ArticleVaccines2021
Immune-Mediated Disease Flares or New-Onset Disease in 27 Subjects Following mRNA/DNA SARS-CoV-2 Vaccination.
Article in Vaccines, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 230 papers, 12 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
230 citing papers in PubMed, 12 syntheses or guidelines pooled it, 369 citations in OpenAlex.
- The immunopathological spectrum of COVID-19: from cytokine storm to autoimmunity-a systematic review.Frontiers in medicine · 2026Pooled it
- Unraveling Cardiovascular Risks and Benefits of COVID-19 Vaccines: A Systematic Review.Cardiovascular toxicology · 2025Pooled it
- Rare COVID-19 vaccine side effects got lost in the shuffle. Primary cutaneous lymphomas following COVID-19 vaccination: a systematic review.Frontiers in medicine · 2024Pooled it
- Neuromuscular diseases associated with COVID-19 vaccines: a systematic review and pooled analysis of 258 patients.BMC neurology · 2023Pooled it
- Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) following COVID-19 vaccines: A systematic review.Revue neurologique · 2023Pooled it
- New-onset inflammatory arthritis after COVID-19 vaccination: A systematic review.International journal of rheumatic diseases · 2023Pooled it
- A systematic and thematic analysis of the top 100 cited articles on mRNA vaccine indexed in Scopus database.Human vaccines & immunotherapeutics · 2022Pooled it
- A systematic review on mucocutaneous presentations after COVID-19 vaccination and expert recommendations about vaccination of important immune-mediated dermatologic disorders.Dermatologic therapy · 2022Pooled it
- COVID-19 Vasculitis and vasculopathy-Distinct immunopathology emerging from the close juxtaposition of Type II Pneumocytes and Pulmonary Endothelial Cells.Seminars in immunopathology · 2022Pooled it
- Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force.Advances in rheumatology (London, England) · 2022Guideline
- A systematic review of cases of CNS demyelination following COVID-19 vaccination.Journal of neuroimmunology · 2022Pooled it
- Response to SARS-CoV-2 vaccination in immune mediated inflammatory diseases: Systematic review and meta-analysis.Autoimmunity reviews · 2022Pooled it
- COVID-19 mRNA vaccination and immune-related adverse events in patients with cancer receiving immune checkpoint inhibitors: a target trial emulation study.Journal for immunotherapy of cancer · 2026Article
- Dermatomyositis with Anti-MDA5 Autoantibodies After SARS-CoV-2 mRNA Vaccination Treated with Tofacitinib: Integrating Literature Evidence and a Novel Observation.Antibodies (Basel, Switzerland) · 2026Review
- Risk of developing thyroid eye disease in patients with thyroid dysfunction that received a COVID-19 vaccination.Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026Article
- The Association of Polymyalgia Rheumatica and Giant Cell Arteritis With COVID-19 Vaccination: A Systematic Review.Clinical medicine insights. Arthritis and musculoskeletal disorders · 2026Review
- C1 Esterase Inhibitor Deficiency in an Indian Female: A Rare Case Report and a Review of Literature with Treatment Update.Current drug targets · 2026Review
- Review
- Proteomic Profiling of Human Peripheral Blood Cell Targets of IgG Induced by SARS-CoV-2: Insights into Vaccine Safety.Vaccines · 2025Article
- Perspectives on the Parathyroid-Thymus Interconnection-A Literature Review.International journal of molecular sciences · 2025Review
170 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors at 9 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfectious diseases and vaccines can occasionally cause new-onset or flare of immune-mediated diseases (IMDs). The adjuvanticity of the available SARS-CoV-2 vaccines is based on either TLR-7/8 or TLR-9 agonism, which is distinct from previous vaccines and is a common pathogenic mechanism in IMDs.
methodsWe evaluated IMD flares or new disease onset within 28-days of SARS-CoV-2 vaccination at five large tertiary centres in countries with early vaccination adoption, three in Israel, one in UK, and one in USA. We assessed the pattern of disease expression in terms of autoimmune, autoinflammatory, or mixed disease phenotype and organ system affected. We also evaluated outcomes.
findings27 cases included 17 flares and 10 new onset IMDs. 23/27 received the BNT - 162b2 vaccine, 2/27 the mRNA-1273 and 2/27 the ChAdOx1 vaccines. The mean age was 54.4 ± 19.2 years and 55% of cases were female. Among the 27 cases, 21 (78%) had at least one underlying autoimmune/rheumatic disease prior the vaccination. Among those patients with a flare or activation, four episodes occurred after receiving the second-dose and in one patient they occurred both after the first and the second-dose. In those patients with a new onset disease, two occurred after the second-dose and in one patient occurred both after the first (new onset) and second-dose (flare). For either dose, IMDs occurred on average 4 days later. Of the cases, 20/27 (75%) were mild to moderate in severity. Over 80% of cases had excellent resolution of inflammatory features, mostly with the use of corticosteroid therapy. Other immune-mediated conditions included idiopathic pericarditis (
interpretationDespite the high population exposure in the regions served by these centers, IMDs flares or onset temporally-associated with SARS-CoV-2 vaccination appear rare. Most are moderate in severity and responsive to therapy although some severe flares occurred.
fundingnone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.