Recommendations and barriers to vaccination in systemic lupus erythematosus

Autoimmun Rev. 2018 Oct;17(10):990-1001. doi: 10.1016/j.autrev.2018.04.006. Epub 2018 Aug 11.

Abstract

Patients with Systemic Lupus Erythematosus (SLE) pose a unique dilemma pertaining to immunization against common pathogens. SLE patients are usually not immunized with vaccines based on the fear of either precipitating infection in this immunosuppressed patient population (with live vaccines) or aggravating autoimmunity and hence lupus flares (with any vaccines). However, elevated vulnerability to infection makes patients with SLE precisely the population that needs protection from vaccine-preventable diseases. A summary of guidelines from the Centers for Disease Control and Prevention, professional societies, review articles and expert opinions regarding use of individual vaccines applicable to adults with SLE is presented in this review.

Keywords: Lupus; Vaccination.

Publication types

  • Review

MeSH terms

  • Adjuvants, Immunologic / adverse effects
  • Adult
  • Clinical Studies as Topic
  • Humans
  • Immunocompromised Host
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / immunology*
  • Lupus Erythematosus, Systemic / pathology
  • Practice Guidelines as Topic
  • Vaccination
  • Vaccines / administration & dosage
  • Vaccines / adverse effects*
  • Vaccines / immunology
  • Vaccines, Inactivated / administration & dosage
  • Vaccines, Inactivated / adverse effects

Substances

  • Adjuvants, Immunologic
  • Vaccines
  • Vaccines, Inactivated