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Do Vaccinations Increase Risk of Gout Flares?


August 20, 2019

According to recent study findings published online in Annals of the Rheumatic Diseases, the recombinant zoster vaccine, as well as others, are associated with an increased risk of gout flares.  

“The recombinant zoster vaccine containing a strong non-aluminium adjuvant is associated with increased risk of gout flares, presumably via NLRP3 inflammasome activation,” wrote lead study author Chio Yokose, MD, Massachusetts General Hospital, and colleagues. “We tested the possibility that other vaccines may also be associated with gout flares. 

To better understand the association between vaccinations and gout flares, Dr Yokose and colleagues conducted an online case-crossover study of patients with gout. The study authors collected information on potential risk factors, including vaccinations during 2-day hazard periods prior to gout flare and 2-day control periods without a flare.

In total, the research team observed 517 participants with gout who experienced gout flares during the follow-up period. The mean age of the participants was 55 years and 79% were male. There were 28 vaccinations during 990 hazard periods and 21 vaccinations during 1407 control periods.

According to the findings, the researchers said that vaccinations was associated with higher odds of gout flare by twofold (adjusted OR 1.99; 95% CI 1.01 to 3.89). 

“Our findings suggest vaccines other than RZV are associated with increased odds of gout flares, potentially through a shared pathogenetic mechanism like NLRP3 inflammasome,” the researchers concluded. “However, the absolute magnitude of increased odds of gout flares with vaccinations remains small and must be interpreted within the context of the overwhelming benefits of vaccinations. 

Julie Gould  

Reference:

Yokose CMcCormick NChen C, et al. Risk of gout flares after vaccination: a prospective case cross-over study [published online ahead of print July 31, 2019]. Ann Rheum Dis. doi: 10.1136/annrheumdis-2019-215724

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