Severe Autoimmune Adverse Events Post Herpes Zoster Vaccine: A Case-Control Study of Adverse Events in a National Database

July 2015 | Volume 14 | Issue 7 | Original Article | 681 | Copyright © July 2015


Yi Chun Lai BSa and Yik Weng Yew MBBS MPHa,b

aHarvard T.H. Chan School of Public Health, Boston, MA
bNational Skin Centre, Singapore

limitations of confounding factors and systemic errors from under-reporting, erroneous reporting, multiple exposures, or multiple outcomes.27 In our study, we have taken care to match the cases to controls to account for possible confounding by age and gender. We have also evaluated all the cases for double reporting. However, there might still be unknown confounders and some adverse events may be coincidental. It is important to note that, even though the VAERs database may be used to document any possible associations, it does not establish any cause and effect relationship between vaccines and adverse events. In conclusion, the present study demonstrated that zoster vaccination carries no increased risks of severe autoimmune adverse events. Although there were reports of SAAEs after zoster vaccination in the VAERS database, they did not occur more frequently than other vaccines. Therefore, dermatologists and primary care physicians should encourage more zoster vaccine use in elderly patients, including selected patients with autoimmune diseases. More follow-up studies or assessment of other vaccine safety databases should be performed to better evaluate the association.

DISCLOSURES

The authors declare that they have no conflicts of interest.

REFERENCES

  1. Hales CM, Harpaz R, Ortega-Sanchez I, et al. Update on recommendations for use of herpes zoster vaccine. MMWR Morb Mortal Wkly Rep. 2014;63:729-31.
  2. Zhang J, Xie F, Delzell E, et al. Association between vaccination for herpes zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases. JAMA. 2012;308:43-49.
  3. Chacon GR, Sinha AA. Bullous pemphigoid after herpes zoster vaccine administration: association or coincidence? J Drugs Dermatol. 2011;10:1328-30.
  4. Erbagci Z. Childhood bullous pemphigoid following hepatitis B immunization. J Dermatol. 2002;29:781-5.
  5. Santoro D, Vita G, Vita R, et al. HLA haplotype in a patient with systemic lupus erythematosus triggered by hepatitis B vaccine. Clin Nephrol. 2010;74:150-3.
  6. de Carvalho JF, Pereira RM, Shoenfeld Y. Systemic polyarteritis nodosa following hepatitis B vaccination. Eur J Intern Med. 2008;19:575-8.
  7. Cerami C, Corbo M, Piccolo G, Autoimmune neuromyotonia following human papilloma virus vaccination. Muscle Nerve. 2013;47:466-7
  8. Soldevilla HF, Briones SF, Navarra SV. Systemic lupus erythematosus following HPV immunization or infection? Lupus. 2012;2:158-61
  9. Agmon-Levin N, Zafrir Y, Paz Z, et al. Ten cases of systemic lupus erythematosus related to hepatitis B vaccine. Lupus. 2009;18:1192-7.
  10. Zafrir Y, Agmon-Levin N, Paz Z, et al. Autoimmunity following hepatitis B vaccine as part of the spectrum of 'Autoimmune (Auto-inflammatory) Syndrome induced by Adjuvants' (ASIA): analysis of 93 cases. Lupus. 2012;21:146-52.
  11. Gatto M, Agmon-Levin N, Soriano A, et al. Human papillomavirus vaccine and systemic lupus erythematosus. Clin Rheumatol. 2013;32:1301-7
  12. Geier D, Geier M. A case-control study of quadrivalent human papillomavirus vaccine-associated autoimmune adverse events. Clinical Rheumatology [serial on the Internet]. (2014, Dec 23), [cited January 18, 2015]
  13. Yu O, Bohlke K, Hanson CA, et al. Hepatitis B vaccine and risk of autoimmune thyroid disease: a Vaccine Safety Datalink study. Pharmacoepidemiol Drug Saf. 2007;16:736-45.
  14. Belloni C, Avanzini MA, De Silvestri A, et al. No evidence of autoimmunity in 6-year-old children immunized at birth with recombinant hepatitis B vaccine. Pediatrics. 2002;110:e4.
  15. Grimaldi-Bensouda L, Guillemot D, Godeau B, et al. Autoimmune disorders and quadrivalent human papillomavirus vaccination of young female subjects. J Intern Med. 2014;275:398-408.
  16. Geier DA, Geier MR. A case-control study of serious autoimmune adverse events following hepatitis B immunization. Autoimmunity. 2005;38:295-301.
  17. Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al., Shingles Prevention Study Group. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005; 352:2271-84.
  18. Grabenstein JD. ImmunoFacts: Vaccines and Immunologic Drugs – 2013 (38th revision). St Louis, MO: Wolters Kluwer Health, 2012.
  19. Agmon-Levin N, Paz Z, Israeli E, Shoenfeld Y. Vaccines and autoimmunity. Nat Rev Rheumatol. 2009;5:648-52.
  20. Kivity S, Agmon-Levin N, Blank M, Shoenfeld Y. Infections and autoimmunity--friends or foes? Trends Immunol. 2009;30:409-14.
  21. Rose NR. Immunologic hazards associated with vaccination of humans. J Autoimmun. 2000;14:11-3.
  22. Relyveld EH, Bizzini B, Gupta RK. Rational approaches to reduce adverse reactions in man to vaccines containing tetanus and diphtheria toxoids. Vaccine. 1998;16:1016-23
  23. Guthridge JM, Cogman A, Merrill JT, et al. Herpes zoster vaccination in SLE: a pilot study of immunogenicity. J Rheumatol. 2013;40:1875-80.
  24. Zhang J, Delzell E, Xie F, et al. The use, safety, and effectiveness of herpes zoster vaccination in individuals with inflammatory and autoimmune diseases: a longitudinal observational study. Arthritis Res Ther. 2011;13:R174
  25. Williams WW, Lu PJ, O'Halloran A, et al. Noninfluenza vaccination coverage among adults – United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63:95-102.
  26. Hurley LP, Lindley MC, Harpaz R, et al. Barriers to the use of herpes zoster vaccine. Ann Intern Med. 2010;152:555-60.
  27. Singleton JA, Lloyd JC, Mootrey GT, Salive ME, Chen RT. An overview of the vaccine adverse event reporting system (VAERS) as a surveillance system. VAERS Working Group.Vaccine 1999;17:2908–2917.

AUTHOR CORRESPONDENCE

Yik Weng Yewyikweng.yew@mail.harvard.edu
Close Menu