Two pneumococcal vaccines are recommended for adults over 65 to prevent pneumonia: PCV13 (Prevnar13®) contains aluminum as an adjuvant, while PPSV23 (Pneumovax23®) does not.
Adjuvants like aluminum are added to vaccines to boost the body’s immune response, but they can potentially trigger severe immune reactions.
The link between vaccine adjuvants like aluminum and immune diseases was only recently discovered. The side effect is called “autoimmune/auto-inflammatory syndrome induced by adjuvants” (ASIA).
There is now evidence that PCV13 vaccines may cause a rare autoimmune disease known as serositis, according to the Journal of Medical Case Reports.
Serositis is an inflammation of tissues lining the lungs, heart, and abdomen. It mostly occurs in people with autoimmune diseases or chronic inflammation associated with lupus, rheumatoid arthritis, or inflammatory bowel disease (Crohn’s).
The report describes a 75 year-old woman who developed serositis within 18 days of receiving the PCV13 vaccine Prevnar13®. It appears to be the first case of serositis in a patient without an underlying autoimmune illness.
She developed a large injection-site skin reaction that persisted for weeks after vaccination. She also had trouble breathing, cough, fever, joint pain, muscle pain, and sleep disturbance for 10 days before she was hospitalized.
The inflammation caused fluid accumulation around her lungs that required placement of a chest tube to drain the fluid.
Given the severity of her illness, her serositis was treated with corticosteroids over the next 3 months while she was hospitalized. She has remained asymptomatic for 1.5 years since discharge. According to the researchers:
“To the best of our knowledge, no such reaction to [PCV13] has previously been documented. Although the benefits of vaccination outweigh the risks, knowledge of this potential side effect can help clinicians in diagnosis and treatment of similar patients.”
The researchers noted that the same NLPR3 inflammatory pathway that aluminum triggers in the body are also critically involved in the development of inflammatory diseases, suggesting a mechanism by which PCV13 might cause serositis.
However, the risk of autoimmune or inflammatory diseases as a result of pneumococcal vaccination is extremely low. PPSV23 was linked to only 14 case reports of rheumatic side effects from 1980 to 2013.