rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2018-373-379rsp-2574Research ArticleОБЗОРЫВакцинация у больных системной красной волчанкой: результаты и перспективыVACCINATION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS AND PROSPECTSБеловБ. С.BelovB. S.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

belovbor@yandex.ruСоловьевС. К.SolovyevS. K.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ТарасоваГ. М.TarasovaG. M.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

АсееваЕ. А.AseevaE. A.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation201815072018563373379Copyright © Белов Б.С., Соловьев С.К., Тарасова Г.М., Асеева Е.А., 20182018Белов Б.С., Соловьев С.К., Тарасова Г.М., Асеева Е.А.Belov B.S., Solovyev S.K., Tarasova G.M., Aseeva E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2574

В ревматологии значимость коморбидных инфекций за последнее время существенно увеличилась, особенно в связи с внедрением в клиническую практику генно-инженерных биологических препаратов. Одним из путей решения указанной проблемы является изучение и активное применение вакцин. В настоящем обзоре рассмотрены вопросы, касающиеся применения вакцин против различных инфекций у больных системной красной волчанкой. Обсуждаются безопасность и иммуногенность вакцинации, в том числе с применением адъювантных вакцин. Обозначены основные направления будущих исследований по рассматриваемой проблеме.

The importance of comorbid infections in rheumatology has increased substantially in recent years, particularly in connection with the introduction of biological agents into clinical practice. One of the ways to solve this problem is to study and actively use vaccines. This review deals with the issues related to the use of vaccines against various infections in patients with systemic lupus erythematosus. It discusses the safety and immunogenicity of vaccination, including the use of adjuvant vaccines. Cardinal directions for future investigations of the problem are denoted.

