These are my notes for a presentation given by Dr Yehuda Shoenfeld, MD, FRCP who specializes in studying autoimmune disease. You can watch the presentation here. This Dr believes wholeheartedly that vaccines are generally a positive thing, however he is studying the cases in which it causes disease. All pharmacological products have risks and all of them can lead to poor outcomes in some people.
All autoimmune diseases share many factors. Genetics are a major risk factor. Hormonal factors are also significant, which is why autoimmune diseases are more common in women than men. Estrogen can enhance the immune system and the risk of autoimmune disorders is highest for women during the childbearing years. Prolactin and vitamin D are also examples of hormones that are relevant. The third factor is immune deficiencies, such as IgA deficiency. People with these deficiencies are more prone to develop allergies, cancer, as well as autoimmune disease.
Lastly you need an environmental trigger that sets it all off. These factors include drugs (all drugs can cause autoimmune disease) and infectious agents such as bacteria and viruses. The Epstein-Barr Virus (EBV) is very much associated with triggering autoimmunity (this is especially interesting as EBV is a herpes virus, and is very similar to HHV-6). Some bugs can cause one disease, some can cause many. Some genes protect a person from autoimmunity.
There are about 80 known autoimmune diseases, and a set of criteria for what makes an illness autoimmune. The causes and therapies for one autoimmune disease are highly relevant to others, it's only the symptomology that varies between the diseases.
How did he come to study vaccines? He was asked to research for a legal case whether vaccines could cause autoimmune diseases. He realized that vaccine-induced autoimmune reactions had a lot in common with known autoimmune diseases. He says that even within one disease, such as vasculitis, there are different presentations and variations in the illness between people and between regions. Some of this is due to variation in genetics between different populations. This is significant to show, as he says that in court there are often very strict definitions of exactly what counts as an autoimmune disease and this does not take the natural variation into account. Another cause for this variation is the different levels of vitamin D that people have depending on how close they are to the equator. Autoimmunity is more common the farther away from the equator you go.
The central point of his talk is that autoimmune disease is the outcome of certain genetic risk factors combined with specific environmental triggers. This specific interaction is why autoimmune diseases are rare. For example, someone with a certain form of one gene that predisposes to autoimmunity who gets EBV might develop Multiple Sclerosis, while someone else with a different variation of that same gene will get an autoimmune thyroid disease. This research is published here.
An adjuvant is an ingredient that is added to a vaccine to enhance the reaction of the immune system to what would otherwise not be enough antigen to lead to immunity. Aluminum is commonly used as an adjuvant. Adjuvants also function to protect the antigen from being broken down, to move the antigen into lymph nodes and to activate both the innate and acquired immune system and to release inflammatory cytokines. He also presents research that looked at which autoimmune diseases occurred by injecting which vaccine adjuvant into animals. The man who did this research was able to induce every autoantibody known in the world by injecting various adjuvants. Once you have the autoantibodies, it is a short time before the patient develops the associated disease.
Some of these adjuvants are commonly around us, so we can be exposed from various sources including processed food. He says that really, most of the bacteria and viruses that we encounter are also adjuvants. So adjuvants are ubiquitous. He says that all autoimmunity is infectious until proven otherwise. He says evidence that vaccines can lead to autoimmunity goes back to 1948, when some nurses given typhoid/paratyphoid vaccine and strep toxin developed Lupus. At 29:37 he shows a slide with references for a list of associations between specific vaccines and autoimmune diseases, including the polio vaccine causing transverse myelitis, the MMR causing Thrombocytopenia, and DTP and Rubella causing arthritis. He also says it was documented that after they changed the ingredients in the Swine Flu vaccine, the incidence of Guillain Barre Syndrome dropped.
He presents animal studies that also support causality between the vaccines and development of autoimmune disease. At 32:10 he shows a slide with references for several studies showing that animals develop autoantibodies following some vaccinations as well. He gives a lot of detail about research that found antibodies associated with Lupus in salmon given a variety of vaccines. A number of other studies are also shown, including several that found an association between Alopecia and the Hep B vaccine.
What is the temporal association between the vaccination and the resulting disease? He says that in US court, there is a very strict idea that the latency period is 3 weeks because this is the time between strep infection and Rheumatic Fever. At 36:10 he shows a list of studies that show that there can be years between the initial exposure and the later development of the autoimmune disease. One study found that the rate of MS in people given the Hep B vaccine was more than 3 times higher, 3 years after vaccination, and that this correlation was not found for other vaccines (MS and autism both involve demyelination, could the hep B at birth be triggering an autoimmune attack on myelin in some kids with autism?). Another study found that vaccination with the Energix brand of Hep B vaccine was associated with an increases risk of demyelination in the CNS by 3 years after vaccination, and an even higher association between that brand and confirmed diagnoses of MS.
What are the possible mechanisms of vaccine components leading to autoimmune disease? He says that Pneumovax is the only vaccine that is not associated with any autoimmune diseases in the literature, and it is also the only vaccine with no adjuvants. This vaccine can also produce protective autoantibodies. He says underlying genetics are very important. Many syndromes, such as Sick Building Syndrome, is an adjuvant response in which there is chronic low-level exposure of an adjuvant. He presents some research exploring the relationship between silicone breast implants and autoimmunity. Nanoparticles of aluminum can enter the brain and lead to problems that way. Adjuvants also trigger cytokines which then trigger inflammation, which is another route.
A study published recently in the journal BMC Medicine (in April 2013) has documented the pathway by which aluminum from adjuvants gets into the brain and other organs. They found that infants, the elderly, and people with certain genetic predispositions were more at risk for this to occur. They also noted that the aluminum accumulated over time, so frequency and amount of immunization are important factors. This is a quote from the results section of the paper "Intramuscular injection of alum-containing vaccine was associated with the appearance
of aluminum deposits in distant organs, such as spleen and brain where they were still
detected one year after injection." The study can be viewed here.
