title: [Immunization in children and adolescents with rheumatic and musculoskeletal diseases].
abstract: BACKGROUND
  Children and adolescents with inflammatory rheumatic diseases have a disease and treatment-related increased risk of infections. This risk includes vaccine-preventable diseases; therefore, vaccinations represent an important preventive measure against infection in these patients. However, approximately one in three patients with a juvenile rheumatic disease is nowadays still inadequately vaccinated, mostly due to uncertainty regarding the efficacy and safety of vaccination in these patients.
  
  
  OBJECTIVE
  This paper summarizes the available evidence regarding the efficacy and safety of vaccinations in children and adolescents with rheumatic diseases and gives recommendations for the clinical practice.
  
  
  RESULTS
  Almost 2000 children and adolescents with rheumatic diseases were examined in the more than 30 previously published vaccination studies, comprising nearly all standard vaccinations in the immunization schedule. The immunogenicity was usually sufficient and there was no evidence of a relevant aggravation of the underlying disease. Recommendations for the clinical practice are given also considering data beyond pediatric rheumatology; however, a final benefit-risk assessment is not yet possible.
authors.affiliation: Universitätskinderklinik Charité, Campus Virchow, Otto-Heubner-Centrum, SPZ, Deutsches Rheuma-Forschungszentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland, minden@drfz.de.
authors.forename: K
authors.initials: K
authors.lastname: Minden
authors.forename: F
authors.initials: F
authors.lastname: Speth
authors.forename: H-I
authors.initials: HI
authors.lastname: Huppertz
authors.forename: M
authors.initials: M
authors.lastname: Borte
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001424:Bacterial Infections / Q000453:epidemiology* / Q000517:prevention & control*; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D007592:Joint Diseases / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012216:Rheumatic Diseases / Q000453:epidemiology*; D018570:Risk Assessment; D014777:Virus Diseases / Q000453:epidemiology* / Q000517:prevention & control*