Question explored with the scientific record
Could the mRNA Covid vaccines have caused autoimmune vasculitis
The short version: the evidence shows a real signal of autoimmune vasculitis after mRNA COVID-19 vaccines, but it comes almost entirely from case reports and a single pharmacovigilance analysis, not from controlled trials.
The published literature contains dozens of case reports of new-onset or relapsed vasculitis after mRNA COVID-19 vaccination. The types include IgA vasculitis (Henoch-Schönlein purpura) [1, 3, 4, 5, 7], ANCA-associated vasculitis [2, 6, 9, 10], eosinophilic granulomatosis with polyangiitis [8], and antiphospholipid syndrome with large-vessel clotting [13, 14]. The timing is consistent: symptoms appear days to weeks after the second dose or booster, often in people with no prior autoimmune history. A 2025 disproportionality analysis of the European EudraVigilance database found that mRNA vaccines had higher reporting odds for vasculitis than viral-vector vaccines (reporting odds ratio about 2.5 for tozinameran/Pfizer) [11]. That is a signal from spontaneous reports, not a measured rate.
But here is what the evidence does not contain. There is no large controlled trial that compared vaccinated to unvaccinated people and tracked autoimmune vasculitis as a pre-specified endpoint. The case reports prove temporal association, not causation. The pharmacovigilance study uses passive reporting, which captures a small fraction of real events and cannot calculate a true incidence. The systematic review of renal disease after COVID-19 vaccination found 130 cases, of which 16 were ANCA vasculitis [12] — again, a count, not a rate. The mechanism is biologically plausible: mRNA vaccines provoke a strong Th1-type inflammatory response, and the spike protein itself can trigger molecular mimicry or immune complex formation. But plausibility is not proof.
| Vasculitis type | Number of case reports in this retrieval | Key finding |
|---|---|---|
| IgA vasculitis (Henoch-Schönlein) | 5+ [1, 3, 4, 5, 7] | New onset in adults, often with kidney involvement |
| ANCA-associated vasculitis | 4+ [2, 6, 9, 10] | MPO-ANCA or PR3-ANCA positive, renal-limited or systemic |
| Eosinophilic granulomatosis with polyangiitis | 1 [8] | After booster, with cardiac involvement |
| Antiphospholipid syndrome | 2 [13, 14] | Triple-positive antibodies, pulmonary embolism |
My call: the evidence supports a plausible link between mRNA COVID-19 vaccines and autoimmune vasculitis, but the data is too thin to quantify the risk. The signal is real enough that a person with a history of vasculitis or autoimmune disease should weigh it seriously. For a healthy person, the absolute risk appears low, but it has not been measured in a proper study. Confidence: moderate that the association exists, low on the size of the risk.
Sources used 14
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IgA vasculitis with transient glomerular hematuria, diarrhea, and pericarditis following COVID-19 mRNA vaccination in a young patient with possible pre-existing ulcerative colitis
This case report describes a young male who developed cutaneous IgA vasculitis with glomerular hematuria, diarrhea, and pericarditis following his second COVID-19 mRNA vaccination, highlighting the potential for vaccines to trigger autoimmune responses in susceptible individuals.
DOI: 10.1007/s13730-022-00727-w -
Antineutrophil Cytoplasmic Antibody-associated Vasculitis after COVID-19 Vaccination with Pfizer-BioNTech
This study presents a case of a 72-year-old man who developed antineutrophil cytoplasmic antibody-associated vasculitis following COVID-19 vaccination with Pfizer-BioNTech, highlighting the potential autoimmune complications of mRNA vaccines.
DOI: 10.2169/internalmedicine.9807-22 -
IgA vasculitis presenting as nephrotic syndrome following COVID-19 vaccination: a case report
This case report describes a 76-year-old man who developed biopsy-proven IgA vasculitis with nephritis presenting as nephrotic syndrome following the second dose of the BNT162b2 mRNA COVID-19 vaccine, highlighting the potential for (re)activation of autoimmune conditions post-va…
DOI: 10.1186/s12882-022-03028-7 -
Henoch-Schönlein purpura following mRNA COVID-19 vaccination: a case report
This case report discusses a 22-year-old man who developed Henoch-Schönlein purpura, an immune-mediated vasculitis, following the administration of the mRNA-1273 COVID-19 vaccine, highlighting the need for further research on vaccine-related autoimmune conditions.
