Immunizations in adult patients with systemic sclerosis

Immunizations are among the most efficient interventions available to prevent infectious diseases. However, there are no specific recommendations regarding vaccination in patients with systemic sclerosis (SSc). The aim of this review is to propose guidelines concerning immunization for patients with SSc. For SSc patients routine vaccine coverage should be assessed, including live vaccines, which are contraindicated after immunosuppressive therapy initiation; immunization against influenza and pneumococcus should be given especially in patients with pulmonary involvement and those receiving immunosuppressive therapy. To limit the risk of vaccine-preventable disease transmission to SSc patients, immunization of close contacts and healthcare professionals against influenza, measles-mumps-rubella, and varicella should be offered routinely. In conclusion, there is potential for serious illness and death in the underimmunization of high-risk patients, including those with SSc, and every effort should be made to ensure adequate protection through immunization.