Is CFS Linked to Vaccinations?
By Charles Shepherd, MD,
ME Association, United Kingdom
There is widespread agreement that a variety of infections are capable of precipitating chronic fatigue syndrome (CFS) in susceptible individuals. In l988, Lloyd et al reported that several of their patients had linked the onset of CFS to receiving a vaccination in the absence of any coincidental infection.l Since then, other anecdotal reports have also linked vaccinations to the onset of CFS.2,3
The explanation for vaccine-induced CFS may be because the primary purpose of any vaccine is to mimic the effects of infection on the immune system. If an antigenic challenge by infection can precipitate CFS, then it is conceivable that vaccines could act in a very similar manner.
This reasoning is further strengthened by the fact that immunologically based illnesses, such as arthritis, can occur when a susceptible host and an environmental trigger, such as an infection or vaccination, interact.4 It is also interesting to note that vaccinations have been suggested as a possible precipitating factor in the development of Gulf War illness.
My research interest in this aspect of developing CFS is largely based on clinical evidence from patients seen in my practice over the past 10 years. As a result, I have gathered details on more than 200 patients with a history of either developing CFS or experiencing a significant relapse/exacerbation of CFS symptoms following a vaccination.
In addition, I have more than 150 reports referring to such a link from members of myalgic enceph-alomyelitis (ME) or CFS self-help support groups and/or their physicians throughout the world.
This data (although unpublished) suggests that tetanus, typhoid, influenza, and hepatitis B are the most commonly implicated vaccines in cases of CFS. I have reports of very few cases involving hepatitis A (using immunoglobulin), polio, or rubella vaccine, or those predominantly given during childhood—-with the possible exception of Bacillus Calmette--Guerin vaccine (three cases).
Almost all of my cases involve adults, and in a significant minority the vaccine was administered when the person had not yet fully recovered from an infective illness such as infectious mononucleosis (known as glandular fever in the U.K.) or had already experienced an adverse reaction to a previous dose of the same vaccine (as is sometimes the case with hepatitis B accine).
About one third of my cases involve vaccine-induced/exacerbated CFS following receiving the hepatitis B vaccine (HBV). Most of these patients are health care workers, particularly nurses. Most of the other patients received HBV for occupational health purposes, often as a condition of employment and without any information on side effects, such as severe neurological reactions.
The prognosis in this group has been poor, with less than 10% of the patients I have personally followed reporting any significant relief of CFS symptoms.
Although chronic debilitating fatigue is the most frequently reported symp-tom of CFS after vaccine administration in this group, around 20% also complained of significant joint pain/arthralgia, a finding consistent with several reports linking HBV to arthritis and other autoimmune disorders.5
Less than 5% of the patients also reported neurological complications/side effects such as tremors or one-sided weakness, which appear to be separate from their CFS symptoms.
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