Vaccines and Autoimmune Diseases of the Adult - and aspartame

[Guest guest]

Recently Dr. Mercola interviewed by Dr. Russell

Blaylock and in this interview he mentions that

adjuvants like squalene and mercury all causes

the same things - MS, lupus, ALS, etc. Also

autism. An adjuvant is an immune

stimulator.

http://articles.mercola.com/sites/articles/archive/2009/11/03/What-We-Have-Learn\

ed-About-the-Great-Swine-Flu-Pandemic.aspx

http://www.infowars.com/dr-mercola-interviews-dr-baylock-on-vaccines/

Also understand that aspartame is an

adjuvant. http://www.rense.com/general/asp.htm

Aspartame also triggers the same things, MS,

lupus, ALS, autism. To make things worse,

aspartame interacts with all vaccines, and drugs

too for that matter because of damage to the

mitochondria. Also aspartame is in some vaccines because it is an adjuvant.

 

With this knowledge read on the following article and be warned.

 

All my best,

Dr. Betty Martini, D.Hum, Founder

Mission Possible International

9270 River Club Parkway

Duluth, Georgia 30097

770 242-2599

www.mpwhi.com, www.dorway.com, www.wnho.net

Aspartame Toxicity Center, www.holisticmed.com/aspartame

Aspartame Information List, www.mpwhi.com, scroll down to banners

 

 

 

<http://snipurl.com/ucu3w>http://snipurl.com/ucu3w [Discovery Medicine]

 

<http://www.discoverymedicine.com/Hedi-Orbach/2010/02/04/vaccines-and-autoimmune\

-diseases-of-the-adult/>Vaccines

and Autoimmune Diseases of the Adult

Published on February 4, 2010

 

Author: <http://www.discoverymedicine.com/Hedi-Orbach/>Hedi Orbach

Specialty:

<http://www.discoverymedicine.com/author/specialty/immunology>Immunology,

<http://www.discoverymedicine.com/author/specialty/rheumatology>Rheumatology,

<http://www.discoverymedicine.com/author/specialty/microbiology>Microbiology,

<http://www.discoverymedicine.com/author/specialty/infectious-diseases>Infectiou\

s

Diseases

Institution: Department of Medicine B, Wolfson Medical Center

Address: Holon, Israel

Author: <http://www.discoverymedicine.com/Nancy-Agmon-Levin/>Nancy Agmon-Levin

Specialty:

<http://www.discoverymedicine.com/author/specialty/immunology>Immunology,

<http://www.discoverymedicine.com/author/specialty/rheumatology>Rheumatology,

<http://www.discoverymedicine.com/author/specialty/microbiology>Microbiology,

<http://www.discoverymedicine.com/author/specialty/infectious-diseases>Infectiou\

s

Diseases

Institution: Center for Autoimmune Diseases &

Department of Medicine B, Sheba Medical Center

Address: Ramat Gan, Israel

Author:

<http://www.discoverymedicine.com/Gisele-Zandman-Goddard/>Gisele

Zandman-Goddard

Specialty:

<http://www.discoverymedicine.com/author/specialty/immunology>Immunology,

<http://www.discoverymedicine.com/author/specialty/rheumatology>Rheumatology,

<http://www.discoverymedicine.com/author/specialty/microbiology>Microbiology,

<http://www.discoverymedicine.com/author/specialty/infectious-diseases>Infectiou\

s

Diseases

Institution: Department of Medicine C, Wolfson Medical Center

Address: Holon, Israel

Institution: Sackler Faculty of Medicine, Tel-Aviv University

Address: Tel-Aviv, Israel

 

Abstract: Infectious agents contribute to the

environmental factors involved in the development

of autoimmune diseases possibly through molecular

mimicry mechanisms. Hence, it is feasible that

vaccinations may also contribute to the mosaic of

autoimmunity. Evidence for the association of

vaccinations and the development of these

diseases is presented in this review.

Infrequently reported post-vaccination autoimmune

diseases include systemic lupus erythematosus,

rheumatoid arthritis, inflammatory myopathies,

multiple sclerosis, Guillain-Barré syndrome, and

vasculitis. In addition, we will discuss

macrophagic myofasciitis, aluminum containing

vaccines, and the recent evidence for

autoimmunity following human papilloma virus vaccine.

 

Introduction

 

Systemic and organ derived autoimmune diseases

are known to develop following infectious

triggers. Recently we have suggested that certain

autoimmune diseases like

<http://www.discoverymedicine.com/category/medical-specialties/rheumatology/syst\

emic-lupus-erythematosus/>systemic

lupus erythematosus

(<http://www.discoverymedicine.com/tag/sle/>SLE)

may result due to specific viral agents.

Furthermore, the spectrum of disease may be

influenced by a certain microbial agent in the

genetically predisposed individual (Zandman-Goddard et al., 2009).

 

Vaccines are a prototypic source for natural

immune stimulation, but may be involved in

pathogenic disease in the setting of aberrant

immune system function. Possibly, the burden on

the immune system resulting from simultaneous

multiple vaccines and even the different types of

vaccines may also be an overwhelming challenge in

the autoimmune prone individual (Shoenfeld et

al., 2008). In this review, we discuss the

evidence for the development of autoimmune diseases following infections.

 

While vaccinations are generally safe, warranted

and have virtually eradicated endemic diseases

and probably lessened morbidity and mortality, a

question arises regarding the evaluation of

possible autoimmune phenomena in vaccinated individuals.

 

Reported

post-<http://www.discoverymedicine.com/category/medical-specialties/preventive-m\

edicine/vaccination/>vaccination

autoimmune diseases in the adult include SLE,

<http://www.discoverymedicine.com/category/medical-specialties/rheumatology/rheu\

matoid-arthritis/>rheumatoid

arthritis (RA),

<http://www.discoverymedicine.com/category/medical-specialties/neurology/inflamm\

atory-myopathies/>inflammatory

myopathies,

<http://www.discoverymedicine.com/category/medical-specialties/neurology/multipl\

e-sclerosis/>multiple

sclerosis (MS), Guillain-Barré syndrome (GBS),

and

<http://www.discoverymedicine.com/category/medical-specialties/rheumatology/vasc\

ulitis/>vasculitis.

Evidence for the association of vaccinations and

the development of these diseases is presented in

this review. In addition, we will discuss

<http://www.discoverymedicine.com/category/medical-specialties/neurology/macroph\

agic-myofasciitis/>macrophagic

myofasciitis, post aluminum containing vaccines

and the recent support for

<http://www.discoverymedicine.com/tag/autoimmunity/>autoimmunity

following human papilloma virus vaccine.

 

The Role of Infections in the Induction of Autoimmune Diseases

 

Infections, including viruses, bacteria,

parasites and fungi, have pivotal roles as

environmental factors contributing to the mosaic

of autoimmune diseases (Shoenfeld et al., 2008).

