Vaccinations Show No Link to Risk for Rheumatoid Arthritis

TOPLINE:

A meta-analysis of 16 observational studies found no significant association between vaccination exposure and risk for rheumatoid arthritis (RA). Short-term follow-up data (< 1 year) suggested that vaccines may protect against RA. 

METHODOLOGY:

• Researchers assessed the association between vaccinations and RA incidence and relapse by conducting an updated systematic review and meta-analysis of 16 observational studies from across Europe, North America, and Asia and published between 2008 and 2024.
• Studies comprising the meta-analysis ranged in size from 202 to 9,258,803 participants and included 12 cohort studies and four case-control studies, with follow-up periods ranging from 0.03 to 9 years.
• Individuals with and without RA who received any vaccination, while those who did not receive vaccination served as the comparator group.
• The outcomes included effect estimates of the association between RA (incidence or relapse) and exposure to vaccines for human papilloma virus, influenza, COVID-19, anthrax, hepatitis B virus, tetanus, and herpes zoster.

TAKEAWAY:

• No significant association was noted between vaccination exposure and an increased risk for new-onset or relapsing RA.
• Subgroup analysis of follow-up duration showed that a follow-up of < 1 year demonstrated a significant protective effect of vaccination on RA (relative risk, 0.92; P = .005).
• Subgroup analysis by study type showed no association between vaccination and RA risk in the cohort and case-control studies.
• The level of evidence for risk for RA associated with any type of vaccine was noted to be very low according to the Grading of Recommendations Assessment, Development, and Evaluation recommendations.

IN PRACTICE:

“This updated meta-analysis suggests that there is no clear evidence supporting an association between vaccination and [risk for RA]. However, it is important to consider factors such as the type of vaccine, the population studied, and the duration of follow-up when interpreting these findings,” the authors wrote. 

SOURCE:

The study was led by Hejing Pan, School of Basic Medical Sciences of Zhejiang, Chinese Medical University, Hangzhou, China. It was published online on March 10, 2025, in BMC Public Health.

LIMITATIONS:

The meta-analysis showed significant heterogeneity possibly due to differences in study design, participant characteristics, and vaccine types. The limited focus on specific vaccines such as hepatitis B virus, anthrax, and shingles restricted subgroup analyses. Furthermore, the study mainly included participants from Europe, America, and Asia, highlighting a lack of studies focused on African populations.

DISCLOSURES:

This study was supported by the National Administration of Traditional Chinese Medicine and the Basic Public Welfare Research Program of Zhejiang Province. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.