DOI: 10.7774/cevr.2024.13.2.166 -
Sudden Onset of IgA Vasculitis Affecting Vital Organs in Adult Patients following SARS-CoV-2 Vaccines
This study reports three cases of new-onset IgA vasculitis in adult patients following COVID-19 vaccination, suggesting a potential link between vaccination and the onset of this autoimmune condition.
DOI: 10.3390/vaccines10060923 -
A Case Report of MPO-ANCA-Associated Vasculitis Following Heterologous mRNA1273 COVID-19 Booster Vaccination
This case report describes a 72-year-old woman who developed renal-limited MPO-ANCA-associated vasculitis following a heterologous booster vaccination with the mRNA1273 (Moderna) COVID-19 vaccine, highlighting potential autoimmune responses triggered by COVID-19 vaccinations.
DOI: 10.3346/jkms.2022.37.e204 -
New-onset kidney biopsy-proven IgA vasculitis after receiving mRNA-1273 COVID-19 vaccine: case report
This case report describes a 47-year-old man who developed kidney biopsy-proven IgA vasculitis following the mRNA-1273 COVID-19 vaccination, highlighting the potential immunological side effects of the vaccine.
DOI: 10.1007/s13730-021-00677-9 -
New Onset of Eosinophilic Granulomatosis with Polyangiitis Following mRNA-Based COVID-19 Vaccine
This study presents a case of a 63-year-old man who developed eosinophilic granulomatosis with polyangiitis (EGPA) following the booster dose of the mRNA-1273 COVID-19 vaccine, highlighting potential immune-mediated disease flares associated with vaccination.
DOI: 10.3390/vaccines10050716 -
Case Report: ANCA-Associated Vasculitis Presenting With Rhabdomyolysis and Pauci-Immune Crescentic Glomerulonephritis After Pfizer-BioNTech COVID-19 mRNA Vaccination
A case report describes a 79-year-old woman who developed MPO-ANCA-associated vasculitis presenting with massive rhabdomyolysis and pauci-immune crescentic glomerulonephritis two weeks after the second dose of the BNT162b2 mRNA COVID-19 vaccine; the authors emphasize early testi…
DOI: 10.3389/fimmu.2021.762006 -
Dual-Positive MPO- and PR3-ANCA-Associated Vasculitis Following SARS-CoV-2 mRNA Booster Vaccination: A Case Report and Systematic Review
This study presents a case of dual-positive MPO-and PR3-ANCA-associated vasculitis following SARS-CoV-2 mRNA booster vaccination, along with a systematic review of similar cases, suggesting a potential causal link between vaccination and the onset of this autoimmune condition.
DOI: 10.3390/vaccines10050653 -
Disproportionality analysis of European safety reports on autoimmune and rheumatic diseases following COVID-19 vaccination
A pharmacovigilance-based disproportionality analysis of European Union safety reports (EudraVigilance) evaluated immune-mediated and rheumatic adverse events after COVID-19 vaccination, showing higher reporting odds for certain autoimmune rheumatic events with mRNA vaccines (no…
DOI: 10.1038/s41598-025-98313-4 -
Side effect of mRNA-based COVID-19 vaccination in renal: pros- and cons- in pathophysiological view on renal function
mRNA-based COVID-19 vaccination is effective and more beneficial than harmful, but renal diseases such as MCD, IgAN, and AKI were reported after vaccination; the mechanism of renal injury remains unclear.
DOI: 10.59747/smjidisurabaya.v1i1.16 -
Case of Covid Mrna Vaccine Linked Antiphospholipid Syndrome
This case report presents a 22-year-old male who developed antiphospholipid syndrome and a large pulmonary embolus following COVID mRNA vaccination, suggesting a potential autoimmune reaction linked to the vaccine.
DOI: 10.33140/ijdmd.07.01.07 -
A Case of COVID mRNA Vaccine Linked Antiphospholipid Syndrome
A 22-year-old healthy male developed antiphospholipid syndrome with a large pulmonary embolus, markedly elevated triple-positive antiphospholipid antibodies, and multisystem symptoms after his second dose of an mRNA COVID vaccine, with negative COVID testing, and improved on api…
DOI: 10.33140/bscr.02.01.13