 

Evidence exists for the association of

streptococcus pyogenes infection with the

development of rheumatic fever (Cunningham et

al., 1988), Trypanosoma cruzi parasitic infection

and Chagas disease cardiomyopathy (Cunha-Neto et

al., 1995), the spirochete Borrelia burgdorfeii

and Lyme disease (Chen et al., 1999),

Campylobacter jejuni infection and Guillain-Barré

syndrome (Vucic et al., 2009; Khamaisi et al.,

2004; Yuki, 2007), viral infections and

<http://www.discoverymedicine.com/category/medical-specialties/endocrinology/dia\

betes/>diabetes

mellitus I (Goldberg et al., 2009), Chlamydia

pneumoniae and

<http://www.discoverymedicine.com/category/species-and-cell-types/virus/epstein-\

barr-virus/>Epstein-Barr

virus

(<http://www.discoverymedicine.com/tag/ebv/>EBV)

and multiple sclerosis (Ercolini et al., 2009;

Bagert, 2009), and EBV infection and SLE

(Zandman-Goddard et al., 2009; Pender, 2003). Our

group recently screened more than 1,300 patients

with different autoimmune diseases and found a

significant association of

<http://www.discoverymedicine.com/category/species-and-cell-types/virus/hepatiti\

s-c-virus/>hepatitis

C virus with other diseases including autoimmune

thyroiditis, Crohn’s disease, pemphigus vulgaris,

antiphospholipid syndrome, and vasculitides. In

addition, in this study, EBV was found to be

linked to SLE, RA, pemphigus vulgaris, giant cell

arteritis, Wegener’s granulomatosis,

polyarteritis nodosa, MS, Sjogren’s syndrome, and

polymyositis (Kivity et al., 2009).

 

The Role of Vaccines in the Induction of Autoimmune Diseases

 

SLE

 

SLE patients show decreased immune responsiveness

and are vulnerable for

<http://www.discoverymedicine.com/category/medical-specialties/infectious-diseas\

es/>infectious

diseases, due to the underlying disease and the

frequent use of immunosuppressive drugs (Zandman-Goddard et al., 2005).

 

In studies of more than 10 patients, the reported

manifestations following

<http://www.discoverymedicine.com/category/medical-specialties/infectious-diseas\

es/hepatitis-b/>hepatitis

B vaccination were arthritis, thrombocytopenia,

demyelinating encephalitis, and demyelinating

<http://www.discoverymedicine.com/category/medical-specialties/neurology/neuropa\

thy/>neuropathy.

A case-control study of 265 newly diagnosed lupus

patients did not show that

<http://www.discoverymedicine.com/tag/hbv/>HBV

vaccine was a risk factor for developing SLE

[odds ratio (OR)-1.4] (Schattner, 2005). In a

current study, 10 lupus patients were diagnosed

within several days and up to one year following

hepatitis B vaccination (Agmon-Levin et al.,

2009). Previously, 11 cases were reported in the

literature regarding the onset or exacerbation of

SLE post hepatitis B vaccination (Schattner, 2005).

 

In concordance, a latency period of less than one

week and up to 2 years between vaccination and

SLE onset was reported. The classical period

between vaccination and autoimmunity was

considered to be several weeks, similarly to the

time frame suggested in the past for

post-infectious autoimmunity phenomena.

Interestingly, in this case series, 70% of

patients continued their

<http://www.discoverymedicine.com/category/medical-specialties/preventive-medici\

ne/immunization/>immunization

protocol although adverse events were documented.

Similarly, in previously reported cases, the

affected subjects continued to be vaccinated and

aggravation of their condition by additional

doses had been documented (Agmon-Levin et al.,

2009). Overall, SLE patients presented post

hepatitis B vaccination with mild to moderate

disease and without life threatening organ involvement.

 

A summary of the serious autoimmune adverse

events following vaccination with hepatitis B

vaccination reported to the vaccine adverse

events reporting system (VAERS) include in

descending order by odds ratio: RA (OR-18), optic

neuritis (OR-14), SLE (OR-9.1), alopecia

(OR-7.2), MS (OR-5.2), and vasculitis (OR-2.6).

Many of the adverse events associated with

hepatitis B vaccination were extra-hepatic and

are manifestations of infection with HBV. In

addition to the potential epitopes in the

<http://www.discoverymedicine.com/tag/hbsag/>HBsAg

(HBV surface antigen) vaccine, adjuvants

containing aluminum and mercury may provide

potential antigenic stimulation (Geier et al., 2005).

 

Routine

<http://www.discoverymedicine.com/category/medical-specialties/infectious-diseas\

es/influenza/>influenza

vaccination of SLE patients seems indicated

although the activation of an autoimmune response

is feasible. Of 10 studies on 265 SLE patients

that received

<http://www.discoverymedicine.com/category/medical-specialties/preventive-medici\

ne/immunization/influenza-vaccine/>influenza

vaccine (with a follow-up period of 4-24 weeks)

only 6 were reported to develop a flare, of those

two patients had renal involvement (Conti et al.,

2008; Del Porto et al., 2008; Holvast et al.,

2007; Abu-Shakra et al., 2007). It is not clear

that the composition of the modern vaccines is

identical to those of over 30 years ago where

most of the studies were performed.

 

In SLE, the immune response to influenza

vaccination led to a blunted humoral response

(Holvast et al., 2007). Generally, in the lupus

patient in remission, flares are infrequent and

influenza vaccine can be administered without

harm. Why a few lupus patients had a flare

following influenza immunization as evaluated

utilizing the systemic lupus erythematosus

disease activity index (SLEDAI) score is yet to

be established (Abu-Shakra et al., 2007).

 

In a small observational study on 24 lupus

patients, the 23 serotype pneumococcal vaccine

did not confer disease activity (Elkayam et al., 2005).

 

Multiple sclerosis

 

Neurological manifestations are common following

vaccinations (Huynh et al., 2008). In a

case-control epidemiological study for serious

adverse events reported in the hepatitis B

vaccination exposed group compared to those that

received tetanus vaccine, MS was prominent with

an odds ratio of 5.2 (P<0.0003). Optic neuritis

was also very commonly encountered (OR-14, p< 0.0002) (Geier et al., 2005).

 

Guillain-Barré syndrome

 

In GBS, activated macrophages invade intact

myelin sheaths resulting in myelin damage and

demyelination (Vucic et al., 2009).

 

Vaccines reported as associated with GBS are

diverse (Schonberger et al., 1979; Hemachudha et

al., 1988; Khamaisi et al., 2004; CDC, 2006;

Slade et al., 2009; Haber et al., 2009). The

evidence of casual relationship with GBS is

strongest with the swine

<http://www.discoverymedicine.com/tag/flu/>flu

(<http://www.discoverymedicine.com/category/species-and-cell-types/virus/influen\

za-a/h1n1/>H1N1)

vaccine that was used in 1976-7. An increased

relative risk [relative risk (RR)-4-8] to develop

GBS 6-8 weeks after the injection was encountered

in the vaccinated group compared to the non

vaccinated group. The risk for GBS was slightly

less than 1 excess case of GBS per 100,000

vaccinated individuals, and hence the vaccine

program was suspended (Schonberger et al., 1979).

