Vaccinations in juvenile chronic inflammatory diseases: an update
- 2 July 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Rheumatology
- Vol. 9 (9), 532-543
- https://doi.org/10.1038/nrrheum.2013.95
Abstract
Vaccination is a powerful tool to reduce the burden of infectious diseases in paediatric patients with chronic rheumatic diseases. Live attenuated vaccines are not recommended for profoundly immunosuppressed patients, but nonlive vaccines have adequate safety and efficacy profiles in the few (admittedly underpowered) studies published to date. No severe vaccine-specific or disease-specific adverse events have been observed in patients with juvenile idiopathic arthritis (JIA) or childhood-onset systemic lupus erythematosus (SLE) who have been vaccinated with live or nonlive agents. The immune response to live vaccines is variable in these patients but generally adequate, despite concomitant use of immunosuppressive and biologic agents. The proposal that onset of autoimmune rheumatic diseases could be induced by vaccination is controversial and primarily based on case reports; however, patients with mevalonate kinase deficiency can experience febrile attacks after immunizations. Adequately powered studies of live and nonlive vaccination in patients with paediatric rheumatic diseases are necessary to clarify safety and efficacy issues. This narrative Review discusses vaccination in patients with JIA, childhood-onset SLE, juvenile dermatomyositis, juvenile systemic sclerosis, primary vasculitis and autoinflammatory syndromes. Vaccine safety, short-term and long-term changes in disease parameters, and the immunogenicity and influence of immunosuppressive agents are outlined for each combination of disease and vaccine.This publication has 80 references indexed in Scilit:
- Effective seroconversion and safety following the pandemic influenza vaccination (anti-H1N1) in patients with juvenile idiopathic arthritisScandinavian Journal of Rheumatology, 2012
- Relapse of Systemic Juvenile Idiopathic Arthritis after Influenza Vaccination in a Patient Receiving TocilizumabClinical and Vaccine Immunology, 2012
- Humoral and Cell-Mediated Immune Responses to Monovalent 2009 Influenza A/H1N1 and Seasonal Trivalent Influenza Vaccines in High-Risk ChildrenThe Journal of Pediatrics, 2012
- Immunogenicity and Reactogenicity of 2009 Influenza A (H1N1) Inactivated Monovalent Non-Adjuvanted Vaccine in Elderly and Immunocompromised PatientsPLOS ONE, 2011
- Morphea profunda in a young infant after hepatitis B vaccinationJournal of the American Academy of Dermatology, 2010
- A multicentre, randomised, double-blind, placebo-controlled trial with the interleukin-1 receptor antagonist anakinra in patients with systemic-onset juvenile idiopathic arthritis (ANAJIS trial)Annals Of The Rheumatic Diseases, 2010
- Improving cellular therapy for primary immune deficiency diseases: Recognition, diagnosis, and managementJournal of Allergy and Clinical Immunology, 2009
- Safety of measles, mumps and rubella vaccination in juvenile idiopathic arthritisAnnals Of The Rheumatic Diseases, 2007
- Should children under treatment for juvenile idiopathic arthritis receive flu vaccination?Archives of Disease in Childhood, 2007
- An ulcerated lesion at the BCG vaccination site during the course of Kawasaki diseaseJournal of the American Academy of Dermatology, 1997