Myalgia and chronic fatigue syndrome following immunization: macrophagic myofasciitis and animal studies support linkage to aluminum adjuvant persistency and diffusion in the immune system.

Observed Findings

• Patients with post-immunization ME/CFS show cognitive dysfunction affecting attention and memory with distinctive cerebral glucose hypometabolism patterns
• Muscle biopsies from affected patients reveal macrophagic myofasciitis with persistent aluminum agglomerates in immune cells
• Animal studies (particularly in sheep) demonstrate that injected aluminum particles are captured by immune cells and transported to distant organs including the brain
• Brain perfusion defects are observed in ME/CFS patients and correlate with cognitive impairment
• Aluminum particles persist longer and distribute more widely than previously assumed by classical toxicology models

Inferred Conclusions

• Aluminum adjuvants may persist in immune cells and cause systemic inflammation and neurotoxicity rather than being rapidly cleared
• Post-immunization ME/CFS represents a manifestation of ASIA (autoimmune/inflammatory syndrome induced by adjuvants)
• Current toxicological models underestimate the hazards of particulate aluminum adjuvants and inadequately assess different aluminum formulations
• Macrophagic myofasciitis serves as a histological biomarker of chronic aluminum adjuvant exposure and may be associated with neurological complications

Remaining Questions