APS and vaccinations

A patient with APS recently emailed me with a question about vaccinations for her two small children.

Her concern was that her children may be genetically susceptible to having a reaction or could develop an autoimmune condition from their vaccinations. She like the rest of the general public has gotten conflicting information about vaccinations, not only for autoimmune diseases, but other illnesses like Autism as well. And she wanted to know where she could get information about the question of vaccinations and autoimmune diseases.

Here is what I wrote her:

There is a Nobel Prize available for the person who can answer your question(s). Current thinking is that lupus (and, by extension, APS) is triggered by a common virus in a susceptible person. The leading suspicious virus is cytomegalovirus (CMV), which causes a mononucleosis-like disease; Epstein-Barr virus (EBV), which causes mononucleosis, is another candidate.

There is an extensive medical literature on this topic. John Harley and Judith James, in Oklahoma, have published several papers indicating that the infection likely occurs a decade or more before the disease becomes obvious. You can hunt for these papers at the National Library of Medicine site (PubMed) and search on the terms “Harley J AND lupus” or “lupus AND CMV” or such to find the papers, or, given a day or two, I can compile a list for you.

None of us in my world think of vaccinations as likely virus triggers; on the other hand, if you have no concept of how devastating polio, tetanus, diphtheria, measles, etc. can be (lethal, brain-damaging, permanently disabling) you may underestimate the value of vaccination.

If you choose not to vaccinate your children, you rely on “herd immunity”, that is, the luck that others they encounter will be immune and protect them. Loss of herd immunity has resulted in epidemics as recently as this year of these common diseases in fundamentalist communities, Native American communities, and “hippie” colonies in the United States this year, so these diseases are by no means gone.

Bottom line: although your children may have inherited (a degree of) susceptibility from you, they are somewhat protected by their father’s genes; vaccinations are not the things to fear. Rather, common infections, some of which can be prevented by vaccination, are more likely triggers.

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