Safety and efficacy of meningococcal c vaccination in juvenile idiopathic arthritis

Abstract

Objective. To determine whether vaccinations aggravate the course of autoimmune diseases such as juvenile idiopathic arthritis (JIA) and whether the immune response to vaccinations may be hampered by immunosuppressive therapy for the underlying disease.Methods. In this multicenter cohort study, 234 patients with JIA (ages 1-19 years) were vaccinated with meningococcal serogroup C (MenC) conjugate to protect against serogroup C disease (caused by Neisseria meningitidis). Patients were followed up for disease activity for 1 year, from 6 months before until 6 months after vaccination. IgG antibody titers against MenC polysaccharide and the tetanus carrier protein were determined by enzyme-linked immunosorbent assay and toxin binding inhibition assay, respectively. A serum bactericidal assay was performed to determine the function of the anti-MenC antibodies.Results. No change in values for any of the 6 components of the core set criteria for juvenile arthritis disease activity was seen after MenC vaccination. Moreover, no increase in the frequency of disease relapse was detected. Mean anti-MenC IgG concentrations in JIA patients rose significantly within 6-12 weeks after vaccination. Of 157 patients tested, 153 were able to mount anti-MenC IgG serum levels >2 g/ml, including patients receiving highly immunosuppressive medication. The 4 patients with a lower anti-MenC antibody response displayed sufficient bactericidal activity despite receiving highly immunosuppressive medication.Conclusion. The MenC conjugate vaccine does not aggravate JIA disease activity or increase relapse frequency and results in adequate antibody levels, even in patients receiving highly immunosuppressive medication. Therefore, patients with JIA can be vaccinated safely and effectively with the MenC conjugate.

Kinetics of the long-term antibody response after meningococcal C vaccination in patients with juvenile idiopathic arthritis: a retrospective cohort study

“…The safety and short-term immunogenicity of the NeisVac-C vaccine has been studied previously in 234 JIA patients 10. The vaccine was found to be safe with no effect on disease activity, and showed good short-term immunogenicity with all patients having protective functional antibodies (SBA titre ≥8).…”

“…The MenCC vaccine has proven to induce MenC-specific antibodies with bactericidal capacity in all JIA patients at 3 months after vaccination 10. However, the long-term persistence of MenC-specific antibodies is still uncertain 9.…”

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.…”

Safety of measles, mumps and rubella vaccination in juvenile idiopathic arthritis

“…Vaccinated healthy children were shown to experience more limb symptoms after the measles, mumps and rubella (MMR) vaccination, and a small number developed acute arthritis 3. The meningococcal C, influenza and hepatitis B vaccines seem to be safe to use in patients with juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA) 4 – 6…”