HealthDay News – Pneumococcal vaccines can trigger a severe local and systemic inflammatory reaction in patients with cryopyrin-associated periodic syndromes (CAPS), according to a study published in the February issue of Arthritis & Rheumatology.

Ulrich A. Walker, MD, from the Unispital Basel in Switzerland, and colleagues retrospectively collected clinical information from seven consecutive patients with CAPS undergoing pneumococcal vaccination.1 The patients were vaccinated with pneumococcal polysaccharide or conjugate vaccines.

The researchers found that all seven patients developed severe local reactions at the injection site within a few hours after the vaccination. Two of the patients were hospitalized for systemic reactions that included fever. In a period of three to 17 days, all symptoms resolved.

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“Our findings indicate that pneumococcal vaccines can trigger a severe local and systemic inflammatory reaction in patients with CAPS and possibly patients with other autoinflammatory diseases,” the authors write. “Careful consideration is warranted when implementing current European League Against Rheumatism immunization guidelines in this patient population.”

Several authors disclosed financial ties to Novartis and Sobi.

Summary and Clinical Applicability

The pneumococcal vaccine has been shown to be safely administered to patients with autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).2  This research article describes a severe adverse reaction to pneumococcal vaccination in CAPS patients, suggesting that CAPS patients may be at a greater risk of more frequent and severe adverse reactions to that particular vaccination. Physicians should be aware of this in weighing the risk of adverse vaccine reaction against the risk of pneumococcal infection.


1. Walker UA, Hoffman HM, Williams R, et al. Brief Report: Sever Inflammation Following Vaccination Against Streptococcus pneumoniae in Patients with Cryoprin-Associated Periodic Syndromes. Arthritis Rheumatol. 2016 Feb;68(2):516-20. doi: 10.1002/art.39482.

2. Van Assen S, Agmon-Levin N, Elkayam O,  et al. EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 2011;70:414–22.

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This article originally appeared on Clinical Advisor