Chang, Hsun, Yao, Wei-Cheng, Yu, Teng-Shun et al. · Journal of translational medicine · 2025 · DOI
This study looked at whether getting the flu increases the risk of developing ME/CFS. Researchers tracked nearly 310,000 people who had the flu and compared them to a similar group who did not get the flu over 12 years. They found that people who had the flu were about 50% more likely to develop ME/CFS afterward, but people who received the flu vaccine had lower rates of developing ME/CFS.
Understanding whether infections like influenza can trigger ME/CFS is crucial for identifying at-risk populations and developing prevention strategies. This large-scale study suggests that influenza vaccination may reduce ME/CFS burden, offering a potentially modifiable intervention for prevention in vulnerable groups.
This observational study demonstrates association, not causation—influenza infection correlates with increased CFS risk, but does not prove the infection directly causes ME/CFS or explain the underlying mechanisms. The study does not define ME/CFS using international diagnostic criteria (e.g., ICC or Canadian Consensus Criteria), so cases identified in the database may not represent true ME/CFS with post-exertional malaise. Additionally, the lack of protective effect in severe cases suggests the relationship is complex and may vary based on infection severity.
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
Chang, Hsun, Yao, Wei-Cheng, Yu, Teng-Shun, Lin, Heng-Jun, Tsai, Fuu-Jen, Ho, Shinn-Ying, et al. (2025). Decreased risk of chronic fatigue syndrome following influenza vaccine: a 20-year population-based retrospective study.. Journal of translational medicine. https://doi.org/10.1186/s12967-025-06600-5
BibTeX
@article{mecfsatlas-chang-2025-decreased-risk,
author = {Chang, Hsun and Yao, Wei-Cheng and Yu, Teng-Shun and Lin, Heng-Jun and Tsai, Fuu-Jen and Ho, Shinn-Ying and Kuo, Chien-Feng and Tsai, Shin-Yi},
title = {Decreased risk of chronic fatigue syndrome following influenza vaccine: a 20-year population-based retrospective study.},
journal = {Journal of translational medicine},
year = {2025},
doi = {10.1186/s12967-025-06600-5},
note = {PubMed: 40640868},
url = {https://www.mecfsatlas.com/evidence/chang-2025-decreased-risk},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/chang-2025-decreased-risk
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