Suboptimal vaccination coverage of recommended vaccines among French children with recurrent autoinflammatory fever syndromes: a study from the Juvenile Inflammatory Rheumatism cohort

Rollet-Cohen, Virginie; Mirete, J Ortuño; Dingulu, Glory; Hofer, François; Hofer, Michaël; Woerner, Andreas; Dommergues, Marie‐Aliette; Hentgen, Véronique

doi:10.1007/s10067-020-05553-y

Cited by 8 publications

(9 citation statements)

References 34 publications

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“…Another study reported a coverage rate for children on bDMARDs of only 46% compared with 65% for patients on csDMARDs and 84% for patients who never received immunosuppressive therapy 58. For patients with autoinflammatory disease coverage numbers were even lower: complete immunisation according to the French vaccination programme was reached in only 32% of patients at 2 years, 28% at 7 years, 6% at 15 years 57. In addition, coverage of vaccines indicated specifically for risk groups, such as the pneumococcal and influenza vaccine for patients with SLE is low.…”

Section: Resultsmentioning

confidence: 99%

“…This overarching principle was also formulated to emphasise the importance of following the NIP in order to improve vaccination coverage. Vaccination coverage is still very low in pedAIIRD patients, although these patients are at increased risk of contracting infections that can be prevented by vaccinations 21 57. In 200 JIA patients complete vaccination according to schedule was identified in only 52% of patients at 2.5 years and 68% at 10.5 years of age 21.…”

Section: Resultsmentioning

confidence: 99%

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EULAR/PRES recommendations for vaccination of paediatric patients with autoimmune inflammatory rheumatic diseases: update 2021

et al. 2022

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ObjectivesRecent insights supporting the safety of live-attenuated vaccines and novel studies on the immunogenicity of vaccinations in the era of biological disease-modifying antirheumatic drugs in paediatric patients with autoimmune/inflammatory rheumatic diseases (pedAIIRD) necessitated updating the EULAR recommendations.MethodsRecommendations were developed using the EULAR standard operating procedures. Two international expert committees were formed to update the vaccination recommendations for both paediatric and adult patients with AIIRD. After a systematic literature review, separate recommendations were formulated for paediatric and adult patients. For pedAIIRD, six overarching principles and seven recommendations were formulated and provided with the level of evidence, strength of recommendation and Task Force level of agreement.ResultsIn general, the National Immunisation Programmes (NIP) should be followed and assessed yearly by the treating specialist. If possible, vaccinations should be administered prior to immunosuppressive drugs, but necessary treatment should never be postponed. Non-live vaccines can be safely given to immunosuppressed pedAIIRD patients. Mainly, seroprotection is preserved in patients receiving vaccinations on immunosuppression, except for high-dose glucocorticoids and B-cell depleting therapies. Live-attenuated vaccines should be avoided in immunosuppressed patients. However, it is safe to administer the measles–mumps–rubella booster and varicella zoster virus vaccine to immunosuppressed patients under specific conditions. In addition to the NIP, the non-live seasonal influenza vaccination should be strongly considered for immunosuppressed pedAIIRD patients.ConclusionsThese recommendations are intended for paediatricians, paediatric rheumatologists, national immunisation agencies, general practitioners, patients and national rheumatology societies to attain safe and effective vaccination and optimal infection prevention in immunocompromised pedAIIRD patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

EULAR/PRES recommendations for vaccination of paediatric patients with autoimmune inflammatory rheumatic diseases: update 2021

et al. 2022

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“…Whereas good to very good vaccination adherence to the NIP was assessed in children with JIA until school age, tetanus and diphtheria booster vaccination were more likely missed in JIA patients aged 7–11 and 12–17 years compared to healthy controls ( 19 ). For French children with fever syndromes the vaccination status according to the NIP was complete in 32% of patients aged 2 years, in 28% aged 7 years, in 6% at age of 15 years and in 44% of children at last outpatient visit ( 30 ). Bizjak et al reported vaccination data for 187 children with PRD ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

“…Diallo et al found that 13/118 children with chronic diseases (11%) had completely received their specific additional recommended vaccinations ( 29 ). Rollet-Cohen studied 14 children with AID and IST and none adhered to the specific additional recommended indication vaccinations against VZV, influenza or pneumococcal disease ( 30 ). Bizjak et al assessed at least one vaccination against VZV in 25/187 children with PRD (13.4%), in 8/187 children (4.3%) against pneumococcal disease and in 19/187 children (10.2%) against influenza at last clinical visit ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Vaccination completeness in children with rheumatic diseases: A longitudinal, observational multicenter cohort study in Switzerland

