Vaccines in Rheumatic Diseases

  • Carlos Pineda
  • Carina Soto-Fajardo
  • Julio Granados


Vaccination is one of the most important public health strategies to prevent infectious diseases, reduce their severity, or prevent the complications thereof, thus decreasing morbidity and mortality in vulnerable groups such as patients with autoimmune inflammatory rheumatic diseases (AIRD).

Patients with AIRD entertain an increased risk of acquiring infections, as well as an increase in the morbidity and mortality associated with these infections, by immunosuppression due to their underlying condition, their comorbidities, and the immunosuppressive treatment. In addition to this, the immunomodulatory medications can modify the effectiveness of vaccines; therefore, it is important that the rheumatologist not only understand the efficacy and safety of each vaccine but also the appropriate time for their prescription.

This chapter focuses on the indications, contraindications, and efficacy of the vaccines included in the adult vaccination schedules of patients with AIRD, as well as special considerations such as schemes for patients traveling abroad.


Vaccine Rheumatic diseases Primary prevention Rheumatoid arthritis Systemic lupus erythematous Infection diseases Influenza Pneumococcal pneumonia Shingles Human papillomavirus Hepatitis B virus Corticosteroids Disease modifying anti-rheumatic drugs (DMARDs) Biologics 



American College of Rheumatology


Autoimmune inflammatory rheumatic diseases

Anti-HBs ab

Antibodies against the HBV surface antigens


Bacillus Calmette-Guérin


Centers for Disease Control and Prevention


Confidence interval


Comorbidities in rheumatoid arthritis




Disease-modifying anti-rheumatic drugs


Diphtheria, tetanus, and pertussis vaccine


European League Against Rheumatism


Hepatitis B virus


Haemophilus influenzae type b


Human immunodeficiency virus


Human papillomavirus


Infectious Diseases Society of America


Invasive pneumococcal disease


Polysaccharide and conjugate against serogroups A, C, W, and Y meningococcal vaccine


Recombinant vaccine against serogroup B of meningococcus


Measles, mumps, and rubella vaccine




13-Valent pneumococcal conjugate vaccine


23-Valent polysaccharide vaccine


Rheumatoid arthritis


Relative risk


Recombinant zoster vaccine


Systemic lupus erythematous


Systemic sclerosis






Tumoral necrosis factor inhibitors


United Kingdom


Varicella zoster virus


Yellow fever vaccine-associated neurologic disease


Yellow fever vaccine-associated viscerotropic disease


Zoster vaccine live


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Carlos Pineda
    • 1
  • Carina Soto-Fajardo
    • 1
  • Julio Granados
    • 2
  1. 1.Division of Musculoskeletal and Rheumatic DisordersInstituto Nacional de Rehabilitacion Luis Guillermo Ibarra IbarraMexico CityMexico
  2. 2.Immunogenetics Division, Department of TransplantsInstituto Nacional de Ciencias Medica y Nutricion Salvador ZubiránMexico CityMexico

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