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Immunogenicity of Influenza Vaccine in Children With Pediatric Rheumatic Diseases Receiving Immunosuppressive Agents

Ogimi, Chikara MD*; Tanaka, Risa MD*; Saitoh, Akihiko MD, PhD†; Oh-ishi, Tsutomu MD, PhD*

Pediatric Infectious Disease Journal: March 2011 - Volume 30 - Issue 3 - pp 208-211
doi: 10.1097/INF.0b013e3181f7ce44
Original Studies

Background: Children with rheumatic diseases receiving immunosuppressive therapy are a high-risk group for influenza virus infection; however, few data are available regarding the efficacy and safety of influenza vaccine for those individuals.

Methods: This was a prospective study evaluating the immunogenicity and safety of influenza vaccine in 49 children (mean ± standard deviation: 12.1 ± 4.8 years, age range: 0–21 years) with pediatric rheumatic diseases including juvenile idiopathic arthritis (n = 23), systemic lupus erythematosus (n = 12), juvenile dermatomyositis (n = 6), and others (n = 8), who were receiving immunosuppressive therapies. A total of 36 healthy children were selected as a control. The influenza virus type-A and B antibody titers were measured using hemagglutinin inhibition before and after the vaccination.

Results: There were no significant differences in the percentage of vaccine recipients with an increase in the serum titers ≥4× after vaccination (H1N1, H3N2, and B strain) between the 2 groups (P = 0.49, P = 0.25, P = 0.56, respectively), demonstrating similar immunogenicity of the influenza vaccination between patients and control groups. There were no serious adverse effects related to the vaccine in either group.

Conclusions: In the children with pediatric rheumatic diseases receiving immunosuppressive agents, influenza vaccination resulted in serum antibody titers similar to those in the controls without major adverse effects. Such children receiving immunosuppressive therapy are a high-risk group for influenza virus infection, therefore vaccine should be given.

From the *Division of Infectious Diseases, Immunology, and Allergy, Saitama Children's Medical Center, Saitama, Japan; and †Division of Infectious Diseases, Department of Medical Specialties, National Center for Child Health and Development, Tokyo, Japan.

Accepted for publication August 17, 2010.

Presented in part at the 47th Infectious Diseases Society of America Annual Meeting, October 31, 2009, Philadelphia, PA.

Address for correspondence: Chikara Ogimi, MD, Division of Infectious Diseases, National Center for Child Health and Development, 2–10–1 Okura, Setagaya-ku, Tokyo 157–8535, Japan. E-mail: ogimi-c@ncchd.go.jp.

© 2011 Lippincott Williams & Wilkins, Inc.