Post-Acute Vaccination Syndromes (PAVS) Hub — reported chronic illness after vaccination

Database counts and case-series frequencies are unverified reports, not proven injury rates. Not medical advice.

A temporal association between vaccination and symptom onset does not establish causation.
Symptom percentages come from small, self-selected or clinic-referred case series with no control group; they cannot be compared to population incidence.
Large registry and self-controlled case series (SCCS) studies are shown alongside case series so that both signals and non-signals are visible. Neither type alone settles the question.
'PAVS' is a descriptive umbrella term used on this dashboard for chronic illnesses reported after vaccination; it is not a recognised diagnosis.

Explore clusters About & methodology Detailed dashboard Cross-vaccine charts

What PAVS means

Post-acute vaccination syndromes (PAVS) is an umbrella label used on this site for persistent, multi-system illness that patients or clinicians report beginning after vaccination and lasting weeks, months or longer. It is a research category, not a diagnosis, and the clusters below are not assumed to be the same disease. Evidence comes mainly from case series and patient surveys; for some clusters, large registry studies have not found increased rates of coded diagnoses. This hub maps the clusters and points to the evidence. It does not decide whether any vaccine caused any person's illness.

How to read this hub

Case series and patient surveys describe who is ill and how, but cannot show how often it happens or whether the vaccine caused it.
Registry and self-controlled case series studies compare vaccinated with unvaccinated people or risk windows, but rely on coded diagnoses that may not capture the reported syndrome.
Regulator and committee reviews reflect the evidence available on their date; several predate the newest patient series and biomarker papers.
The detailed dashboard separates these evidence types for every cluster and grades each study on a GRADE-style scale.

Full method and grading rubric: dashboard methodology. Last compiled 2026-09-21.

Clusters

COVID-19 / PACVS

Active research program

Chronic fatigue, exercise intolerance, brain fog and dysautonomia-type symptoms reported after COVID-19 vaccination. Evidence so far: a self-selected online cohort (n=241), a German biomarker study (191 affected, 89 controls) and registry analyses of POTS diagnoses. We did not locate a regulator assessment of PACVS as a defined syndrome.

Key literature (4)

Krumholz et al. 2023 — Yale LISTEN online cohort, 241 people — PubMed 37986769 · PMC full text · DOI
Semmler et al. 2023 — PACVS vs. healthy vaccinated controls (autoantibodies, IL-6) — PubMed 38005974 · PMC full text · DOI
Kwan et al. 2022 — POTS diagnoses after vaccination vs infection (sequence-symmetry) — PubMed 37303827 · PMC full text · DOI
Yong et al. 2023 — meta-analysis of POTS after infection vs vaccination — PubMed 38000119 · DOI

Hepatitis B–associated

Case series; contested framework

Two US records-based series (19 and 93 patients) describe fatigue, musculoskeletal, neuro-psychiatric and autoimmune manifestations a mean of about six weeks after the last dose, interpreted by the authors within the ASIA framework. The 93-patient series consisted of people who sought legal consultation. Registry data address multiple sclerosis, not this phenotype.

Key literature (5)

Agmon-Levin et al. 2014 — CFS / fibromyalgia after hepatitis B vaccine, 19 patients — PubMed 25427994 · DOI
Ascherio et al. 2001 — hepatitis B vaccine and MS, US nurse cohorts — PubMed 11172163 · DOI
Hernán et al. 2004 — hepatitis B vaccine and MS, UK GPRD — PubMed 15365133 · DOI
IOM 2011 — Adverse Effects of Vaccines: Evidence and Causality (hepatitis B chapter) — DOI · Official document
Zafrir et al. 2012 — immune-mediated disease after hepatitis B vaccine, 93 patients — PubMed 22235045 · DOI

HPV-associated

Contested

Clinic series in Japan (87 patients) and Denmark (35 and 53) describe fatigue, headache, pain, orthostatic intolerance and cognitive symptoms in adolescent girls and young women; median onset was 199 days in the Japanese series. Danish (1.38 million females) and Norwegian (176,453 girls) registry studies found no increased rate of CFS, CRPS or POTS, and EMA and WHO GACVS found no causal link. The disagreement is unresolved.

