Analysis of the Juvenile Idiopathic Arthritis Immunization Schedule

Намазова-Баранова, Л С; Валиева, С. И.; Владиславовна, Федосеенко Марина; Новикова, Д. А.; Ткаченко, Н. Е.; Гайворонская, А. Г.; Броева, М. И.; Калюжная, Т. А.; Шахтахтинская, Ф. Ч.; Алексеева, Е. И.; Исаева, К. Б.

doi:10.15690/pf.v13i4.1604

Cited by 3 publications

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References 17 publications

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“…В Российском ретроспективном исследовании вакцинального статуса детей с ЮИА было установлено, что все дети были однократно привиты в раннем неонатальном периоде вакциной БЦЖ-М. В последующем нарушения графика вакцинации (незаконченная схема первичной серии иммунизации, отсутствие необходимых по возрасту бустерных вакцин) отмечены у 32/44 (73%) детей, что существенно превышает данные европейских и североамериканских исследований [30]. Среди причин несоблюдения положенной схемы иммунизации указаны: намеренный отказ родителей от проведения профилактической прививки; сопутствующие интеркуррентные инфекции у ребенка; манифестация основного заболевания.…”

Section: Discussionunclassified

“…Вакцинация как пусковой фактор развития ревматического заболевания, по мнению родителей, была в 16% случаев, причем только в 7% случаях связь вакцинации с дебютом ЮИА представлялась возможной: у 2 детей -в течение 7 дней после вакцинации АКДС, у 1 ребенка -в поствакцинальном периоде (до 28 сут.) прививки против кори, краснухи, паротита [30]. Аналогичные изменения описаны и у других иммуносупрессированных пациентов, помимо вышеописанных пациентов с ЮИА [31].…”

Section: Discussionunclassified

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The main factors, associated with incomplete vaccination againts measels, parotitis, rubella, and diphtheria in 170 juvenile idiopathic arthritis patients: the results of prospective pilot study

Lybimova

Фридман

Голева

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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Background. Patients with juvenile idiopathic arthritis (JIA) may have incomplete vaccination againts different vaccines leads to lower protective levels of anti-vaccine antibodies.The aim of the study – to evaluate the rate and the main factors of incomplete vaccination against measels, parotitis, rubella (MMR), and diphtheria in JIA patients.Methods. In the present study were included data 170 JIA (55 boys and 115 girls) aged from 2 to 17 years, who received scheduled vaccination before the age of 2 years and before JIA onset against measles, parotitis, diphtheria and rubella. Incomplete vaccination means the reduced number of vaccine to age. In all patients the IgG anti-vaccine antibodies levels were detected with ELISA. Data presented with odds ratio ()OR) with 95 confidence interval (CI).Results. Incomplete vaccination against MMR was in 50 (32.5%) of children less than 6 years. Incomplete vaccination against diphtheria was in 6/16 (37.5%) of children less than 6 year, in 53/110 (48.2%) of children aged 6–14 years and in 26/44 (59.1%) of the JIA patients more than 14 years. The main predictors in logistic regression for incomplete vaccination for MMR were: onset age <4 years (OR=12.2 [95% CI: 5.0–28.9]; p=0.0000001), JIA duration >3.1 years (OR=4.4 [95% CI: 2.0–9.9]; p=0.0002), methotrexate duration >3 years (OR=5.7 [95% CI 2.7–12.0]; p=0.0000012); biologic treatment (OR=2.5 [95% CI: 1.3–4.9]; p=0.008) and treatment >1 biologic (OR=3.3 [95% CI: 1.1–10.4]; p=0.002); for diphtheria were: JIA duration >3.1 years (OR=3.4 [95% CI: 1.8–6.5]; p=0.0002), methotrexate duration >2.8 years (OR=4.1 [95% CI: 2.1–8.1]; p=0.00004), biologic treatment (OR=2.4 [95% CI: 1.3–4.4]; p=0.006). In the multiple regression only JIA onset age (p=0.00001) and duration of methotrexate (p=0.003) were predictors of incomplete vaccination against MMR. Methotrexate duration (p=0.005) and biologics treatment (p=0.05) were predictors of incomplete vaccination against diphtheria.Conclusion. The main predictor of incomplete vaccination was younger onset age of JIA. Children received more intensive immunosupression usually have scheduled vaccination rarely which leads to increased number of patients without protective antibody levels. These facts indicate the attitude of physicians parents to vaccination in immunocompromised children. Further investigations required for assessment of safety of vaccinations in children with rheumatic diseases may be a factor for changing this prejudice.

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Section: Discussionunclassified

The main factors, associated with incomplete vaccination againts measels, parotitis, rubella, and diphtheria in 170 juvenile idiopathic arthritis patients: the results of prospective pilot study

Lybimova

Фридман

Голева

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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Effectiveness and Safety of Vaccination in Patients with Juvenile Idiopathic Arthritis

Фридман¹,

Lyubimova

Kostik

et al. 2021

Pediatr. farmakol.

