EULAR recommendations for vaccination in paediatric patients with rheumatic diseases

Area of Science:

• Rheumatology
• Immunology
• Vaccinology
• Public Health

Background:

• Paediatric patients with rheumatic diseases (PaedRD) are at increased risk of infections.
• Standardized vaccination protocols are crucial for managing this population.
• Existing guidelines require updates based on current evidence.

Purpose of the Study:

• To develop evidence-based vaccination recommendations for paediatric patients with rheumatic diseases (PaedRD).
• To synthesize current literature on vaccine safety and efficacy in this cohort.
• To identify research gaps in paediatric rheumatology vaccination.

Main Methods:

• Systematic literature review of MEDLINE, EMBASE, and major rheumatology conference abstracts (2008/9).
• EULAR (European Alliance of Associations for Rheumatology) standardised guideline development procedures.
• Delphi voting by a multidisciplinary task force to achieve consensus.

Main Results:

• Fifteen recommendations for vaccination in PaedRD were developed with 91.7% overall agreement.
• Literature primarily focused on seasonal influenza and pneumococcal vaccines.
• Limited studies specifically addressed paediatric populations, with a focus on adult rheumatoid arthritis and systemic lupus erythematosus.

Conclusions:

• Evidence-based vaccination recommendations for PaedRD have been established.
• Significant research gaps exist regarding the safety and immunogenicity of vaccinations, especially live-attenuated vaccines and in patients on biologicals.
• Further investigation is required to understand the impact of vaccination on infection prevention in PaedRD.