Key literature (14)

Hineno & Ikeda 2021 — Japanese clinic series, 87 patients — PubMed 34451981 · PMC full text · DOI
Ozawa et al. 2017 — Japanese clinic series, 72 patients — PubMed 28744844 · PMC full text · DOI
Brinth et al. 2015 — Danish syncope-unit series, 35 women — PubMed 25882168 · DOI
Brinth et al. 2015 — Danish series, 53 patients — PubMed 25872549
Mehlsen et al. 2022 — autoantibody study, Danish patients — PubMed 36356549 · DOI
Blitshteyn et al. 2018 — review of HPV case series — PubMed 30478703 · DOI
Ward et al. 2019 — cluster analysis of Danish serious AE reports — PubMed 31088598 · PMC full text · DOI
Pellegrino et al. 2015 — VAERS analysis of suspected ASIA after HPV vaccine — PubMed 25381482 · DOI
Hviid et al. 2020 — Danish nationwide SCCS — PubMed 32878745 · PMC full text · DOI
Feiring et al. 2017 — Norwegian register study — PubMed 28648542 · DOI
Hviid et al. 2018 — Danish/Swedish adult women cohort — PubMed 29044769 · DOI
EMA PRAC, Nov 2015 — HPV vaccines Article 20 review — Official document · EMA news release
WHO GACVS, Dec 2015 statement on HPV vaccine safety — Official document · WHO GACVS HPV safety topic page
WHO GACVS, Jun 2017 statement on HPV vaccine safety — Official document

Anthrax vaccine–associated (Gulf War Illness–adjacent)

Nascent — no VDN vaccine page yet

Small US veteran samples report more Gulf War Illness among anthrax-vaccinated veterans (47.1% vs 17.2%, n=111) and propose an HLA-based mechanism. A US Army cohort of 716,833 soldiers found no increase in disability evaluation, and an IOM 2002 review found no convincing evidence of raised later-onset risk. Gulf War Illness has several proposed exposures; it is related to, not the same as, this cluster. A full VDN anthrax page is not yet built.

Key literature (5)

James et al. 2024 — anthrax vaccination, GWI and HLA (111 veterans) — PubMed 38932342 · PMC full text · DOI
James & Georgopoulos 2025 — HLA-II binding affinity and GWI severity (458 veterans) — PubMed 39852867 · PMC full text · DOI
Hotopf et al. 2000 — UK Gulf War veterans, vaccines and ill health — PubMed 10818024 · PMC full text · DOI
IOM 2002 — The Anthrax Vaccine: Is It Safe? Does It Work? — DOI · Official document · Findings and recommendations (NAP reader)
Sulsky et al. 2004 — US Army disability cohort, 716,833 soldiers — PubMed 15602181 · DOI

Cross-cutting: The ASIA and aluminium-adjuvant hypothesis cuts across the HPV, hepatitis B and other clusters. The dashboard includes both proponent reviews and a critical systematic review, and a 2025 Danish cohort of 1.22 million children. See the ASIA / aluminium entry →

Compare at a glance

Coverage and status only. This table does not rank clusters by strength of evidence; see the dashboard for that.
Cluster	Primary page	OSMF depth	Dossier coverage	Status
COVID-19 / PACVS	COVID-19 vaccine summary	Tracker, Desk and Summit programs	COVID-19 dossiers exist; none is specific to PACVS	Active research program
Hepatitis B–associated	Hepatitis B vaccine summary	Via this hub only	One related dossier (autoimmune disorder)	Case series; contested framework
HPV-associated	HPV vaccine summary	Via this hub only	No dossier specific to this cluster	Contested
Anthrax vaccine–associated (Gulf War Illness–adjacent)	Detailed evidence	Related Gulf War Illness biomarker work in OSMF Tracker	None	Nascent — no VDN vaccine page yet

Cite this page

Open Source Medicine Foundation. Post-Acute Vaccination Syndromes (PAVS) Hub. Vaccine Data Navigator. https://vaccinedatanavigator.org/pavs.html. Last compiled 2026-09-21.

Content available under CC BY 4.0 unless otherwise noted (matches the site footer).