Hepatitis B vaccination in children with juvenile idiopathic arthritis

Abstract

Objectives: To evaluate the responsiveness of children with juvenile idiopathic arthritis (JIA) to hepatitis B vaccination and to determine the most useful vaccination schedule. Methods: 39 children with JIA were enrolled in the study; all were in remission and negative to serological testing for hepatitis B surface antigen (HbsAg). The control group consisted of 41 healthy children. There were two different vaccination schedules: group I was vaccinated at 0, 1, and 3 months; group II was vaccinated at 0, 1, and 6 months. Positive responsiveness to the vaccine was defined as an anti-hepatitis B antibody titre above 10 mIU/ml. Results: All the children except one with systemic JIA developed an antibody response. None of the JIA patients experienced a flare up or clinical deterioration related to the vaccination. The antibody levels in children with JIA were significantly lower than in the healthy controls. Comparison of the antibody levels between the two vaccination schedules showed no statistical difference in the controls; in the JIA subjects the group II schedule resulted in a trend to a greater response than the group I schedule (p,0.07). Vaccine responsiveness was not influenced by either methotrexate or prednisolone treatment. Conclusions: Children with JIA had an adequate response to hepatitis B vaccination and the response was not affected by immunosuppressive treatment. A vaccination schedule at 0, 1, and 6 months seems to be preferable to 0, 1, and 3 months.

Glucocorticoid: Major Factor for Reduced Immunogenicity of 2009 Influenza A (H1N1) Vaccine in Patients with Juvenile Autoimmune Rheumatic Disease

“…The preimmunization rate cannot account for this finding because it was similar to that of the control group. In contrast, previous reports suggest apparently adequate vaccine responses for seasonal influenza 8 and hepatitis 27 in persons with JIA. The inclusion of patients or controls younger than age 9 years 8,27 and 3 years old 8 precludes a definitive conclusion about their findings, as vaccine responses in these 2 age brackets are expected to be much lower than in older children.…”

Safety and immunogenicity of varicella vaccine in patients with juvenile rheumatic diseases receiving methotrexate and corticosteroids

“…Both of them showed that the measles, mumps, and rubella booster vaccination was safe in JIA patients, including those who were taking prednisone, MTX, or etanercept (17,18). Studies of effects of inactivated vaccines, including influenza vaccine (19,20), hepatitis B vaccine (21), and meningococcal C vaccine (22), have not shown changes in disease activity or an increase in the occurrence of flares after vaccination in patients with JIA.…”

New advances in juvenile idiopathic arthritis

“…(28,29) In a prospective study evaluating the effectiveness of hepatitis B vaccination in children with JIA, no children were found to experience disease flare-up or clinical deterioration after vaccination. (30) In another study, Borte et al reported that there was no worsening of disease activity or any increase in medication use after children with JIA (being treated with anti-inflammatory medications including methotrexate and etanercept) received live-attenuated measles, mumps, and rubella vaccinations. (31) Vitamin D plays an important role in modulating the human immune system.…”