Vaccination in adults with autoimmune rheumatic diseases

Abstract

1 Vaccination status should be assessed at diagnosis and periodic examinations in patients with rheumatic diseases Patients with rheumatic disease have 1.4-2.0 times the risk of infection as the general population. 1 Although vaccination is recommended for all patients with rheumatic disease, uptake is suboptimal. 2 2 Inactivated vaccines are safe and generally effective in patients receiving disease-modifying antirheumatic drugs Inactivated vaccines, including influenza, pneumococcal, tetanus, human papillomavirus, Haemophilus influenzae type B, meningococcal and hepatitis A and B, are safe in patients receiving conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and biologic DMARDs. 2 Data on vaccine response in patients receiving DMARDs are limited. Meta-analysis suggests diminished response to pneumococcal vaccination with methotrexate but not tumour necrosis factor inhibitors. 3