Abstract
Objective
To determine whether vaccinations aggravate the course of autoimmune diseases such as juvenile idiopathic arthritis (JIA) and whether the immune response to vaccinations may be hampered by immunosuppressive therapy for the underlying disease.
Methods
In this multicenter cohort study, 234 patients with JIA (ages 1โ19 years) were vaccinated with meningococcal serogroup C (MenC) conjugate to protect against serogroup C disease (caused by Neisseria meningitidis). Patients were followed up for disease activity for 1 year, from 6 months before until 6 months after vaccination. IgG antibody titers against MenC polysaccharide and the tetanus carrier protein were determined by enzymeโlinked immunosorbent assay and toxin binding inhibition assay, respectively. A serum bactericidal assay was performed to determine the function of the antiโMenC antibodies.
Results
No change in values for any of the 6 components of the core set criteria for juvenile arthritis disease activity was seen after MenC vaccination. Moreover, no increase in the frequency of disease relapse was detected. Mean antiโMenC IgG concentrations in JIA patients rose significantly within 6โ12 weeks after vaccination. Of 157 patients tested, 153 were able to mount antiโMenC IgG serum levels >2 ฮผg/ml, including patients receiving highly immunosuppressive medication. The 4 patients with a lower antiโMenC antibody response displayed sufficient bactericidal activity despite receiving highly immunosuppressive medication.
Conclusion
The MenC conjugate vaccine does not aggravate JIA disease activity or increase relapse frequency and results in adequate antibody levels, even in patients receiving highly immunosuppressive medication. Therefore, patients with JIA can be vaccinated safely and effectively with the MenC conjugate.