Further studies substantiated the association

between the H1N1 vaccine and an increased

relative risk (RR-7/1) for GBS 6 weeks after the

vaccine (Safranek et al., 1991). The

pathophysiology is unclear but may be related to

vaccine induced anti-ganglioside antibodies (GM1) (Nachamkin et al., 2008).

 

Studies of influenza vaccines in the following

years were not associated with a substantial

increase in the rate of GBS (Lasky et al., 1998).

Immunizing patients with a history of GBS requires caution.

 

An increased risk for GBS was found in Semple and

SMB rabies vaccines. The vaccine most probably

included brain protein that could cause cross

reactive antibodies to the neural tissue and were

discontinued. The current rabies vaccines are

derived from chick embryo cells and are not

associated with an increased rate of GBS (Hemachudha et al., 1988).

 

The vaccine against Neisseria meningitides is for

use among individuals aged 11-55 years old. The

VAERS published a warning of a possible

association between the Meningococcal

Polisaccharide Diphteria Toxoid Conjugated

Vaccine (MCV4) and GBS, because of 5 cases of GBS

following the MCV4 vaccine, and later 12

additional cases were reported (CDC, 2005). Based

on reports, statistical analysis did not show any

significant increase in the rate of GBS occurring

6 weeks after the MCV4 vaccine compared to

non-vaccinated population. However, it is

recommended that individuals with a history of

GBS should not be vaccinated with MCV4 unless

they are in a high risk for meningococcal

infection. In a mass meningococcal C conjugate

vaccine (CMCV not MCV4) campaign in Quebec,

Canada in 2001, 2 cases of GBS 8 weeks after the

vaccine were identified among 1.5 million

administered vaccinations, a rate expected in the

healthy normal population (De Wals et al., 2008).

 

The FDA licensed the quadrivalent human

papilloamavirus recombinant vaccine (qHPV) in the

United States in June 2006 for use in females

9-26 years old. In a review of the adverse

effects reported over two years to the VAERS

(Slade et al., 2009), 12 of 42 cases reported as

GBS were confirmed, 11 of them in the age 13-30

years old. Only eight of the confirmed cases were

in the range of 4-42 days post vaccination. The

relative risk in 9-26 year old females vaccinated

with qHPV vaccine for GBS was low (Callreus et al., 2009).

 

Vaccine induced myopathies

 

The reports on vaccine induced inflammatory

myopathies are sporadic and include cases of

following immunization with HBV, bacillus

Calmette-Guérin, tetanus, influenza,

<http://www.discoverymedicine.com/category/medical-specialties/infectious-diseas\

es/smallpox/>smallpox,

polio, diphtheria, or combinations with

diphtheria (Orbach et al., 2009). There is no

statistically significant increase in the

incidence of polymyositis or dermatomyositis

after any mass vaccination. Among 289 patients

with inflammatory myopathies followed in the Mayo

Clinic, no recent immunization was recorded

(Winkelman, 1968; Winkelmann, 1982).

 

Macrophagic myofasciitis

 

Macrophagic myofasciitis is a reaction to

intramuscular injections of vaccines containing

aluminum hydroxide as an adjuvant and affects

mainly adults. The symptoms are usually myalgia,

arthralgia, asthenia and, less frequently, muscle

weakness and fever, in the presence of elevated

creatine kinase and erythrocyte sedimentation

rates. The electromyogram has a unique pathologic

pattern characterized mainly by focal

infiltration of the epimysium, perimysium, and

perifascicular endomysium by sheets of large,

non-epithelioid macrophages, which show fine

granular staining for periodic acid-Schiff (PAS)

stain that appear as small, osmiophilic, spiky

structures on

<http://www.discoverymedicine.com/category/research-technology/microscopy/electr\

on-microscopy/>electron

microscopy, representing the aluminum hydroxide

crystals (Gherardi et al., 2001). Immunizations

containing aluminum may trigger Macrophagic

myofasciitis in the context of an

<http://www.discoverymedicine.com/tag/hla/>HLA-DRB1*01

genetic background (Guis et al., 2002).

Frequently, patients improve with steroid therapy.

 

Vasculitis

 

Numerous case reports reported a possible

association between polyarteritis nodosa (PAN)

and hepatitis B vaccination. Overall, 25 cases of

PAN were submitted to VAERS over an 11 year

period until 2001. Among them, only 10

individuals were diagnosed as definite or

possible PAN and are discussed here. The median

age of patients was 45 years old and 5 patients

were hospitalized. A modal peak of 2 weeks and

median of 2.8 weeks post-vaccination was noted.

All cases received at least 2 doses of vaccine

prior to symptom onset. Hepatitis B surface

antigenemia frequently follows hepatitis B

vaccination and is detected many days after the

20 microgram vaccine. This could explain related

immune-complex disease. Recently, there were less

than 20 reports on the development of vasculitis

following influenza vaccination. Small, medium,

and large vessels were involved (Begier et al.,

2004). All in all, this would be considered a rare event.

 

Rheumatoid arthritis

 

A total of 48 out of 898 (5.3%) of patients with

early inflammatory polyarthritis reported an

immunization in the 5 weeks prior to symptom

onset. There were no important clinical or

demographic differences between the 48 immunized

patients and 185 consecutive patients who did not

report prior immunization. The frequencies of HLA

DRB1 *01 and *04 and the shared epitope in 33 of

the immunized patients were no different in the

non- immunized patients compared to healthy

controls. Possibly, in a small number of

susceptible individuals, immunization may act as

a trigger for RA (Harrison et al., 1997).

 

Seropositive

<http://www.discoverymedicine.com/tag/hla-dr4/>HLA-DR4-positive

RA is reported in a few case reports after

hepatitis B vaccination. In a series of 11

patients who developed RA after hepatitis B

vaccination, all individuals were healthy prior

to vaccination and they developed persistent

polyarthritis fulfilling the present American

College of

<http://www.discoverymedicine.com/category/medical-specialties/rheumatology/>Rhe\

umatology

criteria for RA (Pope et al., 1998). Five

subjects expressed HLA-DR4, and HLA class II

genes with the RA shared motif were identified in

nine of 11 patients. In a case-control

epidemiological study, adults receiving hepatitis

B vaccination had an odds ratio of 18 to develop

RA (P<0.0001) (Geier et al., 2005), However, the

available data suggests a benefit of the vaccine

that outweighs the risk (Sibilia et al., 2002).

