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Vaccinations in Rheumatology

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The Microbiome in Rheumatic Diseases and Infection

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.

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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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Authors and Affiliations

  1. Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA

    Paul A. Bryant, Anoma Nellore & John W. Baddley

  2. Medical Service, Birmingham VA Medical Center, Birmingham, AL, USA

    John W. Baddley

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  1. Paul A. Bryant
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  2. Anoma Nellore
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  3. John W. Baddley
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Correspondence to John W. Baddley .

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  1. Faculty of Medicine, Cairo University, Cairo, Egypt

    Gaafar Ragab

  2. University of Alabama, Birmingham, Alabama, USA

    T. Prescott Atkinson

  3. University of Alabama, Birmingham, Alabama, USA

    Matthew L. Stoll

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Bryant, P.A., Nellore, A., Baddley, J.W. (2018). Vaccinations in Rheumatology. In: Ragab, G., Atkinson, T., Stoll, M. (eds) The Microbiome in Rheumatic Diseases and Infection. Springer, Cham. https://doi.org/10.1007/978-3-319-79026-8_32

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