title: A practical approach to vaccination of patients with autoimmune inflammatory rheumatic diseases in Australia.
abstract: Autoimmune inflammatory rheumatic diseases (AIIRD), such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are often complicated by infection, which results in significant morbidity and mortality. The increased risk of infection is probably due to a combination of immunosuppressive effects of the AIIRD, comorbidities and the use of immunosuppressive conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) and more recently, targeted synthetic DMARDs and biologic DMARDs that block specific pro-inflammatory enzymes, cytokines or cell types. The use of these various DMARDs has revolutionised the treatment of AIIRD. This has led to a marked improvement in quality of life for AIIRD patients, who often now travel for prolonged periods. Many infections are preventable with vaccination. However, as protective immune responses induced by vaccination may be impaired by immunosuppression, where possible, vaccination may need to be performed prior to initiation of immunosuppression. Vaccination status should also be reviewed when planning overseas travel. Limited data regarding vaccine efficacy in patients with AIIRD make prescriptive guidelines difficult. However, a vaccination history should be part of the initial work-up in all AIIRD patients. Those caring for AIIRD patients should regularly consider vaccination to prevent infection within the practicalities of routine clinical practice.
authors.affiliation: Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia.|UNSW Rural Clinical School, Coffs Harbour, New South Wales, Australia.
authors.forename: Peter K K
authors.initials: PKK
authors.lastname: Wong
authors.affiliation: Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia.
authors.forename: Hanish
authors.initials: H
authors.lastname: Bagga
authors.affiliation: Department of Rheumatology, Redcliffe Hospital, Brisbane, Queensland, Australia.|Redcliffe Northside Rheumatology, Brisbane, Queensland, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: Barrett
authors.affiliation: Private Rheumatology Practice, South Perth, Western Australia, Australia.|Faculty of Medicine, University of Western Australia, South Perth, Western Australia, Australia.
authors.forename: Paddy
authors.initials: P
authors.lastname: Hanrahan
authors.affiliation: Department of General Medicine and Infectious Diseases, Austin Health, Melbourne, Victoria, Australia.
authors.forename: Doug
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Department of Rheumatology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
authors.forename: Amel
authors.initials: A
authors.lastname: Katrib
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Victorian Infectious Disease Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
authors.affiliation: Private Rheumatology Practice, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Mona
authors.initials: M
authors.lastname: Marabani
authors.affiliation: Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia.|Institute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Peta
authors.initials: P
authors.lastname: Pentony
authors.affiliation: Illawarra Rheumatology and University of Wollongong Graduate School of Medicine, Wollongong, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Riordan
authors.affiliation: Private Rheumatology Practice, Sydney, New South Wales, Australia.
authors.forename: Ray
authors.initials: R
authors.lastname: White
authors.affiliation: Department of Rheumatology, Redcliffe Hospital, Brisbane, Queensland, Australia.|Redcliffe Northside Rheumatology, Brisbane, Queensland, Australia.
authors.forename: Laurel
authors.initials: L
authors.lastname: Young
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001315:Australia / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D014611:Vaccination / Q000379:methods*
chemical_list: D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents
keywords: biologics; immunosuppression; infection; rheumatic disease; vaccination