 

RA patients have almost a doubled risk level of

developing an infection in comparison with age-

and sex-matched subjects. In two randomized

studies on RA patients, a good safety profile for

the influenza vaccine without an increased rate

of exacerbation was shown (Conti et al., 2008).

Ninety nine

<http://www.discoverymedicine.com/tag/adalimumab/>adalimumab

treated patients had a less significant immune

response than 99 placebo treated RA, but the

difference was not statistically relevant (Kaine

et al., 2007). Infliximab and etanercept did not

influence the immunogenicity of influenza vaccine

(Kubota et al., 2007). The effect of

<http://www.discoverymedicine.com/category/medical-specialties/oncology/lymphoma\

/non-hodgkins-lymphoma/rituximab-non-hodgkins-lymphoma-lymphoma-oncology-medical\

-specialties/>rituximab

on the efficacy and immunogenicity of influenza

vaccine was studied in 14 RA patients. During the

4-week follow-up after vaccination, there was no

difference in disease activity in both groups of

patients. In the

<http://www.discoverymedicine.com/tag/rituximab/>rituximab

treated patients, the percentage of responders

was low for all three antigens tested, achieving

statistical significance for the California antigen (Oren et al., 2008).

 

The safety profile of pneumococcal vaccine was

good without exacerbations of RA (Elkayam et al.,

2002). In 5 studies on the immunogenicity of the

pneumococcal vaccine in RA patients, elevated

titers of antibodies occurred but the response

was partial. In 11 RA patients treated with

<http://www.discoverymedicine.com/tag/tnf/>TNF-

blockers, the titer of the antibodies increased

to a lower level compared to other disease

modifying anti-rheumatic drugs

(<http://www.discoverymedicine.com/tag/dmards/>DMARDs)

treated RA patients. In another study,

<http://www.discoverymedicine.com/category/medical-specialties/rheumatology/rheu\

matoid-arthritis/methotrexate/>methotrexate

treated patients had an inferior increase in

antibodies to the 23F and B6 serotypes when

compared to patients treated by TNF- blockers and

healthy controls. In the Aspire trial, 70 RA

patients with early disease were immunized by

pneumococcal vaccine 34 weeks after initiating

therapy. The percentage of patients with antibody

response was similar in the three groups

(infliximab at 2 different doses with

methotrexate or methotrexate alone) (20-25%

response). All treatment groups had a lower

response to vaccine than would be expected in the

normal population. Interestingly, the addition of

infliximab to methotrexate therapy did not impair

the immune response (Visvanathan et al., 2007).

 

Hepatitis B vaccination was safe in 22 RA

patients compared to controls without any

evidence of exacerbation of the disease and was

effective in 68% of patients (Elkayam et al., 2002).

 

<http://www.discoverymedicine.com/tag/hpv-vaccine/>HPV

vaccine and autoimmune manifestations

 

The recently released vaccine for

<http://www.discoverymedicine.com/category/species-and-cell-types/virus/human-pa\

pillomavirus/>human

papillomavirus

(<http://www.discoverymedicine.com/tag/hpv/>HPV)

offers an opportunity to assess the development

of autoimmune phenomena in a high risk population

of young women. Hence, we chose to investigate

and report separately on this vaccine.

 

Recently developed vaccines against human

papillomavirus (HPV) and

<http://www.discoverymedicine.com/category/species-and-cell-types/virus/hepatiti\

s-b-virus/>hepatitis

B virus (HBV) contain a novel Adjuvant System,

AS04, which is composed of 3-O-desacyl-4

monophosphoryl lipid A andd aluminum salts. All

randomized, controlled trials of

<http://www.discoverymedicine.com/tag/hpv-16/>HPV-16/18,

<http://www.discoverymedicine.com/category/species-and-cell-types/virus/herpes-s\

implex-virus/>herpes

simplex virus

(<http://www.discoverymedicine.com/tag/hsv/>HSV),

and HBV vaccines were analyzed in an integrated

analysis of individual data (N = 68,512). A

separate analysis of the HPV-16/18 vaccine trials

alone was also undertaken (N = 39,160). The

reported rates of overall autoimmune events were

around 0.5% and did not differ between the AS04

and control groups. The relative risk

(AS04/control) of experiencing any autoimmune

event was 0.98 (95% confidence intervals 0.80,

1.21) in the integrated analysis and 0.92 (0.70,

1.22) in the HPV-16/18 vaccine analysis. This

integrated analysis of over 68,000 participants

who received AS04 adjuvant vaccines or controls

demonstrated a low rate of autoimmune disorders,

without evidence of an increase in relative risk

associated with AS04 adjuvanted vaccines (Verstraeten et al., 2008).

 

In the Danish Civil Registration system, among

approximately half a million adolescent girls,

414 autoimmune disorders were listed. The 5 most

common autoimmune diseases occurring within 6

weeks of vaccination among 100,000 girls were:

type I diabetes, juvenile arthritis, Crohn’s

disease, Henoch-Schonlein disease, and

<http://www.discoverymedicine.com/category/medical-specialties/gastroenterology/\

ulcerative-colitis/>ulcerative

colitis (Sutton et al., 2009). However, over a 10

year period, the common autoimmune diseases, from

the most to the least common, were: type I

diabetes, juvenile arthritis, Crohn’s disease,

ulcerative colitis, Basedow’s disease,

Henoch-Schonlein purpura,

<http://www.discoverymedicine.com/category/medical-specialties/rheumatology/psor\

iasis/>psoriasis,

and SLE (Verstraeten et al., 2008).

 

Adverse events of potential autoimmune etiology

for HPV 16/18, HBV, and genital HSV vaccine

trials (n = 42) were evaluated in an integrated

analysis of 68,512 individuals. Common to these 3

vaccines is their adjuvant, ASO4. A separate

analysis of HPV 16/18 vaccine trials was

performed in an integrated analysis of 39,160

individuals. The analysis included all completed

or ongoing controlled randomized studies of the 3

vaccines conducted by GlaxoSmithKline Biologicals

or collaborators. No independent sources on this

subject were retrieved in a literature search.

The control group received vaccines that were

ASO4 free, non-adjuvanted, or adjuvanted with

aluminum or aluminum hydroxide. To be included in

the analysis, each individual received at least

one dose of vaccine. The mean follow-up period

was 1.8 years. These studies were not

specifically set up to evaluate the development

of autoimmune phenomena. A total of 362

participants reported at least one autoimmune

event with an event rate of 0.52% in the

vaccinated group which did not differ from the

control group (0.54%). Hypothyroidism was the

most common individual event, followed by

unclassified musculoskeletal and neuroinflammatory disorders.

 

The overall relative risk for developing an

<http://www.discoverymedicine.com/category/medical-specialties/rheumatology/auto\

immune-disease/>autoimmune

disease was 0.98, hence no direct statistically

significant difference between the groups was

encountered. However, when looking at each

disease individually, the highest relative risk

for an individual event was idiopathic

thrombocytopenic purpura (RR-3.74), followed by

SLE (RR-3.00). For organ specific disease,

thyroid involvement was most commonly detected.

