Do vaccines cause arthritis?

Arthritis is a condition characterized by swelling of the joints. It can be short-lived or chronic. A couple of vaccines have been discussed in relation to arthritis.

Lyme vaccine

Occasionally, magazine and newspaper stories have claimed that the Lyme vaccine, available in the United States between 1998 and 2002, was a cause of chronic arthritis (swelling of the joints).

Two excellent, well-controlled studies were performed evaluating the safety of Lyme vaccine. Lyme vaccines were compared with placebo in 10,936 and 10,305 subjects, respectively. Participants were followed for 20 to 24 months.

There were no significant differences in the type or frequency of joint symptoms in vaccine and placebo recipients in either study. Similarly, patients with a previous history of Lyme disease did not experience an increased frequency of joint symptoms compared with controls.

Therefore, the best evidence does not support the hypothesis that Lyme vaccine caused arthritis. Unfortunately, despite its excellent safety record, the Lyme vaccine is no longer available.

Rubella vaccine

The virus used to make the first rubella vaccine, introduced in 1969, was called the HPV-77 strain. It was made in duck embryo cells. This vaccine could cause short-lived arthritis. The risk of developing arthritis increased with age of vaccination. In fact, while girls younger than 13 years old did not experience joint swelling, about half of women older than 25 years had swelling of the joints following vaccination.

Because of this side effect, a different strain, called RA27/3, replaced HPV-77 as the rubella vaccine strain in the United States in 1979. The RA27/3 strain worked just as well to protect against rubella, but caused fewer side effects. While the RA27/3 strain can also cause temporary swelling of the joints, the frequency was much lower. This strain continues to be used in the rubella vaccine that is part of MMR. It is grown in human embryo fibroblast cells.

The joints most commonly affected by rubella vaccine are those of the fingers and knees, although other joints can be involved as well.

Watch a video about the creation of the RA27/3 strain rubella vaccine.

References

Lathrop SL, Ball R, Haber P, et al. Adverse event reports following vaccination for Lyme disease: December 1998-July 2000. Vaccine. 2002 Feb 22;20(11-12):1603-8.

Sigal LH, Zahradnik JM, Lavin P, et al. A vaccine consisting of recombinant Borrelia burgdorferi outer surface protein A to prevent Lyme disease. N Engl J Med 1998;339:216-222.

Steere AC, Sikand VK, Meurice F, et al. Vaccination against Lyme disease with recombinant Borrelia burgdorferi outer-surface lipoprotein A with adjuvant. N Engl J Med 1998;339:209-215.

Plotkin SA, Orenstein W, Offit PA, and Edwards KM. Lyme Disease Vaccines in Vaccines, 7th Edition. 2018, 546-566.

Plotkin SA, Orenstein W, Offit PA, and Edwards KM. Rubella vaccine in Vaccines, 7th Edition, 2018, 970-1000.