Adult Onset Still’s Disease (AOSD) After Pfizer and Moderna COVID-19 mRNA Vaccination

Immune system injury caused by modified mRNA can be debilitating long term; 10 cases

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May 10, 2023 – Pasig, Philippines – 26 year old Fatima Villaflor had her COVID-19 mRNA booster shot in April 2022 and a week later she developed fever, chills, rash and muscle pain. She was diagnosed with AOSD (Adult Onset Still’s Disease) and continues to struggle 1 year later.

Sep. 2023 – Barrie, ON, Canada – Emily had COVID-19 vaccines and was diagnosed with AOSD. Also myocarditis and pericarditis. She is still struggling 2 years later.

May 12, 2023 – Fargo, ND – In April, 22 year old Noah Rooney presented with high grade fever, severe body aches, swollen muscles, and after extensive testing was diagnosed with AOSD. His liver started failing and he was diagnosed with HLH or MAS (Macrophage Activation Syndrome) and died suddenly on May 12, 2023.

Jan. 2023 – Phoenix, AZ – Shaley Lynn (Stone) was hospitalized for 8 weeks with pain, blackouts, etc, and was eventually diagnosed with AOSD and HLH (Hemophagocytic lymphohistiocytosis). She had a bone marrow transplant and still struggles 2 years later.

April 2022 – Canton, SD – 20 year old Logan Kuper developed AOSD 3 weeks after his COVID-19 mRNA Booster. He is doing well with Kineret (Anakinra).

Jan. 28, 2022 (VAERS 2082404) – 33 year old Brandon Pollet from Louisiana had 2nd dose of Pfizer mRNA in Aug. 2021, 3 days later developed fever, chills – was diagnosed with AOSD with 1st Hospital stay Oct. 21-Nov. 2, 2021, then in ICU from Dec. 12, 2021 – was eventually diagnosed with refractory HLH complicated by cytopenias, polymicrobial infections & multi-organ failure, and died Jan. 28, 2022.

Cases in Literature

2022 Oct – Iwata et al – Adult-onset Still’s disease following mRNA-1273 Moderna COVID-19 vaccination: A case report
  • 57 year old woman had 2nd dose of Moderna mRNA
  • one week later developed skin rash, then referred to hospital 3 weeks later after they didn’t go away with topical steroids and oral antihistamines
  • she had papules and plaques on her trunk and extremities, proximal muscle pain, and swelling in her thumbs and wrists.
  • She was diagnosed with AOSD (Adult Onset Stills Disease)
  • Theory: “pathogen-associated- (PAMPs) or damage-associated molecular patterns may activate the immune system in genetically predisposed patients, leading to IL-1β and IL-18 overproduction, known as a “cytokine storm””
    • The SARS-CoV-2 spike proteins are potent PAMPs, whereas the nucleocapsid proteins can block IL-1β release
    • “mRNA vaccines encode only spike protein and thus may disturb the host immune system.”

2021 Dec – Park et alAdult-onset Still’s Disease after BNT162b2 mRNA COVID-19 Vaccine

  • 36F South Korean woman had 1st dose of Pfizer mRNA
  • 10 days later developed high spiking fever, chills, sore throat
  • hospitalized with joint pain in hands and ankles, mildly enlarged lymph nodes and salmon pink maculopapular rash on the trunk

2021 Nov – Jeon et al – A flare of Still’s disease following COVID-19 vaccination in a 34-year-old patient.

  • 34F South Korean woman received 1st dose of AstraZeneca COVID-19 Vaccine 9 days before presenting to ER with fever and rash
  • I’m giving an AstraZeneca case to show it’s not exclusively an mRNA problem.

2021 – Yamamoto et al – Flare-up of adult-onset Still’s disease after receiving a second dose of BNT162b2 COVID-19 mRNA vaccine.

