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Influenza and pneumococcal vaccinations of patients with systemic lupus erythematosus: current views upon safety and immunogenicity.

Abstract

Systemic lupus erythematosus (SLE) is a chronic immune-mediated inflammatory multisystem disease. The onset of viral and bacterial infections may favor the exacerbation of the disease, amplify autoimmune processes and contribute to mortality and morbidity. The prevention of influenza and Streptococcus pneumoniae infections with vaccination should receive particular attention in SLE patients considering their elevated incidence, their high attack rate in epidemic periods, their potentially severe complications as well as the immunocompromised state of the host. The use of non-adjuvanted vaccine preparations should be preferred in order to avoid the onset of the "Autoimmune (auto-inflammatory) Syndrome Induced by Adjuvants" or "ASIA". In this review, we report that influenza and pneumococcal vaccinations in SLE patients are: 1) recommended to reduce the risk of development of these infections; 2) strongly suggested in elderly subjects and in those receiving high dose immunosuppressive treatments; 3) efficacious, even if specific immune responses may be lower than in the general population, as generally the humoral response fulfills the criteria for vaccine immunogenicity; and 4) safe in inactive disease although may favor a transient increase in autoantibody levels and rarely disease flares.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Clinical Immunology Unit, University of Genova, Genova, Italy. Electronic address: Giuseppe.Murdaca@unige.it.

    , , , , ,

    Source

    Autoimmunity reviews 13:2 2014 Feb pg 75-84

    MeSH

    Humans
    Immunocompromised Host
    Influenza Vaccines
    Influenza, Human
    Lupus Erythematosus, Systemic
    Pneumococcal Vaccines
    Practice Guidelines as Topic

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    24044940

    Citation

    Murdaca, Giuseppe, et al. "Influenza and Pneumococcal Vaccinations of Patients With Systemic Lupus Erythematosus: Current Views Upon Safety and Immunogenicity." Autoimmunity Reviews, vol. 13, no. 2, 2014, pp. 75-84.
    Murdaca G, Orsi A, Spanò F, et al. Influenza and pneumococcal vaccinations of patients with systemic lupus erythematosus: current views upon safety and immunogenicity. Autoimmun Rev. 2014;13(2):75-84.
    Murdaca, G., Orsi, A., Spanò, F., Puppo, F., Durando, P., Icardi, G., & Ansaldi, F. (2014). Influenza and pneumococcal vaccinations of patients with systemic lupus erythematosus: current views upon safety and immunogenicity. Autoimmunity Reviews, 13(2), pp. 75-84. doi:10.1016/j.autrev.2013.07.007.
    Murdaca G, et al. Influenza and Pneumococcal Vaccinations of Patients With Systemic Lupus Erythematosus: Current Views Upon Safety and Immunogenicity. Autoimmun Rev. 2014;13(2):75-84. PubMed PMID: 24044940.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Influenza and pneumococcal vaccinations of patients with systemic lupus erythematosus: current views upon safety and immunogenicity. AU - Murdaca,Giuseppe, AU - Orsi,Andrea, AU - Spanò,Francesca, AU - Puppo,Francesco, AU - Durando,Paolo, AU - Icardi,Giancarlo, AU - Ansaldi,Filippo, Y1 - 2013/09/14/ PY - 2013/07/01/received PY - 2013/07/09/accepted PY - 2013/9/19/entrez PY - 2013/9/21/pubmed PY - 2014/2/6/medline KW - Influenza vaccine KW - Pneumococcal vaccine KW - Systemic lupus erythematosus SP - 75 EP - 84 JF - Autoimmunity reviews JO - Autoimmun Rev VL - 13 IS - 2 N2 - Systemic lupus erythematosus (SLE) is a chronic immune-mediated inflammatory multisystem disease. The onset of viral and bacterial infections may favor the exacerbation of the disease, amplify autoimmune processes and contribute to mortality and morbidity. The prevention of influenza and Streptococcus pneumoniae infections with vaccination should receive particular attention in SLE patients considering their elevated incidence, their high attack rate in epidemic periods, their potentially severe complications as well as the immunocompromised state of the host. The use of non-adjuvanted vaccine preparations should be preferred in order to avoid the onset of the "Autoimmune (auto-inflammatory) Syndrome Induced by Adjuvants" or "ASIA". In this review, we report that influenza and pneumococcal vaccinations in SLE patients are: 1) recommended to reduce the risk of development of these infections; 2) strongly suggested in elderly subjects and in those receiving high dose immunosuppressive treatments; 3) efficacious, even if specific immune responses may be lower than in the general population, as generally the humoral response fulfills the criteria for vaccine immunogenicity; and 4) safe in inactive disease although may favor a transient increase in autoantibody levels and rarely disease flares. SN - 1873-0183 UR - https://www.unboundmedicine.com/medline/citation/24044940/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1568-9972(13)00159-6 DB - PRIME DP - Unbound Medicine ER -