The impacts of influenza infection and vaccination on exacerbation of myasthenia gravis

Hung Youl Seok, Ha Young Shin, Jong Kuk Kim, Byoung Joon Kim, Jeeyoung Oh, Bum Chun Suh, Sun Young Kim, Sa Yoon Kang, Suk Won Ahn, Jong Seok Bae, Byung Jo Kim

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22 Citations (Scopus)


Background and Purpose Upper respiratory infection (URI), including influenza, may exacerbate the symptoms of myasthenia gravis (MG), which is an autoimmune disease that causes muscle weakness. There is also concern that the influenza vaccine may trigger or worsen autoimmune diseases. The objective of this study was to determine the impacts of influenza infection and vaccination on symptom severity in MG patients. Methods Patients diagnosed with MG were enrolled from 10 university-affiliated hospitals between March and August 2015. Subjects completed a questionnaire at the first routine follow-up visit after enrolling in the study. The patient history was obtained to determine whether a URI had been experienced during the previous winter, if an influenza vaccination had been administered before the previous winter, and whether their MG symptoms were exacerbated during or following either a URI or vaccination. Influenza-like illness (ILI) was defined and differentiated from the common cold as a fever of ≥38°C accompanied by a cough and/or a sore throat. Results Of the 258 enrolled patients [aged 54.1±15.2 years (mean±SD), 112 men, and 185 with generalized MG], 133 (51.6%) had received an influenza vaccination and 121 (46.9%) had experienced a common cold (96 patients) or ILI (25 patients) during the analysis period. MG symptoms were aggravated in 10 (40%) patients after ILI, whereas only 2 (1.5%) experienced aggravation following influenza vaccination. The rate of symptom aggravation was significantly higher in patients experiencing an ILI (10/25, 40%) than in those with the common cold (15/96, 15.6%, p=0.006). Conclusions The results of this study suggest that the potential risk of aggravating autoimmune disease is higher for ILI than for influenza vaccination, which further suggests that influenza vaccination can be offered to patients with MG.

Original languageEnglish
Pages (from-to)325-330
Number of pages6
JournalJournal of Clinical Neurology (Korea)
Issue number4
Publication statusPublished - 2017 Oct
Externally publishedYes


  • Exacerbation
  • Influenza
  • Myasthenia gravis
  • Safety
  • Vaccination

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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