Influenza and pneumococcal vaccinations of patients with systemic lupus erythematosus: Current views upon safety and immunogenicity

International and multidisciplinary expert recommendations for the use of biologics in systemic lupus erythematosus

“…The fourth important objective was to address specific situations in current practice usually excluded in randomized clinical trials, mainly antiphospholipid syndrome, pregnancy, and vaccinations (20,42). Previous treatment, information given to patients and when needed, the advice of reference centers for autoimmune diseases, were emphasized in these recommendations.…”

Prevention of Infection in Lupus Patients

“…Regardless of the cause of infections, adequate and prompt recognition and proper treatment of the infected patient are imperative [3]. Empiric therapy should be initiated for suspected bacterial infection, covering the most common and most deadly pathogens.…”

“…The risk is also dependent on the degree of immunosuppression [8][9][10]. SLE patients may develop common bacterial opportunistic infections particularly of the respiratory and urinary tracts [3]. Opportunistic infections such as pneumocystis (PCP) are associated with mortality as high as 46% [5,6].…”

“…The treatment includes the use of non-steroidal anti-inflammatory and anti-malarial drugs, corticosteroids and immunosuppressive agents [3]. Despite great improvements in reducing mortality in SLE, the mortality due to infections remains unchanged, constituting the cause of death in 1 out of 3 SLE patients [3][4][5].…”

Will studies in individuals with systemic lupus erythematosus be the key to future HIV vaccine design?

“…We believe that HIV-1 antibodies can be induced in a safe manner. Antigen-specific responses are commonly elicited in SLE subjects upon vaccination with well-characterized vaccines, such as the influenza and pneumococcal vaccines, even though at lower titers than the general population (recently reviewed in [22]) and comparing the immunogenicity of HIV-1 vaccine candidates – both at plasma and at single-cell levels – in people with and without SLE could provide valuable information to elucidate the direct contribution of dysregulations of tolerance mechanisms in shaping the immunogen-specific antibody repertoire in terms of antibody functions, maturation and B-cell populations targeted upon vaccination.…”