REVIEW - Vaccination in patients with chronic rheumatic or autoimmune diseases

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Clin Infect Dis. 2008 May 1;46(9):1459-65.

Vaccination in patients with chronic rheumatic or autoimmune diseases.

Glück T, Müller-Ladner U.

Department of Internal Medicine, District Hospital Trostberg, Germany.

Patients who have chronic rheumatic or autoimmune diseases, such as

rheumatoid arthritis, systemic lupus erythematosus, or vasculitides,

show a risk of infection that is at least 2-fold greater than that for

healthy individuals. This increased risk is not only a result of the

aberrant immunologic reaction itself but also can be attributed to the

immunosuppressive therapy required to control the activity of the

underlying disease and the associated organ complications. Vaccination

is an option for a substantial number of these infections. In this

context, pneumococcal and influenza vaccines are the best evaluated

and are recommended by standard vaccination guidelines. Some studies

have found mildly impaired immune responses to vaccines among patients

receiving long-term immunosuppressive therapy, but postvaccination

antibody titers are usually sufficient to provide protection for the

majority of immunized individuals. The accumulated data on the safety

and effectiveness of vaccines warrant immunization with the majority

of vaccines for patients with chronic autoimmune or rheumatic

diseases, especially vaccination against influenza and pneumococci.

Vaccination protocols for this population should be better implemented

in daily clinical practice.

PMID: 18419456

http://www.ncbi.nlm.nih.gov/pubmed/18419456

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