et al. 2022

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IntroductionChildren with pediatric inflammatory rheumatic diseases (PRD) have an increased infection risk. Vaccinations are effective to avoid vaccine-preventable diseases. This study aimed to assess the vaccination completeness in Swiss PRD patients stratified by immunosuppressive treatment (IST).Materials and methodsThis multicenter observational cohort study of PRD patients was performed in Basel, Geneva, Lucerne, Lausanne, and Zurich in PRD patients aged < 18 years included in the Juvenile Inflammatory Rheumatism Cohort. Completeness was assessed for i) the overall vaccination status (Swiss national immunization program (NIP) and specific additional PRD-recommended vaccinations), ii) for all and each vaccination of the NIP at PRD diagnosis and reference date (RefD) and iii) all and each specific additional PRD-recommended vaccination at RefD. Completeness was assessed over the disease course and stratified by IST.ResultsOf 616 eligible patients, 234 children were analyzed. Of these, 147 (63%) were girls. Median age at PRD diagnosis was 6.5 years (IQR 2.9–10.3) and 10.9 years at RefD (6.9–14.3). The median follow-up since PRD diagnosis was 3 years (1.1–5.5). 120/234 children received IST. At RefD, overall vaccination completeness was 3.8% (9/234 children), completeness for the NIP vaccinations was 70.1% (164/234 children; IST 65%, no IST: 75.4%) and for all specific additional PRD-recommended vaccinations was 3.8% (9/234 children; IST 2.5%; no IST 5.3%). Vaccination completeness against pneumococcal disease, hepatitis B virus, and human papilloma virus (HPV) was 50.4, 20, 37.9%, respectively. In 25/35 children with negative varicella zoster virus history vaccination status was complete (IST: 94.4%, no IST: 47%). Annual non-live influenza vaccination was complete in 24.2% of children during IST; adherence decreased over the disease course.DiscussionThis study identified a low overall vaccination completeness in children with PRD. Particularly, the completeness of specific additional PRD-recommended vaccinations was low. If not performed early after PRD diagnosis, vaccination status remained frequently incomplete. Close collaboration between pediatrician and rheumatologist to improve vaccination completeness is essential. Exchange of vaccination records, standardized assessment of specific PRD-recommended vaccinations and those of the NIP, and annual reminder for influenza vaccination are crucial to improve vaccination completeness in this vulnerable pediatric population.

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“…Unfortunately, no randomized, controlled trials have been performed for patients with SAIDs undergoing either live-attenuated or non-live vaccines, with or without immunosuppressive and biologic therapies. Indeed, the studies available on SAIDs are small, mostly descriptive, and report variable results depending on the type of vaccine used [ 38 , 43 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ].…”

Section: General Data On Vaccinations In Systemic Autoinflammatory Di...mentioning

confidence: 99%

Current Evidence on Vaccinations in Pediatric and Adult Patients with Systemic Autoinflammatory Diseases

et al. 2023

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Systemic autoinflammatory diseases (SAIDs) are defined by recurrent febrile attacks associated with protean manifestations involving joints, the gastrointestinal tract, skin, and the central nervous system, combined with elevated inflammatory markers, and are caused by a dysregulation of the innate immune system. From a clinical standpoint, the most known SAIDs are familial Mediterranean fever (FMF); cryopyrin-associated periodic syndrome (CAPS); mevalonate kinase deficiency (MKD); and periodic fever, aphthosis, pharyngitis, and adenitis (PFAPA) syndrome. Current guidelines recommend the regular sequential administration of vaccines for all individuals with SAIDs. However, these patients have a much lower vaccination coverage rates in ‘real-world’ epidemiological studies than the general population. The main purpose of this review was to evaluate the scientific evidence available on both the efficacy and safety of vaccines in patients with SAIDs. From this analysis, neither serious adverse effects nor poorer antibody responses have been observed after vaccination in patients with SAIDs on treatment with biologic agents. More specifically, no new-onset immune-mediated complications have been observed following immunizations. Post-vaccination acute flares were significantly less frequent in FMF patients treated with colchicine alone than in those treated with both colchicine and canakinumab. Conversely, a decreased risk of SARS-CoV-2 infection has been proved for patients with FMF after vaccination with the mRNA-based BNT162b2 vaccine. Canakinumab did not appear to affect the ability to produce antibodies against non-live vaccines in patients with CAPS, especially if administered with a time lag from the vaccination. On the other hand, our analysis has shown that immunization against Streptococcus pneumoniae, specifically with the pneumococcal polysaccharide vaccine, was associated with a higher incidence of adverse reactions in CAPS patients. In addition, disease flares might be elicited by vaccinations in children with MKD, though no adverse events have been noted despite concurrent treatment with either anakinra or canakinumab. PFAPA patients seem to be less responsive to measles, mumps, and rubella-vaccine, but have shown higher antibody response than healthy controls following vaccination against hepatitis A. In consideration of the clinical frailty of both children and adults with SAIDs, all vaccinations remain ‘highly’ recommended in this category of patients despite the paucity of data available.

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Suboptimal vaccination coverage of recommended vaccines among French children with recurrent autoinflammatory fever syndromes: a study from the Juvenile Inflammatory Rheumatism cohort

Cited by 8 publications

References 34 publications

EULAR/PRES recommendations for vaccination of paediatric patients with autoimmune inflammatory rheumatic diseases: update 2021

EULAR/PRES recommendations for vaccination of paediatric patients with autoimmune inflammatory rheumatic diseases: update 2021

Vaccination completeness in children with rheumatic diseases: A longitudinal, observational multicenter cohort study in Switzerland

Current Evidence on Vaccinations in Pediatric and Adult Patients with Systemic Autoinflammatory Diseases

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