Background Vaccinations have long been considered to be possible triggering agents for chronic arthritis, but no sufficiently definitive epidemiological study has been published on this issue. There are case reports of chronic arthropathy presumably induced by rubella, meales and mumps vaccination (MMR), but controlled studies have failed to establish this association
Objectives The aim of the present prospective cohort study was to investigate the association of MMR vaccination and the onset of acute or chronic articular symptom in healthy subjects
Methods In Brazil, two prospective cohorts studies taken place during two National immunization campaign: first in 2008 against rubella to reach subjects aged 20-40 years and another in 2011 against measles to reach children aged 1-7 years. In both the vaccine used was MMR. In our city the target was the coverage of 9,000 people to be vaccinated in these age groups, including both males and females. Among those, near 2,000 subjects were randomly selected. Follow-up telephone calls were conducted 2 weeks post vaccination and subsequently monthly after the vaccination over a 6 month period, in order to inquire about occurrence and duration of articular symptoms. In cases where the subjects circumstances were unclear a medical visit was scheduled. Subjects with a preexisting autoimmune disease were excluded from the study
Results Of the 2,000 selected vaccinated subjects, 972 adults and 827 children have completed the follow up period of 6 months. The vaccine was the first dose for 543 subjects (55%) in the adult group and for 672 children (81%). At the time of the first phone call 17/972 (1.7%) adults subjects and 14/827 (1,7%) childhood age group reported acute articular symptoms: twelve reported arthralgia and five arthritis with all of them being fleeting, lasting no longer than 7 days; eleven were female and six male (p=0.5); twelve had received their first dose of RV and the remaining five following a booster (p=1,0). For the childhood group the rate of acute articular symptoms in the first evaluation was the same 1,7% (14/827), among of them 4 had arthritis and only in two lasting one month; in 13/14 had received their first dose of RV and in only one was a booster (p=0,71). None in the both groups had a chronic outcome.
Conclusions In our study, which comprised a large number of healthy subjects in different age groups, rubella vaccination was safe and was not associated with the development of chronic arthritis. These findings should be spread among public healthcare providers in order to encourage vaccinations in accordance with recommended national vaccination schedules.
Disclosure of Interest None Declared