ITEM METADATA RECORD
Title: Vaccinations in patients with immune-mediated inflammatory diseases
Authors: Rahier, Jean-François ×
Moutschen, Michel
Van Gompel, Alfons
Van Ranst, Marc
Louis, Edouard
Segaert, Siegfried
Masson, Pierre
De Keyser, Filip #
Issue Date: Oct-2010
Publisher: Oxford University Press
Series Title: Rheumatology vol:49 issue:10 pages:1815-1827
Abstract: Patients with immune-mediated inflammatory diseases (IMID) such as RA, IBD or psoriasis, are at increased risk of infection, partially because of the disease itself, but mostly because of treatment with immunomodulatory or immunosuppressive drugs. In spite of their elevated risk for vaccine-preventable disease, vaccination coverage in IMID patients is surprisingly low. This review summarizes current literature data on vaccine safety and efficacy in IMID patients treated with immunosuppressive or immunomodulatory drugs and formulates best-practice recommendations on vaccination in this population. Especially in the current era of biological therapies, including TNF-blocking agents, special consideration should be given to vaccination strategies in IMID patients. Clinical evidence indicates that immunization of IMID patients does not increase clinical or laboratory parameters of disease activity. Live vaccines are contraindicated in immunocompromized individuals, but non-live vaccines can safely be given. Although the reduced quality of the immune response in patients under immunotherapy may have a negative impact on vaccination efficacy in this population, adequate humoral response to vaccination in IMID patients has been demonstrated for hepatitis B, influenza and pneumococcal vaccination. Vaccination status is best checked and updated before the start of immunomodulatory therapy: live vaccines are not contraindicated at that time and inactivated vaccines elicit an optimal immune response in immunocompetent individuals.
URI: 
ISSN: 1462-0324
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Clinical and Epidemiological Virology (Rega Institute)
Laboratory of Dermatology
Laboratory of Dermatoimmunology (+)
× corresponding author
# (joint) last author

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