title: Vaccination of children and adolescents with rheumatic diseases.
abstract: Children with rheumatic diseases (RDs) are at greater risk of infection because of their aberrant immunity and frequent use of immunosuppressive drugs. However, the use of vaccinations in such children is debated by many experts who think that the patients' immune response is insufficient to assure protection; some of them are also afraid that vaccines could trigger a persistent autoimmune response and lead to severe clinical problems including a relapse of the RD. This review describes the available data regarding the risks of vaccine administration, and the immunogenicity, efficacy and tolerability of the vaccines usually recommended for children with RDs. The data not only show that the schedule suggested for otherwise healthy children should be followed, but also that pneumococcal and influenza vaccinations should be strongly recommended because of the known risk of severe infections in patients with RD. However, there are areas in which further research is urgently required.
authors.affiliation: Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milano, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Dell' Era
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Corona
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D000293:Adolescent; D001327:Autoimmune Diseases / Q000276:immunology*; D002648:Child; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007252:Influenza Vaccines / Q000009:adverse effects / Q000276:immunology; D022242:Pneumococcal Vaccines / Q000009:adverse effects / Q000276:immunology; D012216:Rheumatic Diseases / Q000276:immunology*; D014611:Vaccination; D014612:Vaccines / Q000009:adverse effects* / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines; D014612:Vaccines