✹ Man Develops Autoimmune Hemolytic Anemia After Getting Flu Vaccine, Case Study Reports DECEMBER 3, 2019
The case highlights the importance of educating patients to report any unusual symptoms after vaccination.
The study, “Autoimmune Hemolytic Anemia in a Renal Transplant Patient Following Seasonal Influenza Vaccination,” was published in the journal Case Reports in Hematology.
Autoimmune hemolytic anemia, or AIHA, occurs when the immune system mistakenly attacks the body’s own red blood cells, causing a reduction in the number of these cells and leading to hemolytic anemia.
Symptoms may include weakness, fatigue, and jaundice. Cold agglutinin disease (CAD) is one of the most common forms of AIHA, marked by the formation of autoantibodies against red blood cells formed upon exposure to cold temperatures.
AIHA can have an unknown origin or result from an underlying disease or medication. Vaccines have been associated with triggering this condition.
This report described the case of a man, age 58, who received a seasonal flu vaccine (quadrivalent inactivated influenza vaccine IIV4) as part of routine care.
That may have been considered a “rare” occurrence but researching Autoimmune Hemolytic Anemia brought the following case studies up, also as a result of vaccination. It’s important people are aware of this as it is a serious consequence, not always medically investigated, and can be fatal.
Case in point:
MILLMAN, Special Master On January 28, 1999, petitioner filed a petition on behalf of her daughter, Lauren Brown (hereinafter, “Lauren”),for compensation under the National Childhood Vaccine Injury Act of 19861 (hereinafter the "Vaccine Act" or the "Act"). ...Petitioner alleges that Lauren’s vaccinations were a substantial factor in Lauren’s contraction of hemolytic anemia, causing her death. Respondent denies causation. The court held a hearing in this case on May 10, 2000. Testifying for petitioner was Dr. Ralph Shapiro. Testifying for respondent was Dr. Gregory H. Reaman. Both are specialists in pediatrics, oncology, and hematology….
...The court agrees with Dr. Shapiro that the significance of petitioner’s exhibit 6 is that DPT can cause the hemolytic process in vaccinees resulting in anemia. The Federal Circuit in Knudsen states that requiring “identification and proof of specific biological mechanisms would be inconsistent with the purpose and nature of the vaccine compensation program.” 35 F.3d at 549 (emphasis added). The court does not find Dr. Reaman’s explanation of Lauren’s condition persuasive. First, Dr. Reaman admits that fever post-DPT is quite common. For him to posit that Lauren’s 104-degree fever the evening of her five vaccinations(DPT, HiB, polio) was due to a viral illness, and not to the DPT, is not persuasive….The court is most impressed with the continuity of symptoms from the time of vaccinations until Lauren’s demise….There is also legal precedent to hold that vaccines cause hemolytic anemia…. She has provided a prima facie case of causation in fact that any or all of the vaccinations Lauren received January 30, 1997 caused in fact her acute hemolytic anemia and death. The statute provides that she receive $250,000.00 in compensation
Though it was shown that Lauren’s DPT was responsible for her AIHA and her death, how many other cases have lost? How many more vaccines are also now responsible as well? How heartbreaking.
I dare bring this up for the possible horrible emails that I may get from those who deny vaccine injuries, but I don’t want any family to not know about this possibility. It should not be happening and we need to make sure that our loved ones are safe. The following are other case studies with a variety of vaccines:
The girl experienced two attacks of hemolysis. The first episode occurred 2 weeks after oral polio vaccination, and the second episode was observed 7 months later, when she received a simultaneous vaccination against mumps, rubella, and measles. The DAT was strongly positive with anti-C3d. No autoantibodies were detectable in either episode. The boy experienced acute hemolysis a few days after a simultaneous revaccination against diphtheria-pertussis-tetanus, Haemophilus influenzae, hepatitis B, and polio. The DAT using anti-IgG was strongly positive, and the DAT performed with anti-C3d was weakly positive.
Vaccination-induced AIHA resembles those forms of AIHA related to infectious diseases, and it may occur more frequently than has been reported.
✹ CLINICAL VIGNETTE: COMMON VACCINES, UNCOMMON PROBLEM: HEMOLYTIC ANEMIA FOLLOWING ROUTINE VACCINATION:
Discussion: This case of autoimmune hemolytic anemia (AIHA) illustrates an extremely uncommon complication of routine vaccination in a healthy child. Although cases of AIHA have been reported after DTP, oral polio, hepatitis B, measles, H. influenza, smallpox, and other vaccines, no reports could be found implicating the varicella or pneumoccocal vaccines. This child had the most common form of AIHA, which is characterized by warm IgG autoantibodies, usually formed in response to infections, autoimmune disorders, immunodeficiency syndromes, malignancies, or medications. Mortality from warm AIHA in the pediatric age group ranges from 9 to 29% and is usually due to severe anemia or hemorrhage from associated thrombocytopenia. Corticosteroid therapy is first-line treatment followed by immunosuppressive drugs and splenectomy in refractory cases. Other treatment options include IVIG, plasmapheresis, and immunomodulary agents. As the number of recommended childhood vaccines increase, pediatricians should be aware of the possibility of rare but important complications such as AIHA.
✹ Anti‐Pr antibody induced cold autoimmune hemolytic anemia following pneumococcal vaccination: This is the first reported case of cold antibody autoimmune hemolytic anemia due to anti‐Pr autoantibodies attributed to Pneumococcal vaccination in an adult patient. The patient presented 1 week after receiving the vaccination with low hemoglobin, jaundice, and dyspnea with no prior history of anemia. Extensive workup including ruling out infectious and malignant causes was unremarkable, and his treatment consisted of transfusions and a course of steroids. An autoantibody anti‐Pr was identified with persistence but decreased reactivity up to 3 months after his initial presentation. Most cases of this identified autoantibody are associated with infectious causes or vaccination associated in the pediatric population.
✹ Autoimmune Hemolytic Anemia Following Influenza Virus Infection or Administration of Influenza Vaccine : AIHA associated with influenza infection or vaccination may be fatal in patients with primary illness who are in poor condition at the time of diagnosis
✹ A Toddler With Rash, Encephalopathy, and Hemolytic Anemia: The VZV identified was confirmed to be Oka (vaccine) strain using 4 real-time Forster Resonance Energy Transfer PCR protocols targeting vaccine-associated single nucleotide polymorphisms (Centers for Disease Control and Prevention, Atlanta, GA). In addition, throat swabs obtained 2 months after vaccination were positive for vaccine-genotype mumps and rubella viruses by PCR.
✹ Three Cases of Autoimmune Hemolytic Anemia following Primary Varicella Infection and Vaccination: Possible Pathogenesis in the Context of Current Information: A 14-month-old female patient was administered a measles-mumps-rubella and varicella vaccine at the age of one. She suffered from a varicella infection one month after the vaccine was administered and recovered afterwards. She presented to another hospital due to a widespread rash on her body a month after the varicella infection. The IgA, IgM, IgG and IgE levels were normal but the CD3+ CD4+ lymphocyte value was low and CD3+ CD8+ lymphocyte value high in tests conducted with a suspicion of immunodeficiency when she was ten months old (Table 1). She was referred to our hospital for the investigation of anemia and thrombocytopenia etiology. We found out that her sister and brother had died with high fever when two months old.
✹ A Case of Evans' Syndrome Following Influenza Vaccine: Background
Evans' syndrome is an uncommon condition defined by the combination (either simultaneously or sequentially) of immune thrombocytopenia purpura and autoimmune hemolytic anemia with a positive direct antiglobulin test in the absence of known underlying etiology.
Objectives We present a case of Evans' syndrome following influenza vaccination.
✹ Autoimmune Hemolytic Anemia Following MF59-Adjuvanted Influenza Vaccine Administration: A Report of Two Cases: Influenza vaccination may rarely trigger severe AIHA, shortly after vaccine administration. A mechanism of molecular mimicry is probably involved in the development of these reactions, although the possible role of adjuvants can not be excluded. Patients should be instructed to report signs and symptoms of autoimmune disorders occurring in the first weeks after administration of influenza vaccine
✹ AUTOIMMUNE HEMOLYTIC ANEMIA-THREE CASES REPORT. : Case 3. 10-month old child manifested severe AIHA, 3 days after immunization (diphtheria, poliomyelitis, pertussis and tetanus). ,,,,The result is intravascular destruction of the red cell. Two clinical entities exist - one with cold reacting and the other one with warm reacting antibodies.
✹ Acute autoimmune hemolytic anemia following DTP vaccination: report of a fatal case and review of the literature ….Infection, disorders of autoantibody production, immunodeficiencies and malignancy may stimulate the production of autoantibodies that can result in AIHA 1. We report a fatal case of AIHA temporally related to diphtheria-tetanus-pertussis (DTP) vaccination
It does not appear that “rare” gives an accurate portrayal of the number of vaccines that seem to cause Autoimmune Hemolytic Anemia nor the devastating effects on a life. I am interested in autoimmmune diseases as my daughter has one. Her severe symptoms began after the MMR vaccine in 1994, though other vaccines did cause more subtle reactions, often difficult to ascertain in an infant and toddler. Meg now also has a diagnosis of nonfamilial hypogammaglobulinemia, a condition in which her immune system is unable to mount a good fight against the bacterial, viral and parasitic bad guys in our world (see the MMR insert below). This cascade of events then unfortunately leads to another immune assault on her brain, called PANS . It is a devastating life with 24/7 care needed. Some questions to consider -- Why is it babies and children are not being tested for immune issues before vaccination? Can certain vaccines trigger autoimmune diseases? How can this topic of conversation lead to helping children and adults rather than the whole “anti-vaccination” witch hunt?
On the package insert for the MMR, you can read this as part of the CONTRAINDICATIONS:
...cellular immune deficiencies; and hypogammaglobulinemic and dysgammaglobulinemic states….
That’s important to know but it is not mentioned by medical staff when getting the vaccine. I never was told as a parent nor was Meg checked back then. Many children with autism, PANS/PANDAS or both, have immune issues. Parents need to be vigilant and vocal to the increasing risks for safety. As we watch states wanting to end religious/philosophical vaccine exemptions and make doctors intimidated to grant medical exemptions, these cases continue to grow. Politicians need to be aware and alerted. Being informed and wanting infants and children to be safe should not brand any doctor, parent, researcher or politician as “anti-vaccine.” God bless us, every one.
Teresa Conrick is Science Editor for Age of Autism.