Live polio vaccine exposure while receiving anti-TNF therapy for reactive arthritis.
International guidelines state that live vaccines are contraindicated in patients on anti-TNF therapy. However, we report the experience of a patient who inadvertently received live polio vaccine whilst receiving anti-TNF therapy. Patient did not suffer from any infectious sequel as a result. No clear guidelines are available for all vaccines in patients with specific rheumatic diseases. However, if we consider adult patients with rheumatic diseases to have altered immunocompetence, it is recommended that they receive the usual inactivated vaccines according to standard schedules, and live vaccines should be avoided in those who are treated with more potent forms of immune suppression. Patients should be counseled regarding the risks of live vaccines prior to treatment with anti-TNF therapy.
Dubai Bone & Joint Center, Dubai, United Arab Emirates. humeira.badsha@dbaj.ae
Humeira
H
Badsha
Mirna
M
Daher
Christopher J
CJ
Edwards
D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000188:drug therapy / Q000276:immunology*; D000075202:Contraindications; D000068800:Etanercept; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011055:Poliovirus Vaccine, Oral; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014611:Vaccination / Q000009:adverse effects*
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D011055:Poliovirus Vaccine, Oral; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept