A Closer Look at ASIA

The term "adjuvant," derived from the Latin word for "to aid," refers to substances used in vaccines to enhance immune responses. Common examples include alum, squalene, and mineral oil, which are also found in products like silicone implants and cosmetic fillers.

The mechanisms behind ASIA are intricate and differ among individuals, but one clear factor is that some people's immune systems may react more vigorously to stimuli, resulting in erratic immune responses. Those predisposed to autoimmune disorders may find that the adjuvants in vaccines act as a catalyst for symptoms.

ASIA has been documented after various types of vaccinations, including the flu shot, as noted in a 2013 review by Prof. Shoenfeld. While reports of autoimmune reactions post-vaccination account for a mere fraction (under 0.01%) of total vaccinations, this figure may be skewed due to underreporting. Many reactions tend to be mild and self-resolving. Symptoms associated with ASIA can include muscle weakness, chronic fatigue, sleep disturbances, and cognitive difficulties.

Individuals diagnosed with ASIA often have auto-antibodies in their bloodstream—these are antibodies that, rather than fighting off pathogens, mistakenly attack the body’s own cells due to reasons like molecular mimicry or faulty antibody production.

Identifying Those at Risk for ASIA

In a 2015 literature review, Prof. Shoenfeld and colleagues examined various sources to identify risk factors associated with ASIA. Their findings included:

• A history of autoimmune reactions following vaccinations.
• A history of allergies.
• Pre-existing autoimmune conditions or disorders.
• Factors that increase the risk of autoimmunity, including a family history of such diseases, presence of auto-antibodies, smoking, and hormonal imbalances.

Due to the rarity of ASIA, quantifying these risks remains challenging, particularly in the absence of studies with robust control groups. The review emphasized that the benefits of vaccinations generally outweigh the risks.

In a subsequent 2017 study utilizing an international ASIA registry, data from both published and unpublished cases revealed that:

• 86.7% of ASIA patients were female.
• The average age of diagnosis was 37.6 years, with a range from 4 to 82.
• 20.3% had a personal or familial history of autoimmune diseases.
• 76.6% of cases had received vaccinations within the last decade, primarily for hepatitis B, HPV, and influenza.

These results suggest that gender, personal or family history of autoimmune diseases, and exposure to the hepatitis B vaccine are significant factors in ASIA susceptibility.

However, the study had limitations, including potential underreporting, as only licensed rheumatologists can submit data to the registry. This could introduce bias, affecting the generalizability of the findings.

Dr. Shoenfeld reiterated the importance of vaccines as vital tools for public health, stating that the benefits far outweigh the rare adverse effects associated with them. He advocated for the creation of safer, more personalized vaccine options.

Should Covid-19 Long-Haulers Get Vaccinated?

Covid-19 long-haulers experience symptoms such as fatigue and cognitive impairments for an extended period, which may arise from unresolved inflammation or auto-antibodies. Given this context, SARS-CoV-2 is often referred to as an "autoimmune virus." A recent study indicates that 13.1% of individuals with mild-to-moderate Covid-19 experienced thyroid damage, potentially resulting in thyroid-related autoimmune diseases.

Concerns have been raised about mRNA-based vaccines, as they may provoke strong type I interferon responses linked with inflammation and possibly autoimmunity. Consequently, Covid long-haulers may be classified as individuals at risk for ASIA, prompting questions about whether vaccination could exacerbate or trigger long-Covid symptoms.

While there is a theoretical risk of ASIA post-vaccination, the dangers of not vaccinating must also be weighed. Infections themselves can induce autoimmune conditions, and the risks associated with post-infection autoimmunity are significantly higher. A review in The Lancet supports this perspective.

The European League Against Rheumatism (EULAR) recommends that individuals with autoimmune conditions receive vaccinations, albeit tailored to their specific health needs, to mitigate the complications that infections can cause. For instance, live vaccines should be avoided, and vaccinations should only occur when the autoimmune condition is stable. The CDC also provides guidance for those with a history of autoimmune diseases, advising consultation with healthcare professionals for personalized vaccination strategies.

Even with the highly effective Pfizer mRNA vaccine, the potential for ASIA should not be overlooked. A 2018 article in Nature Reviews Drug Discovery highlighted concerns regarding the type I interferon responses from some mRNA vaccines. Identifying individuals at risk for autoimmune reactions prior to vaccination could help establish necessary precautions.

A Brief Overview

The term Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA) emerged less than ten years ago and is associated with vaccines that include adjuvants, as well as some cosmetic products. ASIA typically impacts those with autoimmune conditions or a familial or personal history of such diseases. Given that long-Covid can be classified as an autoimmune condition, it is essential for Covid long-haulers to exercise caution and seek medical advice before proceeding with vaccination.

For further information on this topic, see here:

Post-Covid-Vaccine Long Haulers: An Emerging Concept

Some individuals develop chronic symptoms like long-Covid after receiving the Covid-19 vaccine, although this occurrence is extremely rare.