  • 37F Japanese woman had 2nd dose of Pfizer mRNA
  • a few days later she started having fever, rash, sore throat and polyarthritis and presented two months later
  • she had a prior history of AOSD 13 years earlier and had experienced relapses and remissions, but for 2 years prior to Pfizer she had no episodes

Literature Review

(2023 Jan – Palassin et al) – Comprehensive description of adult-onset Still’s disease after COVID-19 vaccination
  • Adult-onset Still’s disease (AOSD) is the adult form of systemic juvenile idiopathic arthritis which is a rare systemic inflammatory disorder that primarily affects young adults and mainly involves innate immune response.
  • It corresponds to an aberrant inflammatory response whose precise etiology remains unknown.
  • The role of an infectious (viral or bacterial) or non-infectious triggering factor on the ground of genetic susceptibility is generally accepted.
  • The diagnosis generally remains a diagnosis of exclusion based on nonspecific clinical criteria (called Yamaguchi’s Criteria)
  • AOSD is a rare, multisystem auto-inflammatory disorder characterized by fever, rash, arthritis, and hyperleukocytosis
  • AOSD is 5x more frequently reported with COVID-19 vaccines than other drugs
  • 144 cases with COVID-19 Vaccines in WHO VigiAccess, 15 from literature
  • median age 43.4 years, female 52%, male 48%
  • Time to onset ranged from 0 days to 6 months with a median of 8 days.
  • 80% of AOSD occurred during the 1st three weeks and mostly with Pfizer
  • Most of the cases (86.8%) have been reported as serious including 18 (11.3%) life-threatening conditions and two (1.2%) fatal outcomes.
  • All cases required hospitalization
  • More than 80% of AOSD had hyperferritinemia
  • 12% of AOSD cases had a co-reported myocarditis or pericarditis
  • 7% of AOSD cases were also diagnosed with HLH
  • 2% of AOSD cases had HLH and myocarditis
  • HLH (Hemophagocytic lymphohistiocytosis (HLH) also known as macrophage activation syndrome (MAS) is considered as the most serious life-threatening complication of AOSD

COVID-19 mRNA Vaccine Immune System Damage 

(2022 Feb – Kim et al) give a nice summary:

  • “AOSD is a rare systemic auto-inflammatory disorder characterized by high spiking fever, arthritis, an evanescent salmon-colored rash, and lab abnormalities including leukocytosis, high serum ferritin, elevated liver enzymes, and elevated acute phase reactants (APRs) such as ESR and CRP. “
  • “Pathogenesis of AOSD remains unclear; however, dysregulation of the inflammasome complex with overproduction of pro-inflammatory cytokines(e.g., TNF-α, IL-1, IL-6, IL-18, and interferon-γ) appears to play a pivotal role. “
  • “Treatment using biologics targeting these cytokines, such as the IL-6 receptor antagonist TCZ and IL-1 receptor antagonist Anakinra, has become an attractive therapeutic option in the recent years”
  • COVID-19 mRNA Vaccine: “Possible pathologic mechanism is that mRNA transcribes into spike proteins which are displayed on antigen-presenting cells by molecular mimicry, leading to an acute immune response.
    • Another potential cause is that the mRNA vaccine acts as an adjuvant and stimulates innate immunity through endosomal and cytoplasmic immune receptors, such as Toll-like receptors
    • Pfizer mRNA vaccines may induce a significant increase in IL-6, IL-15, and interferon-γ, which play an important role in the pathogenesis of AOSD.

(2021 Dec – Park et al):

  • Although the exact pathogenic mechanism of AOSD is not fully understood, innate immune system activation, rather than adaptive immunity, is implicated in the pathogenesis of AOSD.
  • Danger signals such as pathogen-associated molecular patterns or damage associated molecular patterns are transmitted to macrophages and neutrophils via Toll-like receptors (TLR) leading to overproduction of interleukin (IL)-1β, which ultimately results in intense innate immune cell activation and overproduction of several proinflammatory cytokines, called ‘cytokine storm’.

My Take… 

  • Pfizer and Moderna COVID-19 mRNA Vaccines severely damage the Immune System, which can cause a number of diseases
  • Adult Onset Still’s Disease (AOSD) is one such disease of Immune damage
  • EPOCH TIMES has an October 12, 2023 Article out called:
  • COVID-19 Vaccines ‘May Trigger’ Rheumatic Inflammatory Diseases: Study
    • “A new review suggests that COVID vaccines “may trigger” rheumatic immune-mediated inflammatory diseases, including arthritis, vasculitis, lupus, and adult-onset Still’s Disease.”

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Dr. William Makis is a Canadian physician with expertise in Radiology, Oncology and Immunology. Governor General’s Medal, University of Toronto Scholar. Author of 100+ peer-reviewed medical publications.

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