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JohnS's avatar

When you consider how dismissive medical authorities are to the plausibility of vaccine injuries, it seems stories like this are only the tip of the iceberg.

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Richard P Handler's avatar

What a horror story, and well analyzed and presented!

In my 36 years of primary care internal medicine + rheumatology twice I encountered systemic necrotizing vasculitis from vaccinations. Both patients had pyoderma gangrenosum (PG).

The first was a previously healthy 30 y.o. lady employed as the dispatcher at an ambulance service. Though she had no patient contact her employer required all employees to have hepatitis B vaccination. After the first dose she had transient cutaneous lesions. Following the 1 month booster these recurred and she was treated with prednisone. After the 6 month booster she developed full blown PG. She had just started a multi state vacation. This was when I saw her. We were in the mid 1990s, before TNF inhibitors. She was showing response to prednisone + leflunomide when I transferred her care to a rheumatologist in her home state.

The second was a healthy man in his early 60s. In September 2008 he was referred to me with deep necrotic and infected ulcers of both legs. He responded to high dose glucocorticoids and rituximab and then had a series of skin grafts. The only suspicious event immediately preceding PG onset was an annual flu shot. I directed that his chart be labeled "Allergic to Influenza Vaccine". After a year he was in remission on low dose alternate day prednisone. At two years PG recurred. Despite my instructions to him never to have another influenza vaccination and the big red label on his chart, his primary care physician had given him a seasonal flu shot. PG recurred days later. Again I had him on rituximab + high dose prednisone. He was still on this regimen when I retired. A year later I read his obituary.

In both cases neither the patients nor their primary care physicians recognized the relationship of vasculitis to vaccinations, because they did not think and take histories carefully. I suspect vaccination as a triggering event before a new onset autoimmune disease is often overlooked.

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