Page 28 - JCTR-9-6

Journal of Clinical and Translational Research 2023; 9(6): 392-397

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

SPECIAL ISSUE ARTICLE

How do the characteristics of juvenile idiopathic arthritis affect the

continuation or refusal of vaccination against diphtheria? A cross-sectional
study data

Natalia A. Lubimova , Olga V. Goleva , Susanna M. Kharit , Mikhail M. Kostik *
1
2,3
3
2
1 Almazov National Medical Research Centre, Saint Petersburg, Russia, Pediatric Research and Clinical Center for Infection Diseases, Saint
2
Petersburg, Russia, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
3
(This article belongs to the Special Issue: Vaccination of pediatric patients with immune-mediated diseases)
ARTICLE INFO ABSTRACT
Article history: Introduction: Patients with juvenile idiopathic arthritis (JIA) often stop being vaccinated after the
Received: August 19, 2023 onset of the disease due to fear of disease flare, although the effectiveness and safety of vaccination in
Revised: September 16, 2023 immune compromised patients have been demonstrated.
Accepted: September 18, 2023 Aim: The objective of this study was to evaluate the JIA characteristics associated with the refusal to
Published: November 18, 2023 continue to be vaccinated against diphtheria.
Methods: In a cross-sectional study, we included data about patients who continued (n = 25) or
Keywords: refused (n = 51) vaccination against diphtheria after the development of JIA. In all patients, the levels
Diphtheria vaccination of anti-diphtheria vaccine antibodies (immunoglobulin G) were determined with the enzyme-linked
Juvenile idiopathic arthritis immunosorbent assay. The data are presented with a median and 25 – 75%.
Immunocompromised children Results: The age of disease onset, JIA duration, and JIA categories were similar between groups.
Vaccine Patients who declined the following vaccination often received methotrexate and biologics and
switched at least one biologic. Methotrexate (odds ratio [OR] = 9.5 [95% confidence interval (CI):
*Corresponding author: 1,004; 90.3]) and biologics (OR = 4.4 [95% CI: 1.6; 12.1]) were predictors of refusal of revaccination
Mikhail M. Kostik against diphtheria. Vaccination against diphtheria was effective, as evidenced by the almost two-fold
Saint-Petersburg State Pediatric Medical prevalence of patients with a protective antibody titer compared to those who refused revaccination.
University, Lytovskaya 2, Saint-Petersburg, Serious adverse events, as well as JIA flares in 3 months after vaccination were not observed.
194100, Russia. Conclusion: The continuation of vaccination against diphtheria in children with JIA was effective
Tel (fax): +7-812-4165298 and safe. The treatment with methotrexate and biologics was a predictor of refusal of revaccination
Email: mikhail.kostik@gmail.com against diphtheria. Further studies are needed to confirm the safety and efficacy of vaccination against
diphtheria in children with JIA and can increase the level of confidence of physicians in the vaccination
© 2023 Author(s). This is an Open-Access of children with rheumatic diseases.
article distributed under the terms of the Relevance for Patients: Patients with JIA should know the necessity, efficacy, and safety of
Creative Commons Attribution-Noncommercial
License, permitting all non-commercial use, vaccination against diphtheria. There are no contraindications from the disease side to vaccination
distribution, and reproduction in any medium, against diphtheria. Health-care providers should discuss and encourage any vaccination in immune-
provided the original work is properly cited. mediated children.

1. Introduction
Vaccination is an important tool for infection prevention, especially for
immunocompromised patients [1]. Immunocompromised patients are at risk for frequent and
severe infections due to immune system dysfunction, treatment with immunosuppressive
medications, and incomplete vaccination [2-6]. High-risk groups include patients with
rheumatic diseases who may have vaccinations according to national schedules but do not

DOI: http://dx.doi.org/10.18053/jctres.09.202306.23-00103