Marcia A Friedman1, Kevin Winthrop. 1. aDepartment of Rheumatology bDepartment of Infectious Diseases, Oregon Health and Science University, Portland, Oregon, USA.
Abstract
PURPOSE OF REVIEW: Rheumatoid arthritis (RA) patients experience increased infectious disease-related morbidity and mortality, and vaccinations represent an important element in their care. However, vaccine immunogenicity can be affected by disease-modifying antirheumatic drug (DMARD) therapy, such that vaccine choice and timing can be clinically challenging. We review the indications, safety, and immunogenicity of vaccines in the setting of RA. RECENT FINDINGS: Recent recommendations highlight the use of influenza, pneumococcal, and shingles vaccines in RA patients. Studies suggest influenza and pneumococcal vaccines are underutilized, but well tolerated in RA patients and generally immunogenic during DMARD use with the exception of rituximab. Though data for other nonlive vaccines are more limited, hepatitis B virus and human papilloma virus vaccines also appear well tolerated and immunogenic in this population. Live vaccines for shingles and yellow fever remain contraindicated in some RA patients; however, limited data suggest they might be well tolerated in certain individuals. SUMMARY: The review updates rheumatologists on the optimal use and timing of routine vaccinations in the care of RA.
PURPOSE OF REVIEW: Rheumatoid arthritis (RA) patients experience increased infectious disease-related morbidity and mortality, and vaccinations represent an important element in their care. However, vaccine immunogenicity can be affected by disease-modifying antirheumatic drug (DMARD) therapy, such that vaccine choice and timing can be clinically challenging. We review the indications, safety, and immunogenicity of vaccines in the setting of RA. RECENT FINDINGS: Recent recommendations highlight the use of influenza, pneumococcal, and shingles vaccines in RApatients. Studies suggest influenza and pneumococcal vaccines are underutilized, but well tolerated in RApatients and generally immunogenic during DMARD use with the exception of rituximab. Though data for other nonlive vaccines are more limited, hepatitis B virus and human papilloma virus vaccines also appear well tolerated and immunogenic in this population. Live vaccines for shingles and yellow fever remain contraindicated in some RApatients; however, limited data suggest they might be well tolerated in certain individuals. SUMMARY: The review updates rheumatologists on the optimal use and timing of routine vaccinations in the care of RA.
Authors: Viviane Ta; Orit Schieir; Marie-France Valois; Ines Colmegna; Carol Hitchon; Louis Bessette; Glen Hazlewood; Carter Thorne; Janet Pope; Gilles Boire; Diane Tin; Edward C Keystone; Vivian P Bykerk; Susan J Bartlett Journal: ACR Open Rheumatol Date: 2022-03-29
Authors: Kevin L Winthrop; Ann G Wouters; Ernest H Choy; Koshika Soma; Jennifer A Hodge; Chudy I Nduaka; Pinaki Biswas; Elie Needle; Sherry Passador; Christopher F Mojcik; William F Rigby Journal: Arthritis Rheumatol Date: 2017-09-06 Impact factor: 10.995