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Global Translational Medicine Autoimmune diseases after vaccination

can be calculated as the background rate multiplied by the at risk, in proportion to the strength of immune system
number of days examined, with adjustments for reporting stimulation (e.g., vaccine reactogenicity ). Based on
[27]
bias. The United States Vaccine Adverse Event Reporting similar ADAE patterns observed for tozinameran (mRNA
System (VAERS) database collects AEFI reports , which vaccine), Moderna mRNA-1273 elasomeran (mRNA
[1]
represent a sample (i.e., subset) of the actual number of vaccine), and Janssen Ad26.Cov2.S (adenoviral vaccine),
adverse events estimated by the underreporting factor it is predicted that the frequencies of ADAE observed for
(URF). Deviations from background population patterns COVID-19 vaccines will be comparable across all mRNA
in the VAERS data serve as indicators of relationships and adenoviral vaccines and therapeutics in proportion
between immunization and the adverse event(s). to the level of stimulated immune system response.

Possible associations between autoimmune diseases Understanding the etiology and relationships between
and immunization have been reported in several ADAE and vaccines can inform strategies for minimizing
studies [2-4] . For example, Guillain-Barré syndrome (GBS) the risk of ADAE occurrences. These strategies may include:
has been linked to influenza vaccination [5-7] , narcolepsy (i) Extending the interval between immunizations within a
to the 2009 H1N1 influenza vaccine , and immune dose series to at least 4 weeks (or longer), (ii) eliminating
[8]
thrombocytopenia (ITP) to various vaccinations [9-11] . aluminum adjuvants and mercury excipients from vaccines,
In addition, multiple autoimmune diseases have been (iii) considering lower-reactogenicity alternatives to mRNA
reported following COVID-19 vaccination [12-21] . Some and adenoviral platforms, and so forth.
researchers have explored the concept of autoimmune 2. Materials and methods
(auto-inflammatory) syndrome induced by adjuvants
(ASIA), implicating adjuvants such as aluminum and 2.1. VAERS data mining
[22]
mercury. Watad et al. have provided an overview of The VAERS database underwent data mining to identify
[23]
thyroid autoimmunity within the ASIA framework. autoimmune adverse events, including: Acute disseminated
However, it is important to note that other studies have encephalomyelitis, alopecia, ankylosing spondylitis,
found no significant associations between autoimmune antiphospholipid syndrome, arthritis, autoimmune
diseases and vaccinations [24-26] . Detecting potential disorder, autoimmune hemolytic anemia, autoimmune
adverse events related to immunization amid a backdrop hepatitis, autoimmune thyroiditis, Behcet’s syndrome, Bell’s
of background adverse events can lead to observations palsy, chronic fatigue syndrome, chronic inflammatory
of both correlation and no correlations. Distinguishing demyelinating polyradiculoneuropathy, chronic lymphocytic
possible adverse events triggered by immunization requires leukemia, complex regional pain syndrome, Crohn’s disease,
the identification of distinctive signals that set them apart dermatomyositis, diabetes mellitus, eczema, encephalitis
from background adverse events. Possible signals may be autoimmune, endometriosis, erythema nodosum, giant
overlooked as the number of days considered increases, cell arteritis, glomerulonephritis, granulomatosis with
potentially overshadowing association signals by extending polyangiitis, GBS, Henoch-Schonlein purpura, hidradenitis,
the considered time frame and consequently elevating the hypogammaglobulinaemia, idiopathic pulmonary fibrosis,
expected number of background events. IgA nephropathy, ITP, juvenile idiopathic fibrosis, Kawasaki’s
In this study, VAERS data were examined to assess the disease, Lichen planus, Lichen sclerosus, Lyme disease,
relationships between autoimmune disease adverse events Meniere’s disease, Miller Fisher syndrome, mixed connective
(ADAE) and vaccines. Varying frequencies of multiple tissue disease, multiple sclerosis, multiple sclerosis relapse,
immediate-onset autoimmune diseases were observed in myasthenia gravis, myositis, narcolepsy, neuromyelitis optica
response to different vaccines. These observed correlation spectrum disorder, neutropenia, optic neuritis, pemphigus,
patterns of immediate onset are inconsistent with the notion polymyalgia rheumatica, polymyositis, postural orthostatic
that these autoimmune diseases are solely background tachycardia syndrome, psoriasis, psoriatic arthropathy,
occurrences. Furthermore, an increase in reports of ADAE Raynaud’s phenomenon, restless legs syndrome, rheumatoid
was observed in association with the second dose of the arthritis, sarcoidosis, scleritis, scleroderma, Sjogren’s
Pfizer-BioNTech COVID-19 mRNA vaccine (tozinameran, syndrome, Still’s disease, systemic lupus erythematosus,
also known as BNT162b2/Comirnaty), occurring 3 weeks Type 1 diabetes mellitus, Type 2 diabetes mellitus, uveitis,
after the initial dose. Associations of vaccine platforms vasculitis, and vitiligo. The downloaded VAERS data include
with numerous autoimmune diseases are apparent for all adverse events reported from 1990 to May 19, 2023. The
both mRNA and adenoviral COVID-19 vaccines. When Ruby program, named vaers_slice2.rb [27,28] , was used to tally
comparing unrelated vaccines, it is predicted that the selected reported vaccine adverse events based on vaccine
likelihood of immediate autoimmune disease onset type and the day of onset. The vaers_slice2.rb program takes
exceeds a certain threshold, particularly in individuals a list of one or more adverse events for characterization,

Volume 2 Issue 3 (2023) 2 https://doi.org/10.36922/gtm.1455