Agmon-Levin, Nancy, Zafrir, Yaron, Kivity, Shaye et al. · Immunologic research · 2014 · DOI
This study looked at 19 people who developed chronic fatigue syndrome (CFS) or fibromyalgia (FM) after receiving the hepatitis B vaccine. Researchers found that most patients experienced multiple symptoms including fatigue, muscle/joint pain, and neurological problems within weeks to months of vaccination. The study suggests that in some cases, these conditions may be triggered by the vaccine's components, particularly in people with genetic predisposition to autoimmune diseases.
This study explores a potential environmental trigger (vaccination) for ME/CFS and FM, contributing to understanding of post-infectious or post-exposure mechanisms in these conditions. Identifying risk factors and temporal relationships may help clinicians recognize and manage vaccine-associated onset of these debilitating illnesses.
This study does not establish a causal relationship between hepatitis B vaccination and CFS/FM—it documents temporal association in a selected group of 19 patients. The lack of a control group means it cannot determine whether similar symptoms occur in vaccinated individuals without CFS/FM. It cannot identify what specific vaccine components or individual factors determine who develops these conditions after vaccination.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Agmon-Levin, Nancy, Zafrir, Yaron, Kivity, Shaye, Balofsky, Ari, Amital, Howard, & Shoenfeld, Yehuda (2014). Chronic fatigue syndrome and fibromyalgia following immunization with the hepatitis B vaccine: another angle of the 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' (ASIA).. Immunologic research. https://doi.org/10.1007/s12026-014-8604-2
BibTeX
@article{mecfsatlas-agmon-levin-2014-chronic-fatigue,
author = {Agmon-Levin, Nancy and Zafrir, Yaron and Kivity, Shaye and Balofsky, Ari and Amital, Howard and Shoenfeld, Yehuda},
title = {Chronic fatigue syndrome and fibromyalgia following immunization with the hepatitis B vaccine: another angle of the 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' (ASIA).},
journal = {Immunologic research},
year = {2014},
doi = {10.1007/s12026-014-8604-2},
note = {PubMed: 25427994},
url = {https://www.mecfsatlas.com/evidence/agmon-levin-2014-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/agmon-levin-2014-chronic-fatigue
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