title: EULAR recommendations for vaccination in paediatric patients with rheumatic diseases.
abstract: Evidence-based recommendations for vaccination of paediatric patients with rheumatic diseases (PaedRD) were developed by following the EULAR standardised procedures for guideline development. The EULAR task force consisted of (paediatric) rheumatologists/immunologists, one expert in vaccine evaluation, one expert in public health and infectious disease control, and one epidemiologist. A systematic literature review was conducted in MEDLINE, EMBASE, and abstracts of the EULAR and American College of Rheumatology meetings of 2008/9. The level of evidence and strength of recommendation were based on customary scoring systems. Delphi voting was applied to assess the level of agreement between task force members. 107 papers and eight abstracts were used. The majority of papers considered seasonal influenza (41) or pneumococcal (23) vaccination. 26 studies were performed specifically in paediatric patients, and the majority in adult rheumatoid arthritis and systemic lupus erythematosus patients. Fifteen recommendations were developed with an overall agreement of 91.7%. More research is needed on the safety and immunogenicity of (live-attenuated) vaccination in PaedRD, particularly in those using biologicals, and the effect of vaccination on prevention of infections.
authors.affiliation: Department of Paediatric Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Room KC 03.063.0, PO Box 85090, 3508 AB Utrecht, The Netherlands. m.w.heijstek@umcutrecht.nl
authors.forename: M W
authors.initials: MW
authors.lastname: Heijstek
authors.forename: L M
authors.initials: LM
authors.lastname: Ott de Bruin
authors.forename: M
authors.initials: M
authors.lastname: Bijl
authors.forename: R
authors.initials: R
authors.lastname: Borrow
authors.forename: F
authors.initials: F
authors.lastname: van der Klis
authors.forename: I
authors.initials: I
authors.lastname: Koné-Paut
authors.forename: A
authors.initials: A
authors.lastname: Fasth
authors.forename: K
authors.initials: K
authors.lastname: Minden
authors.forename: A
authors.initials: A
authors.lastname: Ravelli
authors.forename: M
authors.initials: M
authors.lastname: Abinun
authors.forename: G S
authors.initials: GS
authors.lastname: Pileggi
authors.forename: M
authors.initials: M
authors.lastname: Borte
authors.forename: N M
authors.initials: NM
authors.lastname: Wulffraat
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects; D002648:Child; D000075202:Contraindications; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D016867:Immunocompromised Host; D009894:Opportunistic Infections / Q000150:complications / Q000276:immunology / Q000517:prevention & control*; D012216:Rheumatic Diseases / Q000150:complications / Q000276:immunology* / Q000628:therapy; D014611:Vaccination / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D014613:Vaccines, Attenuated / Q000009:adverse effects / Q000276:immunology; D018074:Vaccines, Conjugate / Q000009:adverse effects / Q000276:immunology
chemical_list: D018501:Antirheumatic Agents; D014613:Vaccines, Attenuated; D018074:Vaccines, Conjugate