Dear VaccineSmarts,

My daughter was diagnosed with juvenile rheumatoid arthritis at the age of 5.

Is there any connection between vaccines and JRA? Three days after her 18-month shots, we had to take her to the ER because she would not put any weight on her legs or stand.

She is fine now, but we have not given her any immunizations since.

Sherry, Santa Fe

We’re happy to hear that your daughter is in remission.

Over the years, there has been speculation that vaccines are involved in the development of juvenile rheumatoid arthritis and other connective tissue disorders.

No one knows what causes JRA, but nearly 50,000 children in the United States are affected by it. Decades of studies indicate that vaccines do not cause these illnesses.

Your daughter not putting any weight on her legs had nothing to do with arthritis. If your daughter was on schedule, the recommended vaccines at that age cover diphtheria, tetanus, pertussis, polio and hepatitis A.

She should have received several injections in her thighs. Localized soreness commonly occurs and a very small percentage of children do not want or refuse to stand up or walk.

We have seen cases similar to your daughter’s and they have all resolved in a few days without incident.

Vaccines on occasion can cause transient synovitis or acute arthritis. Synovitis is inflammation of the lining in a joint. The hip is a commonly affected joint.

Pain and stiffness starts between one and four weeks after vaccination and, as the names imply, resolve within a few days to months. Medications such as ibuprofen treat the pain and inflammation.

The vaccine most likely to cause this condition is the rubella (German measles) component of the MMR vaccine, which is given at age 1 and again at age 4.

Vaccines do not cause symptoms similar to JRA or other chronic arthritis conditions. Interestingly, many of the diseases that vaccines prevent are well known to cause transient synovitis. It occurs more often in women than men.

Natural rubella infections in women are known to cause transient arthritis in between 10 and 15 percent of those who are infected. The occurrence of transient synovitis is less common and less severe among those who have been vaccinated.

There have been extensive studies of vaccines and their effects on people with an autoimmune disease such as JRA or lupus.

Vaccines do not cause the diseases to progress, flare up or make any significant changes to a person’s autoantibodies.

It is important that individuals with such conditions receive their vaccinations as recommended by their health care provider, especially if they are on medications that affect the immune system.

Dr. Richard Rupp is a pediatrician and member of UTMB’s Sealy Center for Vaccine Development. Bridget Hawkins, Ph.D., is the assistant director of the Sealy Center for Vaccine Development. This column is supported by a UTMB President’s Cabinet Award to provide information about vaccines. Visit for more information.