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A practical approach to vaccination of patients with autoimmune inflammatory rheumatic diseases in Australia
Author(s) -
Wong Peter K. K.,
Bagga Hanish,
Barrett Claire,
Hanrahan Paddy,
Johnson Doug,
Katrib Amel,
Leder Karin,
Marabani Mona,
Pentony Peta,
Riordan John,
White Ray,
Young Laurel
Publication year - 2017
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13371
Subject(s) - medicine , vaccination , rheumatoid arthritis , immunosuppression , psoriatic arthritis , ankylosing spondylitis , immunology , intensive care medicine
Autoimmune inflammatory rheumatic diseases ( AIIRD ), such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are often complicated by infection, which results in significant morbidity and mortality. The increased risk of infection is probably due to a combination of immunosuppressive effects of the AIIRD , comorbidities and the use of immunosuppressive conventional synthetic disease‐modifying anti‐rheumatic drugs ( DMARDs ) and more recently, targeted synthetic DMARDs and biologic DMARDs that block specific pro‐inflammatory enzymes, cytokines or cell types. The use of these various DMARDs has revolutionised the treatment of AIIRD . This has led to a marked improvement in quality of life for AIIRD patients, who often now travel for prolonged periods. Many infections are preventable with vaccination. However, as protective immune responses induced by vaccination may be impaired by immunosuppression, where possible, vaccination may need to be performed prior to initiation of immunosuppression. Vaccination status should also be reviewed when planning overseas travel. Limited data regarding vaccine efficacy in patients with AIIRD make prescriptive guidelines difficult. However, a vaccination history should be part of the initial work‐up in all AIIRD patients. Those caring for AIIRD patients should regularly consider vaccination to prevent infection within the practicalities of routine clinical practice.