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Harvard Medical School
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General Medical Questions
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Question : Can recent vaccinations cause a false positive elevation in an antibody test for rheumatoid arthritis? I recently had a hepatitis and HPV vaccine and two weeks later, my test came back with an elevated level of 36.
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The Trusted Source
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Howard LeWine, M.D.

Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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December 01, 2011
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A:

There are rare reports of people developing positive antibody tests for rheumatoid arthritis after multiple vaccinations. But I can’t find a report of this happening after having hepatitis and HPV vaccinations. Plus, there are rare reports of people who have developed rheumatoid arthritis and related conditions soon after getting vaccinated, especially after getting older versions of the rubella (German measles) vaccination.

Doctors do not routinely check these antibodies after a vaccination unless there are other factors, such as joint pain or swelling. So it’s not known how often these antibodies might show up after routine vaccinations like yours.

There are two common antibody tests for evaluating rheumatoid arthritis:

  • Rheumatoid factor (RF) test. This has been in use since the 1950s. But it does have a high rate of false-positive results (that is, abnormal results in people who do not have rheumatoid arthritis).
  • Anti-cyclic citrullinated protein (anti-CCP) antibody test. More recently, this has become popular because false-positive results are much less common.

You don’t name the test you had. A RF level of 36 international units (IU) would be thought of as nearly normal in our lab. Unless you had chronic joint pain and swelling, it’s unlikely to mean much. But an anti-CCP level in this range makes it more likely that you have rheumatoid arthritis now. Or that you might develop it in the future.

Without knowing which test you had, your symptoms, and what your physical exam shows, it’s impossible to say whether your result is a false-positive. For the same reasons, it’s impossible to say whether your positive results might be related to one of your vaccinations.

So talk to your doctor about any joint symptoms you have, and your test results. It may turn out that the timing between the vaccinations and your test results is just a coincidence.

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