Such studies offer opportunities to study vaccine safety aspects that manufacturers have failed to perform. Hepatitis B vaccines (HBV) are recombinant vaccines produced on yeast (Saccharomyces cerevisiae). HBV therefore contain residual yeast proteins. Residual yeast protein quantity can vary from 1 to 5% depending on vendor.(1,2)⁠ HBV vaccines also contain aluminum adjuvants that bias towards a Th2 (allergic) response.(3)⁠ Anti-saccharomyces cerevisiae antibodies (ASCA) have been associated with many allergic and autoimmune diseases.(4,5,5–11)

It is therefore very important to perform pre and post-vaccination serology to check for vaccine-induced ASCA as suggested by Wraith et al.(12) It is important to learn the lesson from the Pandemrix vaccine induced narcolepsy(13)⁠ disaster, to ensure the same is not happening with all other vaccines.(14)⁠

References

1. Recombivax HB Package Insert [Internet]. [cited 2016 May 8]. Available from: http://www.fda.gov/downlo...
2. Engerix B Package Insert [Internet]. [cited 2016 May 8]. Available from: http://www.fda.gov/downlo...
3. Mitkus RJ, King DB, Hess MA, Forshee RA, Walderhaug MO. Updated aluminum pharmacokinetics following infant exposures through diet and vaccination. Vaccine. 2011 Nov 28;29(51):9538–43.
4. Mokrowiecka A, Gasiorowska A, Malecka-Panas E. pANCA and ASCA in the diagnosis of different subtypes of inflammatory bowel disease. Hepatogastroenterology. Greece; 2007;54(77):1443–8.
5. Israeli E, Grotto I, Gilburd B, Balicer RD, Goldin E, Wiik A, et al. Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease. Gut. 2005;54(9):1232–6.
6. Rinaldi M, Perricone R, Blank M, Perricone C, Shoenfeld Y. Anti-saccharomyces cerevisiae autoantibodies in autoimmune diseases: From bread baking to autoimmunity. Clinical Reviews in Allergy and Immunology. 2013. p. 152–61.
7. Krause I, Blank M, Cervera R, Font J, Matthias T, Pfeiffer S, et al. Cross-Reactive Epitopes on beta2-Glycoprotein-I and Saccharomyces cerevisiae in Patients with the Antiphospholipid Syndrome. Ann N Y Acad Sci. 2007;1108(1):481–8.
8. Oshitani N, Hato F, Jinno Y, Sawa Y, Nakamura S, Matsumoto T, et al. IgG subclasses of anti Saccharomyces cerevisiae antibody in inflammatory bowel disease. Eur J Clin Invest. England; 2001 Mar;31(3):221–5.
9. Arumugham V. Significant protein sequence alignment between Saccharomyces cerevisiae proteins (a vaccine contaminant) and Systemic Lupus Erythematosus associated autoepitopes [Internet]. 2017. Available from: https://www.zenodo.org/re...
10. Arumugham V. Atopic dermatitis caused by vaccine-induced allergy to Saccharomyces cerevisiae? [Internet]. 2016. Available from: https://www.zenodo.org/re...
11. Kortekangas-Savolainen O, Lammintausta K, Kalimo K. Skin prick test reactions to brewer’s yeast (Saccharomyces cerevisiae) in adult atopic dermatitis patients. Allergy. Blackwell Publishing Ltd; 1993;48(3):147–50.
12. Wraith DC, Goldman M, Lambert P-H. Vaccination and autoimmune disease: what is the evidence? Lancet (London, England). England; 2003 Nov;362(9396):1659–66.
13. Ahmed SS, Volkmuth W, Duca J, Corti L, Pallaoro M, Pezzicoli A, et al. Antibodies to influenza nucleoprotein cross-react with human hypocretin receptor 2 (ABSTRACT ONLY). Sci Transl Med. 2015;7(294):294ra105–294ra105.
14. Arumugham V. SIDS, Kawasaki Disease and narcolepsy: Same mechanism, different vaccines [Internet]. The BMJ. 2018. Available from: https://www.bmj.com/conte...
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