Vaccination is the most effective preventive measure against infection and as such extremely important in children who are immunocompromised because of treatment with immunomodulatory drugs. Children with rheumatic diseases are commonly treated with such drugs so infections present a major danger for their health. Risk of disease flare, uncertainty about long-term protection after vaccination, and risk of disseminated infection after vaccination with live attenuated vaccine should be taken into account. In general, there are no major safety concerns for vaccination with non-live vaccines in paediatric patients with rheumatic diseases, regardless the therapy, but live attenuated vaccines should be withheld in children with rheumatic diseases treated with immunomodulatory drugs. However, in a case of a high risk of infection, vaccination can be considered on a case-to-case basis. A recent multicentre retrospective study conducted by PRES Vaccination working party provided some evidence about the safety of booster MMR dose in children with rheumatic diseases treated with immunomodulatory therapy, including biologics. However, larger multicentre prospective studies are needed to provide more firm evidence about safety and efficacy of MMR vaccine in these patients.
Speaker: Prof. Natasa Toplak, Children's Hospital, Univ. Medical Center Ljubljana, Slovenia
Moderator: Prof. Yosef Uziel, Meir Medical Center, Kfar Saba, Tel Aviv, Israel
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