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Rubella Vaccines possibly linked to acute arthritis in 13 to 15% of women

Editors note: Requested Peer reviewed citations from earlier studies:

Evidence Concerning Rubella Vaccines and Arthritis, Radiculoneuritis, and Thrombocytopenic Purpura

Institute of Medicine (US) Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines; Howson CP, Howe CJ, Fineberg HV, editors.

Washington (DC): National Academies Press (US); 1991.

Conclusions

The evidence indicates a causal relation between the currently used rubella vaccine strain (RA 27/3) and acute arthritis. Incidence rates are estimated to average 13 to 15 percent among adult women following RA 27/3 immunization with much lower levels noted among children, adolescents, and adult men.

The evidence is consistent with a causal relation between the currently used rubella vaccine strain (RA 27/3) and chronic arthritis in adult women, although the evidence is limited in scope and confined to reports from one institution.2 Prospective, double-masked, controlled trials in which subjects are followed for at least 12 months after rubella vaccination are needed to establish this biologically plausible relation. Additional elements of a definitive study would include attempts to isolate rubella virus from the synovial fluid of affected joints of cases of arthropathy and arthritis and molecular-genetic analysis to determine whether the isolated strain is the one that was injected, a strain derived from the injected strain, or an unrelated strain.

rarthr

Clin Exp Rheumatol. 2001 Nov-Dec;19(6):724-6.

Rubella vaccine and arthritic adverse reactions: an analysis of the Vaccine Adverse Events Reporting System (VAERS) database from 1991 through 1998.

Geier DA1, Geier MR.

Abstract

OBJECTIVE:

The United States Academy of Sciences, Institute of Medicine (IOM) reported in 1991 that the evidence indicates a causal relationship between the currently used rubella vaccine and acute and chronic arthritis. The purpose of this study was to analyze the associated arthritic reactions reported following rubella immunization from 1991 through 1998 to the Vaccine Adverse Events Reporting System (VAERS) database.

METHODS:

A certified copy of the VAERS database was obtained from the CDC. Microsoft Access was used to analyze the database.

RESULTS:

The results show that rubella vaccine is associated with a number of arthritic reactions reported to the VAERS database.

CONCLUSION:

Adult female patients need to make informed decisions on whether or not rubella vaccination is right for them. Doctors and patients must together make an informed consent decision about the risk verses the benefit to the patient in their particular life situation. Additionally, those patients who have had an adverse reaction to rubella vaccination should be informed that they may seek compensation under the no-fault Vaccine Compensation Act, which is administered by the US Claims Court.

Comment in

Hepatitis B vaccination and arthritic adverse reactions: a followup analysis of the Vaccine Adverse Events Reporting System (VAERS) database. [Clin Exp Rheumatol. 2002]

 

J Immunol. 1976 Nov;117(5 Pt 1):1684-7.

Abnormalities of cellular immune response in arthritis induced by rubella vaccination.

Chiba Y, Sadeghi E, Ogra PL.

Abstract

The rubella-specific antibody, activity the levels of immunoglobulins and complement in the serum, the number of T cells, and the nature of cell-mediated immunity as measured by lymphocyte transformation (LTF) of circulating lymphocytes in response to rubella virus and phyto-hemagglutinin (PHA) were studied in 15 children who manifested arthralgia or arthritis after parenteral immunization with HPV-77 DE/5 or RA27/3 live attenuated rubella virus vaccines. Eighteen appropriately matched subjects who developed no post-vaccine complications were included as controls. The immunoglobulins, complement, and rubella antibody levels were similar in all subjects. Although significant rubella specific cell-mediated immunity was detectable in most control subjects, the activity was markedly depressed in subjects with arthritis. The LTF activity in response to PHA was approximately equal in both groups. These findings suggest a selective depression of cell-mediated immunity to rubella virus in subjects with arthritis associated with rubella vaccination.

Clin Infect Dis. 1992 Aug;15(2):307-12.

Chronic arthritis after rubella vaccination.

Howson CP1, Katz M, Johnston RB Jr, Fineberg HV.

Abstract

In August 1991 the Institute of Medicine released a report entitled “Adverse Effects of Pertussis and Rubella Vaccines” that examined, among other relations, the relation between immunization with the RA 27/3 rubella vaccine strain and chronic arthritis. The committee spent 20 months reviewing a wide range of information sources including case series and individual case reports published in peer-reviewed journals and reported by vaccine manufacturers; unpublished case reports from physicians, parents, and other concerned persons; epidemiological studies; and laboratory studies. There were no animal studies available. The committee found that the evidence is consistent with a causal relation between the RA 27/3 rubella vaccine strain and chronic arthritis in adult women, although the evidence is limited in scope. Proving that rubella vaccination can cause chronic arthritis will require a better understanding of pathogenetic mechanisms and additional well-designed studies. We briefly describe the committee’s evaluative methods and present the evidence underlying its conclusion.

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A 2007 CDC study estimates that 294,000 U.S. children under age 18 (or 1 in 250 children) have been diagnosed with arthritis or another rheumatologic condition. This study provides for the first time a national data-based estimate of the number of children diagnosed with arthritis and related rheumatic conditions across the United States and within each state, creating a benchmark to measure future shifts in occurrence.

Arthritis Rheum. 2007 Dec 15;57(8):1439-45.

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