For analysis of the entire database which

included data for HBV and HSV vaccine as well,

the highest relative risk for an individual event

was for SLE (RR-2.39) (Verstraeten et al., 2008).

 

Discussion

[see the rest on site]

 

=====

 

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[Guest guest]

When the body is exposed to two or more different toxic heavy metals such as mercury, lead, nickel, aluminum, cadmium, etc. in combination these metals act synergistically compounding their toxicity many times more than any one of the toxic heavy metals alone is capable of.

Betsy

 

--- On Sun, 2/14/10, Dr. Betty Martini,D.Hum. <bettym19 wrote:

Dr. Betty Martini,D.Hum. <bettym19 Vaccines and Autoimmune Diseases of the Adult - and aspartamebettym19Date: Sunday, February 14, 2010, 1:37 PM

Recently Dr. Mercola interviewed by Dr. Russell Blaylock and in this interview he mentions that adjuvants like squalene and mercury all causes the same things - MS, lupus, ALS, etc. Also autism. An adjuvant is an immune stimulator. http://articles. mercola.com/ sites/articles/ archive/2009/ 11/03/What- We-Have-Learned- About-the- Great-Swine- Flu-Pandemic. aspx http://www.youtube. com/watch? v=Dq2YVnwEnBwhttp://www.infowars .com/dr-mercola- interviews- dr-baylock- on-vaccines/ Also understand that aspartame is an adjuvant. http://www.rense. com/general/ asp.htm Aspartame also triggers the same things, MS, lupus, ALS, autism. To make things worse, aspartame interacts with all vaccines, and drugs too for that matter because of damage to the mitochondria. Also aspartame is in some vaccines because it is an adjuvant.With this knowledge read on the following article and be warned.All my best,Dr. Betty Martini, D.Hum, FounderMission Possible International9270 River Club ParkwayDuluth, Georgia 30097770 242-2599www.mpwhi.com, www.dorway.com, www.wnho.netAspartame Toxicity Center, www.holisticmed. com/aspartameAspartame Information List, www.mpwhi.com, scroll down to banners<http://snipurl. com/ucu3w>http://snipurl. com/ucu3w [Discovery Medicine]<http://www.discover ymedicine. com/Hedi- Orbach/2010/ 02/04/vaccines- and-autoimmune- diseases- of-the-adult/>Vaccines and Autoimmune Diseases of the AdultPublished on February 4, 2010Author: <http://www.discover ymedicine. com/Hedi- Orbach/>Hedi OrbachSpecialty: <http://www.discover ymedicine. com/author/ specialty/ immunology>Immunology, <http://www.discover ymedicine. com/author/ specialty/

rheumatology>Rheumatology, <http://www.discover ymedicine. com/author/ specialty/ microbiology>Microbiology, <http://www.discover ymedicine. com/author/ specialty/ infectious- diseases>Infectious DiseasesInstitution: Department of Medicine B, Wolfson Medical CenterAddress: Holon, IsraelAuthor: <http://www.discover ymedicine. com/Nancy- Agmon-Levin/>Nancy Agmon-LevinSpecialty: <http://www.discover ymedicine. com/author/ specialty/ immunology>Immunology, <http://www.discover ymedicine. com/author/ specialty/ rheumatology>Rheumatology, <http://www.discover ymedicine. com/author/ specialty/ microbiology>Microbiology, <http://www.discover ymedicine. com/author/ specialty/ infectious- diseases>Infectious DiseasesInstitution: Center for Autoimmune Diseases & Department of Medicine B, Sheba Medical CenterAddress: Ramat Gan, IsraelAuthor: <http://www.discover ymedicine. com/Gisele- Zandman-Goddard/>Gisele Zandman-GoddardSpecialty: <http://www.discover ymedicine. com/author/ specialty/ immunology>Immunology, <http://www.discover ymedicine. com/author/ specialty/ rheumatology>Rheumatology, <http://www.discover ymedicine. com/author/ specialty/ microbiology>Microbiology, <http://www.discover ymedicine. com/author/ specialty/ infectious- diseases>Infectious DiseasesInstitution: Department of Medicine C, Wolfson Medical CenterAddress: Holon, IsraelInstitution: Sackler Faculty of Medicine, Tel-Aviv UniversityAddress:

Tel-Aviv, IsraelAbstract: Infectious agents contribute to the environmental factors involved in the development of autoimmune diseases possibly through molecular mimicry mechanisms. Hence, it is feasible that vaccinations may also contribute to the mosaic of autoimmunity. Evidence for the association of vaccinations and the development of these diseases is presented in this review. Infrequently reported post-vaccination autoimmune diseases include systemic lupus erythematosus, rheumatoid arthritis, inflammatory myopathies, multiple sclerosis, Guillain-Barré syndrome, and vasculitis. In addition, we will discuss macrophagic myofasciitis, aluminum containing vaccines, and the recent evidence for autoimmunity following human papilloma virus vaccine.IntroductionSystemic and organ derived autoimmune diseases are known to develop following infectious triggers.

Recently we have suggested that certain autoimmune diseases like <http://www.discover ymedicine. com/category/ medical-specialt ies/rheumatology /systemic- lupus-erythemato sus/>systemic lupus erythematosus (<http://www.discover ymedicine. com/tag/sle/>SLE) may result due to specific viral agents. Furthermore, the spectrum of disease may be influenced by a certain microbial agent in the genetically predisposed individual (Zandman-Goddard et al., 2009).Vaccines are a prototypic source for natural immune stimulation, but may be involved in pathogenic disease in the setting of aberrant immune system function. Possibly, the burden on the immune system resulting from

simultaneous multiple vaccines and even the different types of vaccines may also be an overwhelming challenge in the autoimmune prone individual (Shoenfeld et al., 2008). In this review, we discuss the evidence for the development of autoimmune diseases following infections.While vaccinations are generally safe, warranted and have virtually eradicated endemic diseases and probably lessened morbidity and mortality, a question arises regarding the evaluation of possible autoimmune phenomena in vaccinated individuals.Reported post-<http://www.discover ymedicine. com/category/ medical-specialt ies/preventive- medicine/ vaccination/>vaccination autoimmune diseases in the adult include SLE, <http://www.discover ymedicine. com/category/ medical-specialt ies/rheumatology /rheumatoid- arthritis/>rheumatoid arthritis (RA), <http://www.discover ymedicine. com/category/ medical-specialt ies/neurology/ inflammatory- myopathies/>inflammatory myopathies, <http://www.discover ymedicine. com/category/ medical-specialt ies/neurology/ multiple- sclerosis/>multiple sclerosis (MS), Guillain-Barré syndrome (GBS), and <http://www.discover ymedicine. com/category/ medical-specialt ies/rheumatology /vasculitis/>vasculitis. Evidence for the association of vaccinations and the development of these diseases is presented in this review. In addition, we will discuss <http://www.discover ymedicine. com/category/ medical-specialt ies/neurology/ macrophagic- myofasciitis/>macrophagic myofasciitis, post aluminum containing vaccines and the recent support for <http://www.discover ymedicine. com/tag/autoimmu nity/>autoimmunity following human papilloma virus vaccine.The Role of

