Inesa Arštikytė, Giedrė Kaplerytė, Irena Butrimienė


There are twenty eight infections, which might be prevented byvaccination [1]. Lithuania’s National vaccination program startedin 1992, and the calendar for children prophylactic vaccinationwas approved in 2007. At this moment, the important question isabout vaccination in adults [2]. The usefulness of vaccinationsin adult patients at increased risk are the basic issue. It should beidentified which adult patients are at increased risk of contractinginfections, which vaccines could be used for these patients andwhen vaccination should be administered.Patients with autoimmune inflammatory rheumatic diseases(AIIRD) are at increased risk of contracting infections. They areprone to more serious infections and infectious complicationscausing significant morbidity and mortality. In patients withrheumatoid arthritis (RA), the incidence of severe infections isestimated to be twofold greater than that in general population;in patients with systemic lupus erythematosus (SLE) infectionsmay be responsible for almost 25 proc. of all deaths.Theincreased susceptibility to infection can be due to: comorbidities,immunosuppressive effect of underlying autoimmune inflammatoryprocess; the effect of immunomodulatory medication with diseasemodifyingantirheumatic drugs (DMARDs), glucocorticoids and/orbiologic agents. Moreover, the efficacy of vaccination in patientswith AIIRD may be reduced and there is a potential risk of flaresof underlying diseases after vaccination.Our aim is to evaluate, discuss and present recommendationsfor vaccination in patients with AIIRD to work group of Lithuanianspecialists which is preparing recommendations for vaccinationin adult patients with increased risk of contracting infections asfound in the literature review and The European League AgainstRheumatism (EULAR) recommendations for vaccination inpatients with AIIRD.

Keyword(s): autoimmune inflammatory rheumatic diseases, vaccination, vaccines
DOI: 10.5200/sm-hs.2014.121
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