Evidence so far doesn’t indicate an association between COVID-19 vaccines and autoimmune diseases

Key takeaway

More than one hundred autoimmune diseases are known to scientists, several of which affect joints, like arthritis and lupus. The causes aren’t well understood but likely involve a combination of genetic and environmental factors. There have been cases of people developing such autoimmune diseases after COVID-19 vaccination. However, the data so far doesn’t show that it was the vaccination that caused these autoimmune diseases. COVID-19 itself may increase the risk of autoimmune disease, while being vaccinated mitigates that risk.

Reviewed content

Verdict:

Unsupported

Claim:

COVID-19 vaccination is associated with a higher risk of autoimmune rheumatic diseases

Verdict detail

Inadequate support: Available scientific data doesn’t support the implication that getting a COVID-19 vaccine causes rheumatic diseases like arthritis. While there are case reports of rheumatic diseases occurring after COVID-19 vaccination, these alone cannot demonstrate a causal association.
Lack of context: The post didn’t explain that COVID-19 itself can increase the risk of autoimmune diseases like arthritis, and that this risk is reduced in vaccinated people.

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Full Claim

Receiving a COVID-19 vaccine is associated with a higher risk of autoimmune rheumatic diseases; The “best rheumatologist in New York” said that “test[ing] positive for an autoimmune issue” had to do with getting a COVID-19 vaccine booster

A Facebook reel published in May 2024 implied that COVID-19 vaccines were associated with autoimmune diseases. This isn’t the first time that claims linking COVID-19 vaccines to autoimmune conditions have circulated on social media. Published fact-checks showed that those claims are inaccurate and not supported by scientific evidence.

More generally, presenting vaccines as a cause of autoimmune disease is a classic vaccine disinformation narrative that Science Feedback refuted on previous occasions.

The reel from May 2024 is an excerpt from the Megyn Kelly Show originally posted on YouTube in September 2023. In this excerpt, former Fox News host Megyn Kelly began by affirming that she “regrett[ed] getting the vaccine” and that “For the first time [she] tested positive for an autoimmune issue” soon after vaccination. She added that her rheumatologist had confirmed to her that it had to do with her getting the COVID-19 vaccine.

Autoimmune diseases occur when one’s immune system attacks one’s own body, damaging tissues and organs. The causes of autoimmune diseases are difficult to pinpoint, although we know that genetic predispositions and environmental conditions can play a role. Well-known autoimmune diseases are, for example, multiple sclerosis, where the immune system attacks the myelin cells lining up the nerves, and type 1 diabetes where the immune system attacks the insulin-producing cells of the pancreas.

There are over one hundred known autoimmune diseases, and the Facebook reel didn’t specify which one it referred to. However, Kelly mentioned having consulted a rheumatologist. So, we can plausibly narrow it down to common autoimmune diseases with rheumatoid symptoms, like psoriatic arthritis, rheumatoid arthritis, Sjögren’s syndrome, systemic lupus erythematosus (SLE), ankylosing spondylitis, and scleroderma.

Some autoimmune diseases can alternate between phases with little to no symptoms and sudden worsening, known as flares. Environmental factors such as stress, diet, or infections can cause the disease to flare up. However, Kelly declared that she had been diagnosed with this autoimmune condition for the first time. So the question to be addressed here is whether COVID-19 vaccines are associated with new-onset autoimmune diseases, and not flares of preexisting conditions.

The large clinical trials that led to the authorization of COVID-19 vaccines in the U.S. didn’t detect clear signs of an increased risk of the autoimmune diseases listed above following vaccination. More specifically, the clinical trial of the Pfizer-BioNTech vaccine didn’t detect any new onset autoimmune issue. The clinical trial of the Moderna vaccine reported one case of rheumatoid arthritis out of more than 15,000 individuals who got vaccinated.

The U.S. Food and Drug Administration (FDA) deemed the hypothesis that vaccines contributed to the onset of that condition in this specific person “not excluded”. In other words, arthritis might have been a side effect of vaccination for this particular person out of thousands, but the data wasn’t strong enough to draw this conclusion with certainty.

