[Vaccination and autoimmunity: a real or imagined risk?]

A better understanding of mechanisms leading to or limiting the development of autoimmune diseases allows an evaluation of the real risk associated with infections or immunizations. It appears that regulatory mechanisms efficiently limit autoimmune responses following exposure to mimicking antigens or to activators of innate autoimmunity. When strict criteria of causality are applied, autoimmune adverse effects of vaccination are scarce. In fact, recent allegations suggesting such associations have not been confirmed. The use of vaccines against hepatitis B, influenza, and pneumococcal infections in patients with an ongoing autoimmune disease is actually recommended in view of the favourable risk-benefit equation.