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EULAR/PRES recommendations for vaccination of paediatric patients with autoimmune inflammatory rheumatic diseases:

Marc H A Jansen1,2, Christien Rondaan3, Geertje E Legger2,4

  • 1Department of Paediatric Immunology & Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands m.h.a.jansen@umcutrecht.nl.

Annals of the Rheumatic Diseases
|June 20, 2022
PubMed

Insights

Updated EULAR recommendations emphasize safe vaccination for children with autoimmune/inflammatory rheumatic diseases (AIIRD) on immunosuppressants. Non-live vaccines are generally safe, while live vaccines require careful consideration for immunocompromised pediatric patients.

Area of Science:

  • Rheumatology and Immunology
  • Vaccinology
  • Pediatric Health

Background:

  • Autoimmune/inflammatory rheumatic diseases (AIIRD) in children often require immunosuppressive therapies.
  • Vaccination is crucial for infection prevention in immunocompromised pediatric populations.
  • Existing vaccination guidelines needed updating due to new safety and immunogenicity data.

Approach:

  • EULAR standard operating procedures were followed.
  • Two international expert committees reviewed literature and formulated recommendations.
  • Separate guidelines were developed for pediatric and adult patients with AIIRD.

Key Points:

  • National Immunisation Programmes (NIP) should be followed and assessed annually.
  • Vaccinations are best given before immunosuppressants, but treatment should not be delayed.
  • Non-live vaccines are safe for immunosuppressed pediatric AIIRD patients, with preserved seroprotection.
  • Live-attenuated vaccines should generally be avoided in immunosuppressed patients, with specific exceptions.
  • Seasonal influenza vaccination is strongly recommended for immunosuppressed pediatric AIIRD patients.

Conclusions:

  • These updated recommendations aim to ensure safe and effective vaccination for immunocompromised pediatric patients with AIIRD.
  • Optimal infection prevention strategies are essential for this vulnerable population.
  • The guidelines are intended for healthcare providers, immunisation agencies, and patient advocacy groups.
Abstract

Keywords:
Arthritis, JuvenileAutoimmune DiseasesBiological TherapyImmune System DiseasesVaccination

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