Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milano, Italy.
Rheumatology (Oxford). 2011 Aug;50(8):1358-65. doi: 10.1093/rheumatology/ker102. Epub 2011 Apr 10.
Children with rheumatic diseases (RDs) are at greater risk of infection because of their aberrant immunity and frequent use of immunosuppressive drugs. However, the use of vaccinations in such children is debated by many experts who think that the patients' immune response is insufficient to assure protection; some of them are also afraid that vaccines could trigger a persistent autoimmune response and lead to severe clinical problems including a relapse of the RD. This review describes the available data regarding the risks of vaccine administration, and the immunogenicity, efficacy and tolerability of the vaccines usually recommended for children with RDs. The data not only show that the schedule suggested for otherwise healthy children should be followed, but also that pneumococcal and influenza vaccinations should be strongly recommended because of the known risk of severe infections in patients with RD. However, there are areas in which further research is urgently required.
患有风湿性疾病 (RDs) 的儿童由于免疫异常和经常使用免疫抑制剂，感染风险更高。然而，许多专家对这类儿童使用疫苗存在争议，他们认为患者的免疫反应不足以确保保护；其中一些人还担心疫苗会引发持续的自身免疫反应，导致严重的临床问题，包括 RD 复发。这篇综述描述了关于疫苗接种风险的现有数据，以及通常推荐给患有 RDs 的儿童使用的疫苗的免疫原性、有效性和耐受性。这些数据不仅表明应遵循为其他健康儿童建议的疫苗接种计划，还表明由于 RD 患者严重感染的已知风险，应强烈推荐接种肺炎球菌和流感疫苗。然而，在某些领域还迫切需要进一步的研究。
