New study debunks theoretical risks of live-attenuated vaccines in children with rheumatic diseases

  • Uziel Y, et al.
  • EULAR 2019
  • 13 Jun 2019

  • curated by Priscilla Lynch
  • Univadis
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No vaccine-related infections or disease flares occurred in paediatric rheumatic patients who received live-attenuated booster vaccination while taking immune-suppressing therapies, according to a study presented at the Annual European Congress of Rheumatology (EULAR 2019), jointly organised with the Paediatric Rheumatology Society (PReS).

Patients with rheumatic disease on immune-suppressing therapies are being offered live-attenuated MMR (measles, mumps, rubella) or MMRV (MMR, varicella) boosters by some doctors in light of recent measles epidemics in Europe and the United States.

This retrospective study identified 234 such patients from 13 paediatric centres across 10 countries.

Their mean age was five years; 70 per cent were female. The vast majority had juvenile idiopathic arthritis (n=206) with disease activity considered low, moderate and high in 38, 7, and 2 per cent, respectively.

Live-attenuated MMR or MMRV booster vaccine was given to: 110 patients on methotrexate with three reporting mild injection-site reactions; 76 patients on methotrexate plus anti-tumour necrosis factor (TNF) drugs with seven reporting mild transient adverse events; and 39 patients on an anti-TNF alone with one reporting fever. The remaining patients used other biologic therapies (tocilizumab, anakinra, and canakinumab).

No disease flares or vaccine-related infections were reported.

The PReS vaccination study group now plans a large, prospective data collection study.