A case of systemic lupus erythematosus (SLE) following Human papillomavirus (HPV) vaccination

Ito, Haruyasu; Noda, Kentaro; Hirai, Kenichiro; Ukichi, Taro; Furuya, Keizo; Kurosaka, Daitaro

doi:10.2177/jsci.39.145

Cited by 23 publications

(17 citation statements)

References 11 publications

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“…Overall, the immunogenicity of the HPV vaccine was similar in patients with SLE and controls, without significant safety signals in patients with SLE 30 177–179. Notably, concerns regarding the safety of HPV vaccine have been raised based by case reports and case series on the onset of autoimmune diseases following HPV vaccination 180–185. Population based studies have consistently shown that quadrivalent HPV vaccine was not associated with increased incidence of new-onset autoimmune disease in girls and women with pre-existing autoimmune disease 186–188.…”

Section: Resultsmentioning

confidence: 99%

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

et al. 2019

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To update the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD) published in 2011. Four systematic literature reviews were performed regarding the incidence/prevalence of vaccine-preventable infections among patients with AIIRD; efficacy, immunogenicity and safety of vaccines; effect of anti-rheumatic drugs on the response to vaccines; effect of vaccination of household of AIIRDs patients. Subsequently, recommendations were formulated based on the evidence and expert opinion. The updated recommendations comprise six overarching principles and nine recommendations. The former address the need for an annual vaccination status assessment, shared decision-making and timing of vaccination, favouring vaccination during quiescent disease, preferably prior to the initiation of immunosuppression. Non-live vaccines can be safely provided to AIIRD patients regardless of underlying therapy, whereas live-attenuated vaccines may be considered with caution. Influenza and pneumococcal vaccination should be strongly considered for the majority of patients with AIIRD. Tetanus toxoid and human papilloma virus vaccination should be provided to AIIRD patients as recommended for the general population. Hepatitis A, hepatitis B and herpes zoster vaccination should be administered to AIIRD patients at risk. Immunocompetent household members of patients with AIIRD should receive vaccines according to national guidelines, except for the oral poliomyelitis vaccine. Live-attenuated vaccines should be avoided during the first 6 months of life in newborns of mothers treated with biologics during the second half of pregnancy. These 2019 EULAR recommendations provide an up-to-date guidance on the management of vaccinations in patients with AIIRD.

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Section: Resultsmentioning

confidence: 99%

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

et al. 2019

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“…While some of the aforementioned studies report no significant association between SLE and HPV vaccines, several case reports have been published describing disease onset following vaccination. [95][96][97] Although case reports describing temporal association do not provide proof of causation, these reports are complemented by more recent publications relating to large-scale data. 98,99 Of note, a case-control analysis of reports submitted to the US Vaccine adverse event reporting system compared 48 816 reports of SLE to 21 998 controls (reporting adverse events other than SLE).…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Vaccine-induced autoimmunity: the role of molecular mimicry and immune crossreaction

2018

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Since the early 1800s vaccines have saved numerous lives by preventing lethal infections. However, during the past two decades, there has been growing awareness of possible adverse events associated with vaccinations, cultivating heated debates and leading to significant fluctuations in vaccination rates. It is therefore pertinent for the scientific community to seriously address public concern of adverse effects of vaccines to regain public trust in these important medical interventions. Such adverse reactions to vaccines may be viewed as a result of the interaction between susceptibility of the vaccinated subject and various vaccine components. Among the implicated mechanisms for these reactions is molecular mimicry. Molecular mimicry refers to a significant similarity between certain pathogenic elements contained in the vaccine and specific human proteins. This similarity may lead to immune crossreactivity, wherein the reaction of the immune system towards the pathogenic antigens may harm the similar human proteins, essentially causing autoimmune disease. In this review, we address the concept of molecular mimicry and its application in explaining post vaccination autoimmune phenomena. We further review the principal examples of the influenza, hepatitis B, and human papilloma virus vaccines, all suspected to induce autoimmunity via molecular mimicry. Finally, we refer to possible implications on the potential future development of better, safer vaccines.

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“…Reports in the literature describe new-onset SLE, lupus-like syndromes, and exacerbations of underlying autoimmune disease following HPV vaccine administration [73, 74]. However, most of these patients had personal or family history of autoimmune diseases, making them more genetically susceptible to autoimmunity [75, 76]. A case-control study based on reports to the VAERS database from 2006 to 2014 included 28 reports of SLE developing among female HPV vaccine recipients and an odds ratio of 7.626 (95% CI 3.385–19.366) for development of SLE following administration of quadrivalent HPV vaccine [77, 78].…”

Section: Human Papilloma Virus (Hpv) Vaccinementioning

confidence: 99%

Recommendations and barriers to vaccination in systemic lupus erythematosus

Garg

Mufti

Palmore

2018

Autoimmunity Reviews

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Patients with Systemic Lupus Erythematosus (SLE) pose a unique dilemma pertaining to immunization against common pathogens. SLE patients are usually not immunized with vaccines based on the fear of either precipitating infection in this immunosuppressed patient population (with live vaccines) or aggravating autoimmunity and hence lupus flares (with any vaccines). However, elevated vulnerability to infection makes patients with SLE precisely the population that needs protection from vaccine-preventable diseases. A summary of guidelines from the Centers for Disease Control and Prevention, professional societies, review articles and expert opinions regarding use of individual vaccines applicable to adults with SLE is presented in this review.

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A case of systemic lupus erythematosus (SLE) following Human papillomavirus (HPV) vaccination

Cited by 23 publications

References 11 publications

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

Vaccine-induced autoimmunity: the role of molecular mimicry and immune crossreaction

Recommendations and barriers to vaccination in systemic lupus erythematosus

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