Vaccination of patients with auto-immune inflammatory rheumatic diseases requires careful benefit-risk assessment.
Will vaccination raise the incidence of autoimmune diseases, what is the impact of increasingly crowded vaccination schedules, the vaccination in age groups and the risk of coincidental temporal association? All these issues are still under debate. However, for the time being, to avoid confusion in the medical community and the media, we have to adhere to guidelines established consensually by experts while ensuring a strict surveillance and reporting possible side effects. Recommendation for vaccination in patients with autoimmune inflammatory rheumatic diseases (AIIRD) based on the currently available evidence and expert opinion were recently formulated by an EULAR task force. Major recommendations for AIIRD include: i) vaccination should ideally be administered during stable disease; ii) influenza vaccination and pneumococcal vaccination should be strongly considered; iii) vaccination can be administered during the use of DMARDs and TNF-inhibitors, but before starting rituximab; iv) live attenuated vaccines should be avoided whenever possible in immunosuppressed patients; v) BCG vaccination is not recommended.
Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, The Netherlands. m.bijl@reuma.umcg.nl
M
M
Bijl
N
N
Agmon-Levin
J-M
JM
Dayer
E
E
Israeli
M
M
Gatto
Y
Y
Shoenfeld
D000818:Animals; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D015551:Autoimmunity; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012306:Risk; D018570:Risk Assessment; D014611:Vaccination / Q000009:adverse effects*
D007166:Immunosuppressive Agents