Infections in the Induction of Autoimmune DiseasesInfections, including viruses, bacteria, parasites and fungi, have pivotal roles as environmental factors contributing to the mosaic of autoimmune diseases (Shoenfeld et al., 2008).Evidence exists for the association of streptococcus pyogenes infection with the development of rheumatic fever (Cunningham et al., 1988), Trypanosoma cruzi parasitic infection and Chagas disease cardiomyopathy (Cunha-Neto et al., 1995), the spirochete Borrelia burgdorfeii and Lyme disease (Chen et al., 1999), Campylobacter jejuni infection and Guillain-Barré syndrome (Vucic et al., 2009; Khamaisi et al., 2004; Yuki, 2007), viral infections and <http://www.discover ymedicine. com/category/ medical-specialt ies/endocrinolog

y/diabetes/>diabetes mellitus I (Goldberg et al., 2009), Chlamydia pneumoniae and <http://www.discover ymedicine. com/category/ species-and- cell-types/ virus/epstein- barr-virus/>Epstein-Barr virus (<http://www.discover ymedicine. com/tag/ebv/>EBV) and multiple sclerosis (Ercolini et al., 2009; Bagert, 2009), and EBV infection and SLE (Zandman-Goddard et al., 2009; Pender, 2003). Our group recently screened more than 1,300 patients with different autoimmune diseases and found a significant association of <http://www.discover ymedicine.

com/category/ species-and- cell-types/ virus/hepatitis- c-virus/>hepatitis C virus with other diseases including autoimmune thyroiditis, Crohn’s disease, pemphigus vulgaris, antiphospholipid syndrome, and vasculitides. In addition, in this study, EBV was found to be linked to SLE, RA, pemphigus vulgaris, giant cell arteritis, Wegener’s granulomatosis, polyarteritis nodosa, MS, Sjogren’s syndrome, and polymyositis (Kivity et al., 2009).The Role of Vaccines in the Induction of Autoimmune DiseasesSLESLE patients show decreased immune responsiveness and are vulnerable for <http://www.discover ymedicine. com/category/ medical-specialt ies/infectious- diseases/>infectious diseases, due to the underlying disease and the frequent use of

immunosuppressive drugs (Zandman-Goddard et al., 2005).In studies of more than 10 patients, the reported manifestations following <http://www.discover ymedicine. com/category/ medical-specialt ies/infectious- diseases/ hepatitis- b/>hepatitis B vaccination were arthritis, thrombocytopenia, demyelinating encephalitis, and demyelinating <http://www.discover ymedicine. com/category/ medical-specialt ies/neurology/ neuropathy/>neuropathy. A case-control study of 265 newly diagnosed lupus patients did not show that <http://www.discover ymedicine. com/tag/hbv/>HBV

vaccine was a risk factor for developing SLE [odds ratio (OR)-1.4] (Schattner, 2005). In a current study, 10 lupus patients were diagnosed within several days and up to one year following hepatitis B vaccination (Agmon-Levin et al., 2009). Previously, 11 cases were reported in the literature regarding the onset or exacerbation of SLE post hepatitis B vaccination (Schattner, 2005).In concordance, a latency period of less than one week and up to 2 years between vaccination and SLE onset was reported. The classical period between vaccination and autoimmunity was considered to be several weeks, similarly to the time frame suggested in the past for post-infectious autoimmunity phenomena. Interestingly, in this case series, 70% of patients continued their <http://www.discover ymedicine. com/category/ medical-specialt ies/preventive- medicine/ immunization/>immunization protocol although adverse events were documented. Similarly, in previously reported cases, the affected subjects continued to be vaccinated and aggravation of their condition by additional doses had been documented (Agmon-Levin et al., 2009). Overall, SLE patients presented post hepatitis B vaccination with mild to moderate disease and without life threatening organ involvement.A summary of the serious autoimmune adverse events following vaccination with hepatitis B vaccination reported to the vaccine adverse events reporting system (VAERS) include in descending order by odds ratio: RA (OR-18), optic neuritis (OR-14), SLE (OR-9.1), alopecia (OR-7.2), MS (OR-5.2), and vasculitis (OR-2.6). Many of the adverse events associated with hepatitis B

vaccination were extra-hepatic and are manifestations of infection with HBV. In addition to the potential epitopes in the <http://www.discover ymedicine. com/tag/hbsag/>HBsAg (HBV surface antigen) vaccine, adjuvants containing aluminum and mercury may provide potential antigenic stimulation (Geier et al., 2005).Routine <http://www.discover ymedicine. com/category/ medical-specialt ies/infectious- diseases/ influenza/>influenza vaccination of SLE patients seems indicated although the activation of an autoimmune response is feasible. Of 10 studies on 265 SLE patients that received <http://www.discover ymedicine. com/category/ medical-specialt ies/preventive- medicine/ immunization/ influenza- vaccine/>influenza vaccine (with a follow-up period of 4-24 weeks) only 6 were reported to develop a flare, of those two patients had renal involvement (Conti et al., 2008; Del Porto et al., 2008; Holvast et al., 2007; Abu-Shakra et al., 2007). It is not clear that the composition of the modern vaccines is identical to those of over 30 years ago where most of the studies were performed.In SLE, the immune response to influenza vaccination led to a blunted humoral response (Holvast et al., 2007). Generally, in the lupus patient in remission, flares are infrequent and influenza vaccine can be administered without harm. Why a few lupus

patients had a flare following influenza immunization as evaluated utilizing the systemic lupus erythematosus disease activity index (SLEDAI) score is yet to be established (Abu-Shakra et al., 2007).In a small observational study on 24 lupus patients, the 23 serotype pneumococcal vaccine did not confer disease activity (Elkayam et al., 2005).Multiple sclerosisNeurological manifestations are common following vaccinations (Huynh et al., 2008). In a case-control epidemiological study for serious adverse events reported in the hepatitis B vaccination exposed group compared to those that received tetanus vaccine, MS was prominent with an odds ratio of 5.2 (P<0.0003). Optic neuritis was also very commonly encountered (OR-14, p< 0.0002) (Geier et al., 2005).Guillain-Barré syndromeIn GBS, activated macrophages invade intact myelin sheaths resulting in myelin

damage and demyelination (Vucic et al., 2009).Vaccines reported as associated with GBS are diverse (Schonberger et al., 1979; Hemachudha et al., 1988; Khamaisi et al., 2004; CDC, 2006; Slade et al., 2009; Haber et al., 2009). The evidence of casual relationship with GBS is strongest with the swine <http://www.discover ymedicine. com/tag/flu/>flu (<http://www.discover ymedicine. com/category/ species-and- cell-types/ virus/influenza- a/h1n1/>H1N1) vaccine that was used in 1976-7. An increased relative risk [relative risk (RR)-4-8] to develop GBS 6-8 weeks after the injection was encountered in the vaccinated group compared to the non vaccinated group. The risk for GBS was

slightly less than 1 excess case of GBS per 100,000 vaccinated individuals, and hence the vaccine program was suspended (Schonberger et al., 1979). Further studies substantiated the association between the H1N1 vaccine and an increased relative risk (RR-7/1) for GBS 6 weeks after the vaccine (Safranek et al., 1991). The pathophysiology is unclear but may be related to vaccine induced anti-ganglioside antibodies (GM1) (Nachamkin et al., 2008).Studies of influenza vaccines in the following years were not associated with a substantial increase in the rate of GBS (Lasky et al., 1998). Immunizing patients with a history of GBS requires caution.An increased risk for GBS was found in Semple and SMB rabies vaccines. The vaccine most probably included brain protein that could cause cross reactive antibodies to the neural tissue and were discontinued. The current rabies vaccines are

derived from chick embryo cells and are not associated with an increased rate of GBS (Hemachudha et al., 1988).The vaccine against Neisseria meningitides is for use among individuals aged 11-55 years old. The VAERS published a warning of a possible association between the Meningococcal Polisaccharide Diphteria Toxoid Conjugated Vaccine (MCV4) and GBS, because of 5 cases of GBS following the MCV4 vaccine, and later 12 additional cases were reported (CDC, 2005). Based on reports, statistical analysis did not show any significant increase in the rate of GBS occurring 6 weeks after the MCV4 vaccine compared to non-vaccinated population. However, it is recommended that individuals with a history of GBS should not be vaccinated with MCV4 unless they are in a high risk for meningococcal infection. In a mass meningococcal C conjugate vaccine (CMCV not MCV4) campaign in Quebec,

Canada in 2001, 2 cases of GBS 8 weeks after the vaccine were identified among 1.5 million administered vaccinations, a rate expected in the healthy normal population (De Wals et al., 2008).The FDA licensed the quadrivalent human papilloamavirus recombinant vaccine (qHPV) in the United States in June 2006 for use in females 9-26 years old. In a review of the adverse effects reported over two years to the VAERS (Slade et al., 2009), 12 of 42 cases reported as GBS were confirmed, 11 of them in the age 13-30 years old. Only eight of the confirmed cases were in the range of 4-42 days post vaccination. The relative risk in 9-26 year old females vaccinated with qHPV vaccine for GBS was low (Callreus et al., 2009).Vaccine induced myopathiesThe reports on vaccine induced inflammatory myopathies are sporadic and include cases of following immunization with HBV, bacillus

Calmette-Guérin, tetanus, influenza, <http://www.discover ymedicine. com/category/ medical-specialt ies/infectious- diseases/ smallpox/>smallpox, polio, diphtheria, or combinations with diphtheria (Orbach et al., 2009). There is no statistically significant increase in the incidence of polymyositis or dermatomyositis after any mass vaccination. Among 289 patients with inflammatory myopathies followed in the Mayo Clinic, no recent immunization was recorded (Winkelman, 1968; Winkelmann, 1982).Macrophagic myofasciitisMacrophagic myofasciitis is a reaction to intramuscular injections of vaccines containing aluminum hydroxide as an adjuvant and affects mainly adults. The symptoms are usually myalgia, arthralgia, asthenia and, less frequently, muscle

weakness and fever, in the presence of elevated creatine kinase and erythrocyte sedimentation rates. The electromyogram has a unique pathologic pattern characterized mainly by focal infiltration of the epimysium, perimysium, and perifascicular endomysium by sheets of large, non-epithelioid macrophages, which show fine granular staining for periodic acid-Schiff (PAS) stain that appear as small, osmiophilic, spiky structures on <http://www.discover ymedicine. com/category/ research- technology/ microscopy/ electron- microscopy/>electron microscopy, representing the aluminum hydroxide crystals (Gherardi et al., 2001). Immunizations containing aluminum may trigger Macrophagic myofasciitis in the context of an <http://www.discover ymedicine. com/tag/hla/>HLA-DRB1*01 genetic background (Guis et al., 2002). Frequently, patients improve with steroid therapy.VasculitisNumerous case reports reported a possible association between polyarteritis nodosa (PAN) and hepatitis B vaccination. Overall, 25 cases of PAN were submitted to VAERS over an 11 year period until 2001. Among them, only 10 individuals were diagnosed as definite or possible PAN and are discussed here. The median age of patients was 45 years old and 5 patients were hospitalized. A modal peak of 2 weeks and median of 2.8 weeks post-vaccination was noted. All cases received at least 2 doses of vaccine prior to symptom onset. Hepatitis B surface antigenemia frequently follows hepatitis B vaccination and is detected many days after the 20

microgram vaccine. This could explain related immune-complex disease. Recently, there were less than 20 reports on the development of vasculitis following influenza vaccination. Small, medium, and large vessels were involved (Begier et al., 2004). All in all, this would be considered a rare event.Rheumatoid arthritisA total of 48 out of 898 (5.3%) of patients with early inflammatory polyarthritis reported an immunization in the 5 weeks prior to symptom onset. There were no important clinical or demographic differences between the 48 immunized patients and 185 consecutive patients who did not report prior immunization. The frequencies of HLA DRB1 *01 and *04 and the shared epitope in 33 of the immunized patients were no different in the non- immunized patients compared to healthy controls. Possibly, in a small number of susceptible individuals, immunization may act as a

trigger for RA (Harrison et al., 1997).Seropositive <http://www.discover ymedicine. com/tag/hla- dr4/>HLA-DR4-positive RA is reported in a few case reports after hepatitis B vaccination. In a series of 11 patients who developed RA after hepatitis B vaccination, all individuals were healthy prior to vaccination and they developed persistent polyarthritis fulfilling the present American College of <http://www.discover ymedicine. com/category/ medical-specialt ies/rheumatology />Rheumatology criteria for RA (Pope et al., 1998). Five subjects expressed HLA-DR4, and HLA class II genes with the RA shared motif were identified in nine of 11 patients. In a case-control epidemiological

study, adults receiving hepatitis B vaccination had an odds ratio of 18 to develop RA (P<0.0001) (Geier et al., 2005), However, the available data suggests a benefit of the vaccine that outweighs the risk (Sibilia et al., 2002).RA patients have almost a doubled risk level of developing an infection in comparison with age- and sex-matched subjects. In two randomized studies on RA patients, a good safety profile for the influenza vaccine without an increased rate of exacerbation was shown (Conti et al., 2008). Ninety nine <http://www.discover ymedicine. com/tag/adalimum ab/>adalimumab treated patients had a less significant immune response than 99 placebo treated RA, but the difference was not statistically relevant (Kaine et al., 2007). Infliximab and etanercept did not influence the

immunogenicity of influenza vaccine (Kubota et al., 2007). The effect of <http://www.discover ymedicine. com/category/ medical-specialt ies/oncology/ lymphoma/ non-hodgkins- lymphoma/ rituximab- non-hodgkins- lymphoma- lymphoma- oncology- medical-specialt ies/>rituximab on the efficacy and immunogenicity of influenza vaccine was studied in 14 RA patients. During the 4-week follow-up after vaccination, there was no difference in disease activity in both groups of patients. In the <http://www.discover ymedicine. com/tag/rituxima b/>rituximab treated patients, the percentage of responders was low for all

three antigens tested, achieving statistical significance for the California antigen (Oren et al., 2008).The safety profile of pneumococcal vaccine was good without exacerbations of RA (Elkayam et al., 2002). In 5 studies on the immunogenicity of the pneumococcal vaccine in RA patients, elevated titers of antibodies occurred but the response was partial. In 11 RA patients treated with <http://www.discover ymedicine. com/tag/tnf/>TNF- blockers, the titer of the antibodies increased to a lower level compared to other disease modifying anti-rheumatic drugs (<http://www.discover ymedicine. com/tag/dmards/>DMARDs) treated RA patients. In another study, <http://www.discover ymedicine. com/category/ medical-specialt ies/rheumatology /rheumatoid- arthritis/ methotrexate/>methotrexate treated patients had an inferior increase in antibodies to the 23F and B6 serotypes when compared to patients treated by TNF- blockers and healthy controls. In the Aspire trial, 70 RA patients with early disease were immunized by pneumococcal vaccine 34 weeks after initiating therapy. The percentage of patients with antibody response was similar in the three groups (infliximab at 2 different doses with methotrexate or methotrexate alone) (20-25% response). All treatment groups had a lower response to vaccine than would be expected in the normal population. Interestingly, the addition of infliximab to methotrexate therapy

did not impair the immune response (Visvanathan et al., 2007).Hepatitis B vaccination was safe in 22 RA patients compared to controls without any evidence of exacerbation of the disease and was effective in 68% of patients (Elkayam et al., 2002).<http://www.discover ymedicine. com/tag/hpv- vaccine/>HPV vaccine and autoimmune manifestationsThe recently released vaccine for <http://www.discover ymedicine. com/category/ species-and- cell-types/ virus/human- papillomavirus/>human papillomavirus (<http://www.discover ymedicine. com/tag/hpv/>HPV) offers an opportunity to assess

the development of autoimmune phenomena in a high risk population of young women. Hence, we chose to investigate and report separately on this vaccine.Recently developed vaccines against human papillomavirus (HPV) and <http://www.discover ymedicine. com/category/ species-and- cell-types/ virus/hepatitis- b-virus/>hepatitis B virus (HBV) contain a novel Adjuvant System, AS04, which is composed of 3-O-desacyl- 4 monophosphoryl lipid A andd aluminum salts. All randomized, controlled trials of <http://www.discover ymedicine. com/tag/hpv- 16/>HPV-16/18, <http://www.discover ymedicine. com/category/ species-and- cell-types/ virus/herpes- simplex-virus/>herpes simplex virus (<http://www.discover ymedicine. com/tag/hsv/>HSV), and HBV vaccines were analyzed in an integrated analysis of individual data (N = 68,512). A separate analysis of the HPV-16/18 vaccine trials alone was also undertaken (N = 39,160). The reported rates of overall autoimmune events were around 0.5% and did not differ between the AS04 and control groups. The relative risk (AS04/control) of experiencing any autoimmune event was 0.98 (95% confidence intervals 0.80, 1.21) in the integrated analysis and 0.92 (0.70, 1.22) in the HPV-16/18 vaccine analysis. This integrated analysis of over 68,000 participants who received AS04 adjuvant vaccines or controls demonstrated a

low rate of autoimmune disorders, without evidence of an increase in relative risk associated with AS04 adjuvanted vaccines (Verstraeten et al., 2008).In the Danish Civil Registration system, among approximately half a million adolescent girls, 414 autoimmune disorders were listed. The 5 most common autoimmune diseases occurring within 6 weeks of vaccination among 100,000 girls were: type I diabetes, juvenile arthritis, Crohn’s disease, Henoch-Schonlein disease, and <http://www.discover ymedicine. com/category/ medical-specialt ies/gastroentero logy/ulcerative- colitis/>ulcerative colitis (Sutton et al., 2009). However, over a 10 year period, the common autoimmune diseases, from the most to the least common, were: type I diabetes, juvenile

arthritis, Crohn’s disease, ulcerative colitis, Basedow’s disease, Henoch-Schonlein purpura, <http://www.discover ymedicine. com/category/ medical-specialt ies/rheumatology /psoriasis/>psoriasis, and SLE (Verstraeten et al., 2008).Adverse events of potential autoimmune etiology for HPV 16/18, HBV, and genital HSV vaccine trials (n = 42) were evaluated in an integrated analysis of 68,512 individuals. Common to these 3 vaccines is their adjuvant, ASO4. A separate analysis of HPV 16/18 vaccine trials was performed in an integrated analysis of 39,160 individuals. The analysis included all completed or ongoing controlled randomized studies of the 3 vaccines conducted by GlaxoSmithKline Biologicals or collaborators. No independent sources on this subject

were retrieved in a literature search. The control group received vaccines that were ASO4 free, non-adjuvanted, or adjuvanted with aluminum or aluminum hydroxide. To be included in the analysis, each individual received at least one dose of vaccine. The mean follow-up period was 1.8 years. These studies were not specifically set up to evaluate the development of autoimmune phenomena. A total of 362 participants reported at least one autoimmune event with an event rate of 0.52% in the vaccinated group which did not differ from the control group (0.54%). Hypothyroidism was the most common individual event, followed by unclassified musculoskeletal and neuroinflammatory disorders.The overall relative risk for developing an <http://www.discover ymedicine.

com/category/ medical-specialt ies/rheumatology /autoimmune- disease/>autoimmune disease was 0.98, hence no direct statistically significant difference between the groups was encountered. However, when looking at each disease individually, the highest relative risk for an individual event was idiopathic thrombocytopenic purpura (RR-3.74), followed by SLE (RR-3.00). For organ specific disease, thyroid involvement was most commonly detected. For analysis of the entire database which included data for HBV and HSV vaccine as well, the highest relative risk for an individual event was for SLE (RR-2.39) (Verstraeten et al., 2008).Discussion[see the rest on site]=====In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational

purposes.