European Journal of Rheumatology
Case based Review

Relapse of polymyalgia rheumatica following adjuvanted influenza vaccine: A case-based review


Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK


Department of Hepatology & Gastroenterology, Imperial College London, London, UK


Northumbria University, School of Health and Life Sciences, Newcastle upon Tyne, UK

Eur J Rheumatol 2020; 7: 37-40
DOI: 10.5152/eurjrheum.2019.19152
Read: 531 Downloads: 281 Published: 07 January 2020

Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatological condition affecting individuals aged >50 years. There have been rare reports of PMR and other vasculitides developing within 3 months of influenza vaccination. Influenza is a major public health issue associated with seasonal increased mortality and intensified health care service use. Annual vaccination is the most effective intervention to prevent influenza, especially in elderly individuals. We report a severe “flare” of PMR in a 70-year-old patient after receiving the adjuvanted trivalent influenza vaccine, as recommended by the Joint Committee on Vaccination and Immunisations for this age group in the UK National Health Service in 2018-2019. The adverse event (AE) could be interpreted as the newly described autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome) as both PMR and ASIA display hyperactive immune responses. Caution is warranted in the use of vaccine adjuvants in patients with PMR with pre-existing imbalance of B and T cell homeostasis. Rare AEs are important to individuals, and personalized medicine means we should move away from “one size fits all” for vaccines, as well as for therapeutics.

Cite this article as: Bassendine MF, Bridge SH. Relapse of polymyalgia rheumatica following adjuvanted influenza vaccine: A case-based review. Eur J Rheumatol 2020; 7(1): 37-40.

ISSN2147-9720 EISSN 2148-4279