Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations
Open accessAbstract
Aim: To present a systematic literature review (SLR) on efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD), aiming to provide a basis for updating the EULAR evidence-based recommendations. Methods: An SLR was performed according to the standard operating procedures for EULAR-endorsed recommendations. Outcome was determined by efficacy, immunogenicity and safety of vaccination in adult patients with AIIRD, including those receiving immunomodulating therapy. Furthermore, a search was performed on the effect of vaccinating household members of patients with AIIRD on the occurrence of vaccine-preventable infections in patients and their household members (including newborns). The literature search was performed using Medline, Embase and the Cochrane Library (October 2009 to August 2018). Results: While most investigated vaccines were efficacious and/or immunogenic in patients with AIIRD, some were less efficacious than in healthy control subjects, and/or in patients receiving immunosuppressive agents. Adverse events of vaccination were generally mild and the rates were comparable to those in healthy persons. Vaccination did not seem to lead to an increase in activity of the underlying AIIRD, but insufficient power of most studies precluded arriving at definite conclusions. The number of studies investigating clinical efficacy of vaccination is still limited. No studies on the effect of vaccinating household members of patients with AIIRD were retrieved. Conclusion: Evidence on efficacy, immunogenicity and safety of vaccination in patients with AIIRD was systematically reviewed to provide a basis for updated recommendations.
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Prior data show anti-CD20 therapy negatively impacts humoral response to various vaccines, though seroprotection can still occur in rituximab- and ocrelizumab-treated patients.
“Our findings are in line with the previously published data regarding the negative impact of anti-CD20 therapy on the humoral response to various vaccines, although seroprotection could be still achieved after vaccination in rituximab-treated 20 26 34-36 and ocrelizumab-treated 37 patients.”
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Müller, R., Maier, R., Höschler, K., Zambon, M. C. F. A., Ludewig, B., i, M. H., Schulze‐Koops, H., & von Kempis, J. (2013) · PubMed · Cited by 17 · see citing works
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Immunogenicity and safety of pneumococcal vaccination in patients with systemic sclerosis
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Flagged first, then by citations
Research works printed but not linked: 2
- Phillips B, Ball C, Sackett D, et al. Last update by Howick J.Oxford centre for evidence-based medicine -levels of evidence (March 2009), 2018.
- Polachek A, Korobko U, Mader-Balakirski N, et al. Immunogenicity and safety of vaccination against seasonal 2012 influenza virus among patients with psoriatic arthritis and psoriasis. Clin Exp Rheumatol 2015;33:181-6.
Cited by
Sorted by citations
Neuromuscular Diseases Care in the Era of COVID-19
Bertran Recasens, B., & Rubio, M. A. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.588929 · Cited by 43 · see citing works
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- Authors
- Rondaan, C., Furer, V., Heijstek, M. W., Agmon-Levin, N., Bijl, M., Breedveld, F. C., D’Amelio, R., Dougados, M., Kapetanovic, M. C., van Laar, J. M., Ladefoged de Thurah, A., Landewé, R., Molto, A., Müller-Ladner, U., Schreiber, K., Smolar, L., Walker, J., Warnatz, K., Wulffraat, N. M., van Assen, S., & Elkayam, O.
- Affiliations
- University Medical Center Groningen (NL)
- Tel Aviv University (IL)
- University Medical Center Utrecht (NL)
- Faculty of Medicine, Tel Aviv University Sackler, Tel Aviv, Israel
- Martini Ziekenhuis (NL)
- Leiden University Medical Center (NL)
- Sapienza University of Rome (IT)
- Sorbonne Paris Cité (FR)
- Lund University (SE)
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Rheumatology, Aarhus University Hospital, Aarhus, Denmark
- Amsterdam UMC Location University of Amsterdam (NL)
- Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France
- Rheumatology and Clinical Immunology, Giessen University, Giessen, Germany
- St Thomas' Hospital (GB)
- Patient Research Partner, Tel Aviv, Israel
- Patient Research Partner, Elgin, Scotland
- University Medical Center Freiburg (DE)
- Wilhelmina Children's Hospital (NL)
- Internal medicine (infectious diseases), Treant Care Group, Hoogeveen, The Netherlands
- Corresponding author
- Rondaan, Christien
- ORCID
- Venue
- RMD Open
- Publisher
- BMJ
- Published
- 2019-09
- Volume
- 5
- Issue
- 2
- Pages
- e001035
- ISSN
- 2056-5933 (ISSN-L)
- PMC
- PMC6744079
- OpenAlex
- W2972635716
- Cited by
- 154
- References
- 213
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 10 · 2023: 18 · 2022: 31 · 2021: 49 · 2020: 21 · 2019: 1 · 2017: 1
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- RMD Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by-nc)
- Pure Amsterdam UMC (acceptedVersion, cc-by-nc)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Lund University Publications (Lund University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Keywords
- vaccination, autoimmune inflammatory rheumatic diseases, vaccine efficacy, vaccine immunogenicity, vaccine safety, immunomodulatory therapy, immunosuppressants, vaccine-preventable diseases, EULAR recommendations, adults
- MeSH terms
- Immunogenicity, Vaccine, Adult, Autoimmune Diseases, Communicable Disease Control, Communicable Diseases, Humans, Immunosuppressive Agents, Rheumatic Diseases, Vaccination, Vaccines, Treatment Outcome, Antirheumatic Agents
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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