[Vaccination in chronic autoimmune and inflammatory rheumatic diseases]

Vaccine preventable infections occur more often in patients with autoimmune and chronic rheumatic diseases when compared to the general population. Most vaccines are immunogenic, efficacious and safe in those patients, even with immunosuppressive treatment, excluding rituximab. Live attenuated vaccines should be avoided in patients receiving long-term immunosuppressive therapy. The occurrence of adverse events and autoimmune phenomena is almost the same in vaccinated patients with rheumatic diseases and in vaccinated healthy individuals. A deeper research is needed regarding safety of vaccination and the influence of new immunomodulating drugs on efficacy of vaccination since the studies that were undertaken so far are retrospective or performed on small cohorts of patients. Evidence-based recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases developed by European League Against Rheumatism (EULAR) will help rheumatologists in making a decision about vaccinating their patients.