk for RA, as well as the impact of vaccinations on two subsets of RA patients: those with and without antibodies to citrullinated peptides. Ms. Bengtsson discussed their findings on potential interactions between vaccination and smoking and between vaccination and the presence of HLA-DRB1 SE alleles with respect to RA risk, both of which have been implicated anecdotally as possible catalysts for the disease.
To evaluate these potential associations, the investigators compared the 582 individuals in the EIRA data set who had been vaccinated in the 5 years prior to disease onset with the 1,269 RA patients who had not been vaccinated within 5 years prior to disease onset. Among the control subjects, 617 had been vaccinated and 1,367 had not been vaccinated within the preceding 5 years.
Vaccine by vaccine, the odds ratio for developing RA after influenza vaccination was 1.1 (252 RA patients and 279 controls had received the flu vaccine during the period of interest). The OR for RA after tetanus vaccination was 1.0 (170 cases and 179 controls had received that vaccination). The OR was 1.0 for diphtheria vaccination (71 cases/71 controls). For tick-borne encephalitis, the OR was 0.8 (91 cases/122 controls). The OR for hepatitis A, B, and C was 0.9 (105 cases/124 controls). The OR for polio vaccination was 1.1 (29 cases/31 controls). The OR for pneumococcus was 1.0 (22 cases/22 controls). The RA OR for the unvaccinated was 1.0 (1,269 cases/1,367 controls).
There was no statistically significant difference among the outcomes. Based on the analysis, vaccinations did not increase the risk of RA overall. Being negative or positive for antibodies to citrullinated peptides did not alter the risk for RA among the vaccinated or unvaccinated subjects, according to Ms. Bengtsson. Additionally, there was no association between any specific vaccine and the risk of RA, nor did vaccinations increase the risk of RA among smokers or among carriers of HLA-DRB1 SE alleles, she said.
The results indicate that “immunological provocation with common vaccines given to adults in their present form is not a major risk factor for RA, at least not vaccines administered [within 5 years] before onset of disease,” Ms. Bengtsson noted, suggesting that clinicians point to these findings to encourage patients to follow recommended immunization guidelines.
No conflicts of interest were reported.