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Vaccinations in Rheumatology

  • Paul A. Bryant
  • Anoma Nellore
  • John W. Baddley
Chapter

Abstract

Immunization against vaccine-preventable diseases has improved morbidity and mortality for a wide range of patient populations, including both children and adults with rheumatic diseases. While patients with rheumatic diseases are at increased risk for infections at baseline, the addition of immunosuppressive therapy amplifies this risk. Inactivated vaccines (e.g., influenza, pneumococcus) are generally safe, while many live vaccines (e.g., MMR, zoster) are contraindicated depending on the degree of immunosuppression (e.g., conventional DMARDs vs. TNF inhibitors). This chapter will provide vaccine-specific recommendations and summarize host immune response and vaccine safety and efficacy among patients with rheumatic diseases.

Keywords

Immunization Immunocompromised Hepatitis Human papilloma virus Influenza Pneumococcus Rheumatic diseases Varicella Varicella Zoster 

Abbreviations

ABT

Abatacept

ACIP

Advisory Committee on Immunization Practices

HAV

Hepatitis A virus

HBV

Hepatitis B virus

HPV

Human papilloma virus

HZ

Herpes zoster

JIA

Juvenile idiopathic arthritis

LAIV

Live attenuated influenza vaccine

MMR

Measles mumps and rubella (vaccine)

MSM

Men who have sex with men

MTX

Methotrexate

PCV

Pneumococcal conjugate vaccine

PPSV

Pneumococcal polysaccharide vaccine

PsA

Psoriatic arthritis

Pso

Psoriasis

PY

Person-years

RA

Rheumatoid arthritis

RD

Rheumatic diseases

RTX

Rituximab

SLE

Systemic lupus erythematosus

TAC

Tacrolimus

TNF-I

Tumor necrosis factor inhibitors

VZV

Varicella zoster virus

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Paul A. Bryant
    • 1
  • Anoma Nellore
    • 1
  • John W. Baddley
    • 1
    • 2
  1. 1.Department of Medicine, Division of Infectious DiseasesUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Medical Service, Birmingham VA Medical CenterBirminghamUSA

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