Vaccination in pediatric acquired inflammatory immune-mediated neuromuscular disorders
Nina Barišić1, Daniel Turudić2, Lorna Stemberger Marić3
1Department of Pediatrics, Clinical Medical Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia.
Insights
This study found no strong evidence linking pediatric vaccines to new or recurring immune-mediated neuromuscular disorders (NMD). Vaccination is generally safe for children with a history of these conditions, with specific precautions noted.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Background:
- Acquired inflammatory immune-mediated neuromuscular disorders (NMD) affect children.
- Vaccination safety and efficacy in this population require careful evaluation.
Purpose of the Study:
- To review literature on vaccine-associated disease induction, worsening, or recurrence in pediatric NMD.
- To assess vaccine safety and efficacy in pediatric patients with NMD.
Main Methods:
- Comprehensive literature search (Medline, PubMed, Scopus) from 1975-2020.
- Focused on pediatric vaccination and specific NMDs: Guillain-Barré syndrome (GBS), Bell's palsy, optic neuritis (ON), myasthenia gravis (MG), chronic inflammatory demyelinating polyneuropathy (CIDP), and immune-mediated inflammatory myopathy (IM).
- Included peer reviews, meta-analyses, and epidemiological studies.
Main Results:
- No robust evidence supports a link between pediatric vaccines and the onset or recurrence of GBS, Bell's palsy, ON, juvenile MG, CIDP, or IM.
- Inactivated vaccines are considered safe for children with a history of these NMDs.
Conclusions:
- Vaccination is generally safe for pediatric NMD patients, with specific vaccine recommendations and precautions.
- Live vaccines should be administered before immunosuppressive therapy.
- Revaccination may be needed for immunosuppressed patients with low antibody titers.
Aim:
To analyse literature data on vaccine related induction, worsening of the disease and disease reccurrences as well as vaccine safety and efficacy among pediatric patients with acquired inflammatory immune-mediated neuromuscular disorders (NMD).
Methods:
Medline, Pub Med and Scopus database search from 1975 to 2020 focused on pediatric age was conducted including peer reviews, meta analyses and epidemiological studies on vaccination and Guillain-Barré syndrome (GBS), Bell's palsy, optic neuritis (ON), myasthenia gravis (MG), chronic inflammatory demyelinating polyneuropathy (CIDP) and immune-mediated inflammatory myopathy (IM).
Results And Conclusion:
s: There are no strong evidence supporting relationship between vaccination with different pediatric vaccines and development of first episodes or reccurrences of GBS, Bell's palsy, optic neuritis (ON), juvenile MG, CIDP, and IM. The vaccination and revaccination with inactivated vaccines is considered safe in children with medical history of GBS, Bell's palsy, ON, MG and IM. Caution when immunization against influenza, quadrivalent conjugated meningococcal vaccine (MCV4) and pneumococcal disease and avoiding tetanus toxoid immunization in CIDP patients is suggested. Patients with immune mediated acquired NMD should be vaccinated with live vaccines before the initiation of immunosupressive treatment. Immunosuppressed patients with low protective antibody titers should be considered for revaccination.
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