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Background. Vaccination is the most effective method for reducing morbidity, disability, mortality from of various infections. However, there was a view for a long time that vaccines are ineffective and unsafe to use in people with rheumatological diseases, including juvenile idiopathic arthritis (JIA). Objective.The aim of the study is to analyze literature data on safety and efficacy of vaccination for JIA patients with live and non-live vaccines.Methods: literature analysis was based on data from medical databases PubMed and Google Scholar.Results. Both live and non-live vaccines are safe and immunogenic enough for children with JIA. Most studies confirm vaccination efficacy in patients with JIA when using glucocorticosteroids (GCS) and methotrexate, while therapy with disease-modifying antirheumatic drugs (DMARD) can reduce antibody titers over time. In general, antibodies levels preservation in previously vaccinated children with JIA is less than in global population. This indicates the need to administer booster doses for such patients. No adverse effects on the course of primary disease after vaccination and no post-vaccine complications were revealed.Conclusion. Vaccination of patients with JIA should be performed with reference to the therapy that the patient already receives, under the control of antibodies level. Booster doses should be implemented in case of titers decrease below the protective levels.

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Safety of antibodies to measles, mumps, rubella and diphtheria in patients with juvenile idiopathic arthritis

Фридман

Lybimova²,

Голева

et al. 2021

jour

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Introduction. The issue of protection against vaccinepreventable diseases has acquired new urgency in connection with the decrease in the vaccination rate established by WHO against the background of the COVID-19 pandemic. This creates the conditions for outbreaks and puts patients with immunopathological diseases at particular risk, who are most often not vaccinated from the moment of diagnosis Purpose of the study – to assess the safety of specific antibodies to measles, mumps, rubella and diphtheria in children with JIA, depending on the duration of vaccination, the duration of the disease and the therapy received.Materials and methods. The vaccination rate of 171 children with juvenile idiopathic arthritis (JIA) aged (11,31±0,31 years) with the duration of the disease at the time of examination was 4,69±0,29 years, who had previously received 1-2 vaccinations against measles, mumps, rubella and 3-6 vaccinations against diphtheria. Antibodies to these infections were determined by ELISA.Results. 42.1% of children had no protective titers of antibodies to measles, 19,9% – to mumps, 9,4% – to rubella and 16,4% – to diphtheria. Among 93 vaccinated and revaccinated patients, there were no protective titers of antibodies to measles – 40,9% (38 children), mumps – 13,9% (13 people), rubella – 5,4% (5 children), and among 78 vaccinated once, respectively: measles – 43.6% (34 children), mumps – 25.6% (20 children), rubella – 14,1% (11). The level of protection against diphtheria was comparable for those who received 3-5 vaccinations. Depending on the therapy, 3 groups were identified: group 1-71 children received metatrexate and glucocorticosteroids, 2-82 children received modifying anti-rheumatic drugs (DMARD) and 18 children without this therapy (Group 3). Children of the 2nd group were on average older (12,48±0,42 years) than in the 1st and 3rd groups (10,04±0,48 and 10,96±0,96 years, respectively), they had significantly more frequent systemic variant and polyarthritis (64,6% compared to 36,6% and 16,7%, px2<0,001). The number of vaccine doses received by children in all groups before the onset of the disease did not significantly differ. >˂0,001). The number of vaccine doses received by children in all groups before the onset of the disease did not significantly differ. The average level of antibodies to measles in children of group 2 (0,32±0,07 IU/ml) was 2,8 times less than in group 3 and significantly less than in group 1 (0,78±0,16, Pt=0.009), the average value of antibodies to rubella was also significantly less in group 2 (84,48±7,34 IU/ml) than in group 1 (109,73±8,09, Pt=0,022) and in group 3 (120,01±15,42, Pt=0,042). The analysis showed that the safety of antibodies to antigens of live vaccines, especially against measles, is negatively affected by the duration of the disease and the nature of therapy. Children who received combined therapy with anti-TNF, anti-IL-6 and anti-CD-80 drugs had a longer duration of the disease (7,5±0,97 years)=0,00082 compared to those who received only anti-IL-6 (2,9±0,7 years) and antiTNF therapy (6,1±0,5 years) and with a comparable number of vaccine doses received, significantly lower average values of antibodies and a larger number of unprotected ones.Conclusions. The duration of the disease, the lack of timely age-related revaccinations, as well as the presence of combination therapy aimed at suppressing various mechanisms of the immune response in children with JIA are factors that lead to an increase in the number of unprotected from controlled infections. Immunity to measles suffers the most – 40.9% of revaccinated people are unprotected.

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Analysis of the Juvenile Idiopathic Arthritis Immunization Schedule

Cited by 3 publications

References 17 publications

The main factors, associated with incomplete vaccination againts measels, parotitis, rubella, and diphtheria in 170 juvenile idiopathic arthritis patients: the results of prospective pilot study

The main factors, associated with incomplete vaccination againts measels, parotitis, rubella, and diphtheria in 170 juvenile idiopathic arthritis patients: the results of prospective pilot study

Effectiveness and Safety of Vaccination in Patients with Juvenile Idiopathic Arthritis

Safety of antibodies to measles, mumps, rubella and diphtheria in patients with juvenile idiopathic arthritis

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