title: Safety and efficacy of meningococcal c vaccination in juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To determine whether vaccinations aggravate the course of autoimmune diseases such as juvenile idiopathic arthritis (JIA) and whether the immune response to vaccinations may be hampered by immunosuppressive therapy for the underlying disease.
  
  
  METHODS
  In this multicenter cohort study, 234 patients with JIA (ages 1-19 years) were vaccinated with meningococcal serogroup C (MenC) conjugate to protect against serogroup C disease (caused by Neisseria meningitidis). Patients were followed up for disease activity for 1 year, from 6 months before until 6 months after vaccination. IgG antibody titers against MenC polysaccharide and the tetanus carrier protein were determined by enzyme-linked immunosorbent assay and toxin binding inhibition assay, respectively. A serum bactericidal assay was performed to determine the function of the anti-MenC antibodies.
  
  
  RESULTS
  No change in values for any of the 6 components of the core set criteria for juvenile arthritis disease activity was seen after MenC vaccination. Moreover, no increase in the frequency of disease relapse was detected. Mean anti-MenC IgG concentrations in JIA patients rose significantly within 6-12 weeks after vaccination. Of 157 patients tested, 153 were able to mount anti-MenC IgG serum levels >2 micro g/ml, including patients receiving highly immunosuppressive medication. The 4 patients with a lower anti-MenC antibody response displayed sufficient bactericidal activity despite receiving highly immunosuppressive medication.
  
  
  CONCLUSIONS
  The MenC conjugate vaccine does not aggravate JIA disease activity or increase relapse frequency and results in adequate antibody levels, even in patients receiving highly immunosuppressive medication. Therefore, patients with JIA can be vaccinated safely and effectively with the MenC conjugate.
authors.affiliation: Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: Zonneveld-Huijssoon
authors.forename: Arash
authors.initials: A
authors.lastname: Ronaghy
authors.forename: Marion A J
authors.initials: MA
authors.lastname: Van Rossum
authors.forename: Ger T
authors.initials: GT
authors.lastname: Rijkers
authors.forename: Fiona R M
authors.initials: FR
authors.lastname: van der Klis
authors.forename: Elisabeth A M
authors.initials: EA
authors.lastname: Sanders
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Vermeer-De Bondt
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.forename: Jan Jaap
authors.initials: JJ
authors.lastname: van der Net
authors.forename: Carla
authors.initials: C
authors.lastname: Engels
authors.forename: Wietse
authors.initials: W
authors.lastname: Kuis
authors.forename: Berent J
authors.initials: BJ
authors.lastname: Prakken
authors.forename: Maarten J D
authors.initials: MJ
authors.lastname: Van Tol
authors.forename: Nico M
authors.initials: NM
authors.lastname: Wulffraat
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology* / Q000517:prevention & control; D001770:Blood Bactericidal Activity; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007107:Immune System / Q000276:immunology / Q000503:physiopathology; D007074:Immunoglobulin G / Q000276:immunology / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000276:immunology / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000276:immunology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use*; D009426:Netherlands; D012008:Recurrence
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine