Vitiligo, autoimmunity & vaccinations - The Vit Pro (A Vitiligo Blog)

Last Updated on 16th February 2024 by Caroline Haye

A balanced look at a tricky subject

Vaccination against the flu and and other potentially serious diseases plays an important role in preventative medicine. Indeed, it protects and saves countless lives every year the world over. However – leaving aside the unhelpful politicisation of the subject in the wake of the COVID pandemic – individuals with immune system disorders may, understandably, wonder if vaccinations pose more risks than benefits in their particular situation… Which is why I want to use this space to consider the subject of vitiligo, autoimmunity and vaccinations.

To jab or not to jab: that is the question

It strikes me that there are two tricky questions for those of us who have vitiligo. (Or any other autoimmune disease).

Does vitiligo count as one of those health conditions that carry a greater risk of serious virus-related complications? [I have attempted to answer the same question specifically in relation to Coronavirus in Vitiligo and Coronavirus.] And…
Do any such risks outweigh those that might be associated with having the vaccination itself? [Of course, the answer to this may well differ for COVID, as compared to seasonal flu or childhood diseases.]

These are questions I ponder every time flu season rolls around… Because, while my vitiligo has substantially gone now (after spreading steadily for 5 decades), I know that I am still prone to common de-pigmentation triggers. And, if vaccinations might be one of these, I really want to know about it.

So far, I have always chosen to run the risk of possibly catching flu over the potential risks of vaccination. I have never been quite sure whether this is the right decision. Nevertheless, I have continued to make that same choice. This is mainly because I never noticed any adverse effect on my vitiligo as a result of getting the influenza virus, whereas most vaccinations I ever had in the past have left me feeling unwell.

I am aware that this could be either coincidence or imagination on my part. You could argue that catching the flu is likely to make me feel much more unwell. But my reluctance to have the jab is based on more than just a vague perception. I base it on a simple exercise of weighing up the potential pros and cons as far as I understand them… And realising that I am the only person who can make the decision. Because no one knows for sure whether it is wise for someone with vitiligo to have the flu jab or not.

Of course, the advice routinely handed out to anyone asking this sort of question is “ask your doctor”. But, since – in my experience – most GPs know less about vitiligo than the patients who have it, all you would get would be a well-intentioned opinion, based on limited knowledge. And, judging by everything I can find on the subject, asking a dermatologist would probably not be very much more helpful either. The fact is that the jury is still out on the subject of whether patients with autoimmune diseases should receive vaccinations. And, to some extent, the jury is still out on the subject of whether vitiligo is a classic autoimmune disease anyway. So, where does that leave you and me? I think it leaves us to look at whatever evidence we can find and make up our own minds as rationally and responsibly as we can.

The vaccination battle ground

When it comes to vaccinations in general, feelings seem to run high. (And they have been further polarised in the popular media since COVID). Opinions differ widely, both within the mainstream medical profession and the wider health community. Not to mention among the general public. No doubt some opinions are based on emotion, some on vested interests and some on a lack of accurate information. So this can make it difficult to get to the real facts. Added to which, the field of immunology is extremely complex. So research still has a way to go before scientists fully understand all the workings of the immune system.

Much of the controversy around the safety of vaccinations revolves around the question of infant inoculations. One camp says, quite rightly, that infant vaccination has saved millions of lives. They point out that it has helped to eradicate a number of destructive and deadly diseases from the planet. When you look at the statistics, this is undeniable. Equally undeniable, though, is that definite cause and effect has been established, over the past few decades, between certain individual cases of illness, and even fatalities, following vaccination. This is one reason the anti-vaccination camp argue that the body’s own immune system should be left alone to do its job of protecting against infection without interference.

From what I have read about infant vaccination, the latter concept makes a lot of sense. To interfere with an infant’s immune system while it is still in the process of developing, does seem counter-intuitive. And there appears to be quite a bit of credible scientific evidence to support this view. However, the question of infant vaccination is so complex and emotive that I really don’t want to go there. So I will confine this blog mainly to adult vaccination in cases of vitiligo. (But, I shall briefly mention the implications of infant vaccination later.)

10 known facts

I have read a lot about this subject while preparing this blog and realised what a minefield it is. To try to present all the research on this page would result in one indigestible lump of text. So I’ll summarise some of the main facts below in a very simple 10 point overview.

Vaccination, for the majority of the population, is a “no brainer”. It saves lives and helps to prevent epidemics. [Or, in the recent emergency, it was crucial in stamping out a pandemic.]
Like all drugs, vaccinations do have side-effects and, in a small minority of cases, these can be extreme, even fatal.
Research into the effects of vaccines is ongoing. So the full extent of their effects (both good and bad) are not yet fully understood.
On balance, most credible sources believe that the benefits of vaccination, for the vast majority of people, outweigh the risks.
There is a small percentage of the general population for whom vaccination carries potentially more risk than benefit. These may include individuals who have a genetic predisposition to autoimmune disease.
It is possible that vitiligo sufferers are among this at-risk group but very little research has been done into this.
Vitiligo sufferers run the additional risk of developing new patches of de-pigmentation at the vaccination site. This is due to the phenomenon known as Koebnerisation. (See Why Do Skin Injuries Cause Vitiligo?)
The practitioners responsible for administering vaccinations are not, on the whole, aware of this group of at-risk individuals. And, even if they were, they do not have a screening process in place to identify them as unsuitable for vaccination or else to talk through the risks with them first.
There is a lack of screening for adults, based on their family and medical history, to alert them to their risk of developing an autoimmune disease or the possible risks of vaccination.
Screening of infants, based on family history and genetics (as they have no medical history to speak of) is needed in order to avoid inappropriate vaccinations that could adversely affect their health for life.

Personal opinion

In forming my personal conclusions, I needed to filter out some of the misleading and biased information doing the rounds online. I recognise that some doctors and researchers may be swayed by vested interests and personal reputation. And, as regards the views of non-scientists, there is a lot of well-meaning, but often ill-informed, popularist hype on the subject.

It can be hard not to get swept along by some of the views of the anti-vaccine lobby. Especially if you, like me, are a believer in the power of nature to promote good health. I instinctively feel that the immune system should be left to do its thing so that immunity to infection can develop naturally over the course of a lifetime.

My own instinct is probably an overly simplistic one. But it is that vaccinations might not be necessary if people all ate correctly from infancy to old age and lived in healthy environments, drank pure water and avoided environmental toxins. (But, of course, this is not the case.) And, for those of us who are prone to autoimmune disease, I believe that the answer should not be to boost or suppress the immune system artificially. But rather to balance it naturally wherever possible.

Expert opinion

Putting my own instincts to one side though, I wanted to get to the bottom of the science behind the whole question. And the best expert resource I found whilst I was reading up on this subject was Professor Yehuda Shoenfeld, founder and head of the Zabludowicz Center for Autoimmune Diseases attached to Tel-Aviv University, Israel.

Professor Shoenfeld is not without his critics. (As is so often the case with anyone who sticks their head above the parapet, I suppose). But, based on what appear to be credible and well substantiated findings, as well as on everything else I have read so far, my personal conclusion is that I shall be sticking to my policy of avoiding the seasonal flu vaccination. I have not had flu for several years now and would, in any case, quarantine myself if I did catch it so as not to pass it on to others. So, for myself, I feel the choice is a reasonable one.

[I did reluctantly get my first two doses of COVID vaccine, since I felt the risks to me and those around me of catching this were far greater and outweighed the risk of a possible autoimmune flare-up. I still caught the virus – relatively mildly – at least 3 times. And I am now relying on the cumulative effect of this and the original vaccinations to protect me going forward. In common with most of the population, I would have much preferred not to have been faced with this kind of choice. But, just like anyone else, I weighed up the pros and cons as best I could and made my best choice.]

Vitiligo, autoimmunity and vaccinations: 10 known facts

A balanced look at a tricky subject