EULAR update on vaccination in autoimmune inflammatory rheumatic diseases


  • Dawn O'Shea
  • Univadis Medical News
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The European League Against Rheumatism (EULAR) has published updated recommendations for vaccination of patients with autoimmune inflammatory rheumatic diseases (AIIRD).

The update includes six overarching principles as follows:

  • Rheumatology team should assess vaccination status yearly.
  • Rheumatology team should explain individualised vaccination programmes to patients and implement programmes jointly with the primary care physician and the patient.
  • Preferably administer vaccination during quiescent disease.
  • Preferably, vaccinate prior to planned immunosuppression, especially B-cell depleting therapy.
  • Non-live vaccines can be administered during treatment with glucocorticoids and disease-modifying antirheumatic drugs (DMARDs).
  • Consider live-attenuated vaccines with caution.

The updated recommendations are:

  • Consider influenza vaccination for most patients.
  • Consider pneumococcal vaccination for most patients.
  • Tetanus toxoid vaccination as per recommendations for the general population. Consider passive immunisation with B-cell depleting therapy.
  • At-risk patients should receive hepatitis A and B vaccination.
  • Consider herpes zoster vaccination in high-risk patients.
  • Generally, avoid yellow fever vaccination.
  • Administer human papillomavirus vaccination, especially in patients with systemic lupus erythematosus, as per recommendations for the general population.
  • Immunocompetent household members should be encouraged to be vaccinated according to national guidelines, except oral polio vaccines.
  • Avoid live-attenuated vaccines during the first six months of life in newborns of mothers treated with biologics during the second half of pregnancy.

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