Furthermore, there is no post-marketing clinical data conclusively showing that getting vaccinated against COVID-19 would cause any of the diseases listed above.

A search on PubMed^#, a digital repository of articles published in biomedical and life sciences journals maintained by the U.S. National Library of Medicine, returned several case reports and case series of patients experiencing new-onset autoimmune diseases including SLE and rheumatoid arthritis^[1-4].

These case reports describe the clinical features of autoimmune disease that occurred in patients some time after their COVID-19 vaccination. Case reports contribute to scientific knowledge but they aren’t sufficient to prove a causal association between an intervention like vaccination and a disease. This is because they don’t include a control group of unvaccinated individuals and focus on one to a few patients at best, making them unsuitable for statistical analysis.

Without a statistical comparison with a control group that serves as a baseline, we can’t tell if the likelihood of autoimmune disease after vaccination is significantly greater, which is a prerequisite for establishing causality. Therefore, they cannot tell us that those patients wouldn’t have developed their autoimmune issues if they hadn’t had received a vaccine. They also cannot tell us whether the risk of developing an autoimmune condition is higher among vaccinated individuals.

Rather than case reports, other experimental methods involving control groups of unvaccinated individuals and a larger number of participants, like controlled observational studies or randomized controlled clinical trials, would be necessary for reliably determining whether COVID-19 vaccines increase the risk of autoimmune diseases. However, our PubMed search returned no such published study at the time of writing. Thus, we find this claim to be unsubstantiated.

Furthermore, research showed that COVID-19 itself is associated with a higher risk of autoimmune diseases. Retrospective studies showed that unvaccinated individuals who recovered from COVID-19 had a greater risk of developing diseases such as rheumatoid arthritis, SLE and Sjögren’s syndrome than unvaccinated people who never got COVID-19^[5,6].

Another retrospective study comparing one million COVID-19 patients to three million people who didn’t have COVID confirmed that getting COVID-19 was associated with a higher risk of rheumatoid arthritis, psoriatic arthritis, and other autoimmune arthritis^[7].

However, it also found that having two doses of COVID-19 vaccine was associated with a reduced risk of arthritis and SLE in COVID-19 patients.

Thus, available results indicate that COVID-19 may increase the risk of developing autoimmune rheumatoid conditions, while being vaccinated may limit this risk of complication.

In summary, there is no scientific evidence to date to conclusively support the implication that getting vaccinated against COVID-19 is connected with a higher risk of autoimmune rheumatoid diseases, like arthritis. Instead, the available data indicates that COVID-19 vaccines may mitigate the risk of autoimmune conditions associated with getting COVID-19.

NOTE:

# Pubmed search query: COVID-19[Title] AND vaccin*[Title] AND (arthrit*[Title] OR Sjögren[Title] OR lupus[Title] OR osteoarthritis[Title]) NOT “Case Reports”[pt]

REFERENCES:

• 1 – Rai et al. (2022) Prevalence of rheumatoid arthritis following COVID-19 vaccine: An autoimmune disorder. Annals of Medicine and Surgery.
• 2 – Sagy et al. (2022) New-onset systemic lupus erythematosus following BNT162b2 mRNA COVID-19 vaccine: a case series and literature review. Rheumatology International.
• 3 – Rodríguez et al. (2022) Autoimmune and autoinflammatory conditions after COVID-19 vaccination. New case reports and updated literature review. Journal of Autoimmunity.
• 4 – Watad et al. (2021) Immune-Mediated Disease Flares or New-Onset Disease in 27 Subjects Following mRNA/DNA SARS-CoV-2 Vaccination. Vaccines.
• 5 – Tesch et al. (2023) Incident autoimmune diseases in association with SARS-CoV-2 infection: a matched cohort study. Clinical Rheumatology.
• 6 – Chang et al. (2023) Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study. EClinical Medicine.
• 7 – Peng et al. (2023) Risk of autoimmune diseases following COVID-19 and the potential protective effect from vaccination: a population-based cohort study. EClinical Medicine.