Appel, Shmuel, Chapman, Joab, Shoenfeld, Yehuda · Autoimmunity · 2007 · DOI
This review examines whether vaccinations might trigger ME/CFS, since infections can sometimes lead to the condition. The authors found some case reports of ME/CFS occurring after vaccination, but most studies did not find a reliable connection. A Canadian health organization concluded there is no strong evidence linking vaccinations to ME/CFS, though researchers agree more studies are needed.
This study addresses a significant patient concern about vaccination safety in ME/CFS and clarifies the current state of evidence. Understanding whether and how infections or immune stimulation might trigger ME/CFS could inform both prevention strategies and mechanistic research into the condition.
This review does not establish that vaccinations cause ME/CFS—it documents the lack of convincing evidence for such a relationship. The existence of case reports does not prove causation, and the absence of large prospective studies means a rare association cannot be completely ruled out. This review also does not definitively explain ME/CFS pathogenesis itself.
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
Appel, Shmuel, Chapman, Joab, & Shoenfeld, Yehuda (2007). Infection and vaccination in chronic fatigue syndrome: myth or reality?. Autoimmunity. https://doi.org/10.1080/08916930701197273
BibTeX
@article{mecfsatlas-appel-2007-infection-vaccination,
author = {Appel, Shmuel and Chapman, Joab and Shoenfeld, Yehuda},
title = {Infection and vaccination in chronic fatigue syndrome: myth or reality?},
journal = {Autoimmunity},
year = {2007},
doi = {10.1080/08916930701197273},
note = {PubMed: 17364497},
url = {https://www.mecfsatlas.com/evidence/appel-2007-infection-vaccination},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/appel-2007-infection-vaccination
Contribute
Private, reviewed by a human. Not a public comment thread.