Vaccines do not increase risk for lupus, meta-analysis finds
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Key takeaways:
- A pooled analysis found no overall connection between vaccination for various conditions and risk for SLE.
- HBV vaccination had a “significant connection” to SLE, but newer studies are needed.
Vaccinations in general do not increase the risk for systemic lupus erythematosus, but hepatitis B vaccines may have a “significant connection” with the disease, according to a meta-analysis published in Arthritis Research & Therapy.
“Vaccinations have been theorized as potential triggers for the onset of SLE, considering their role in eliciting antigen-specific immune responses,” Meijiao Wang, of Zhejiang Chinese Medical University, and colleagues wrote.
“While an earlier review suggested a connection between vaccinations and an elevated risk of SLE, subsequent studies have yielded conflicting results, with some demonstrating no discernible impact on SLE risk,” they added. “Due to these contradictory findings, a definitive conclusion regarding the relationship between vaccinations and the risk of SLE has remained elusive.”
To examine the potential association between vaccines and SLE more comprehensively, Wang and colleagues conducted a meta-analysis of studies investigating SLE risk following any type of vaccination. Following a literature search, the researchers used statistical models, a sensitivity analysis and subgroup analyses to assess the overall results.
Their final analysis included 17 studies — 10 cohort and seven case-control — comprising 45,067,349 individuals with average follow-ups ranging from 6 months to 2 years. There were seven studies on human papillomavirus (HPV) vaccines, four on hepatitis B virus (HBV) vaccination, two on influenza vaccines, two regarding COVID-19 vaccination, and one each on zoster and anthrax vaccines. Additional studies mentioned various other vaccines or did not specify.
According to the researchers, there was no significant association between vaccination and increased SLE risk in the pooled analysis (OR = 1.14; 95% CI, 0.86-1.52). In fact, COVID-19 vaccination was “marginally” associated with a decreased risk for SLE (OR = 0.44; 95% CI, 0.18-1.21), they wrote.
However, HBV vaccination was linked to significantly increased SLE risk (OR = 2.11; 95% CI, 1.11-4), while HPV vaccination was “slightly” associated with increased risk (OR = 1.43; 95% CI, 0.88-2.31), according to the researchers.
That said, Wang and colleagues noted that the studies included for the HBV vaccine were 1 to 2 decades old, and suggested that vaccine technology developed since that time necessitates new clinical trials to “provide new evidence.”
“This meta-analysis indicates that vaccination may not be significantly associated with an increased risk of SLE,” Wang and colleagues wrote. “However, for HBV vaccination, it shows a potential association with a risk of SLE. Our meta-analysis results provide valuable insights, alleviating concerns about SLE risk post-vaccination and supporting further vaccine development efforts.”
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