системная красная волчанкакоморбидные инфекциигрипппневмонияхронические вирусные инфекциивакцинацияsystemic lupus erythematosuscomorbid infectionsinfluenzapneumoniachronic viral infectionsvaccinationReferencesЮщук НД, Венгеров ЮА, редакторы. Инфекционные болезни: Национальное руководство. Москва: ГЭОТАР-Медиа; 2009. 1056 с. [Yushchuk ND, Vengerov YuA, editors. Infekcionnye bolezni: Nacional'noe rukovodstvo [Infectious Diseases: National Guidelance]. Moscow: GEHOTAR-Media; 2009. 1056 p. (In Russ.)].Ющук НД, Венгеров ЮА, редакторы. Инфекционные болезни: Национальное руководство. Москва: ГЭОТАР-Медиа; 2009. 1056 с. [Yushchuk ND, Vengerov YuA, editors. Infekcionnye bolezni: Nacional'noe rukovodstvo [Infectious Diseases: National Guidelance]. Moscow: GEHOTAR-Media; 2009. 1056 p. (In Russ.)].Tektonidou MG, Lewandowski LB, Hu J, et al. Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016. Ann Rheum Dis. 2017 Dec;76(12):2009-16. doi: 10.1136/annrheumdis-2017-211663Tektonidou MG, Lewandowski LB, Hu J, et al. Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016. Ann Rheum Dis. 2017 Dec;76(12):2009-16. doi: 10.1136/annrheumdis-2017-211663Левицки А, Линдер С, ван Волленховен РФ. Ритуксимаб в терапии системной красной волчанки. Научно-практическая ревматология. 2013;51(3):223-39 [Levitsky A, Linder S, van Vollenhoven RF. Rituximab in the management of systemic lupus erythematosus. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(3):223-39 (In Russ.)].Левицки А, Линдер С, ван Волленховен РФ. Ритуксимаб в терапии системной красной волчанки. Научно-практическая ревматология. 2013;51(3):223-39 [Levitsky A, Linder S, van Vollenhoven RF. Rituximab in the management of systemic lupus erythematosus. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(3):223-39 (In Russ.)].Merrill JT, Ginzler EM, Wallace DJ, et al. Long-term safety profile of belimumab plus standard therapy in patients with systemic lupus erythematosus. Arthritis Rheum. 2012 Oct;64(10):3364-73. doi: 10.1002/art.34564Merrill JT, Ginzler EM, Wallace DJ, et al. Long-term safety profile of belimumab plus standard therapy in patients with systemic lupus erythematosus. Arthritis Rheum. 2012 Oct;64(10):3364-73. doi: 10.1002/art.34564Van Assen S, Agmon-Levin N, Elkayam O, et al. EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis. 2011;70(3):414- 22. doi: 10.1136/ard.2010.137216Van Assen S, Agmon-Levin N, Elkayam O, et al. EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis. 2011;70(3):414- 22. doi: 10.1136/ard.2010.137216Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheum. 2016;68(1):1-26. doi: 10.1002/art.39480Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheum. 2016;68(1):1-26. doi: 10.1002/art.39480Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):e44-100. doi: 10.1093/cid/cit684Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):e44-100. doi: 10.1093/cid/cit684Krasselt M, Baerwald C, Seifert O. Insufficient vaccination rates in patients with systemic lupus erythematosus in a German outpatient clinic. Z Rheumatol. 2017 Dec 13. doi: 10.1007/s00393-017-0410-5Krasselt M, Baerwald C, Seifert O. Insufficient vaccination rates in patients with systemic lupus erythematosus in a German outpatient clinic. Z Rheumatol. 2017 Dec 13. doi: 10.1007/s00393-017-0410-5Lawson EF, Trupin L, von Scheven E, et al. Reasons for failure to obtain influenza and pneumococcal vaccines among immunosuppressed individuals with systemic lupus erythematosus. Arthritis Rheum. 2013;65(10 Suppl):362.Lawson EF, Trupin L, von Scheven E, et al. Reasons for failure to obtain influenza and pneumococcal vaccines among immunosuppressed individuals with systemic lupus erythematosus. Arthritis Rheum. 2013;65(10 Suppl):362.Ditto MC, Batticiotto A, Gerardi MC, et al. Reasons Why Patients Failed Vaccinations Vs Influenza and Pneumococcus. Monocentric Cross-Sectional Study. Arthritis Rheum. 2017;69(Suppl 10):S396-7.Ditto MC, Batticiotto A, Gerardi MC, et al. Reasons Why Patients Failed Vaccinations Vs Influenza and Pneumococcus. Monocentric Cross-Sectional Study. Arthritis Rheum. 2017;69(Suppl 10):S396-7.Wise K, Barbar-Smiley F, Lemle S, et al. Pre-Visit Planning Improves Pneumococcal Vaccination in Patients with ChildhoodOnset Systemic Lupus Erythematosus. Arthritis Rheum. 2017;69(Suppl 10):S2924-5.Wise K, Barbar-Smiley F, Lemle S, et al. Pre-Visit Planning Improves Pneumococcal Vaccination in Patients with ChildhoodOnset Systemic Lupus Erythematosus. Arthritis Rheum. 2017;69(Suppl 10):S2924-5.Brocq O, Acquacalda E, Berthier F, et al. Influenza and pneumococcal vaccine coverage in 584 patients taking biological therapy for chronic inflammatory joint: A retrospective study. Joint Bone Spine. 2016;83(2):155-9. doi: 10.1016/j.jbspin.2015.11.005Brocq O, Acquacalda E, Berthier F, et al. Influenza and pneumococcal vaccine coverage in 584 patients taking biological therapy for chronic inflammatory joint: A retrospective study. Joint Bone Spine. 2016;83(2):155-9. doi: 10.1016/j.jbspin.2015.11.005Williams GW, Steinberg AD, Reinertsen JL, et al. Influenza immunization in systemic lupus erythematosus. A double-blind trial. Ann Intern Med. 1978;88(6):729-34. doi: 10.7326/0003-4819- 88-6-729Williams GW, Steinberg AD, Reinertsen JL, et al. Influenza immunization in systemic lupus erythematosus. A double-blind trial. Ann Intern Med. 1978;88(6):729-34. doi: 10.7326/0003-4819- 88-6-729Brodman R, Gilfillan R, Glass D, Schur PH. Influenza vaccine response in systemic lupus erythematosus. Ann Intern Med. 1978;88(6):735-40. doi: 10.7326/0003-4819-88-6-735Brodman R, Gilfillan R, Glass D, Schur PH. Influenza vaccine response in systemic lupus erythematosus. Ann Intern Med. 1978;88(6):735-40. doi: 10.7326/0003-4819-88-6-735Louie JS, Nies KM, Shoji KT, et al. Clinical and antibody responses after influenza immunization in systemic lupus erythematosus. Ann Intern Med. 1978;88(6):790-2. doi: 10.7326/0003- 4819-88-6-790Louie JS, Nies KM, Shoji KT, et al. Clinical and antibody responses after influenza immunization in systemic lupus erythematosus. Ann Intern Med. 1978;88(6):790-2. doi: 10.7326/0003- 4819-88-6-790Ristow SC, Douglas RG Jr, Condemi JJ. Influenza vaccination of patients with systemic lupus erythematosus. Ann Intern Med. 1978;88(6):786-9. doi: 10.7326/0003-4819-88-6-786Ristow SC, Douglas RG Jr, Condemi JJ. Influenza vaccination of patients with systemic lupus erythematosus. Ann Intern Med. 1978;88(6):786-9. doi: 10.7326/0003-4819-88-6-786Herron A, Dettleff G, Hixon B, et al. Influenza vaccination in patients with rheumatic diseases. Safety and efficacy. JAMA. 1979;242(1):53-6. doi: 10.1001/jama.1979.03300010037025Herron A, Dettleff G, Hixon B, et al. Influenza vaccination in patients with rheumatic diseases. Safety and efficacy. JAMA. 1979;242(1):53-6. doi: 10.1001/jama.1979.03300010037025Abu-Shakra M, Zalmanson S, Neumann L, et al. Influenza virus vaccination of patients with systemic lupus erythematosus: effects on disease activity. J Rheumatol. 2000;27(7):1681-5.Abu-Shakra M, Zalmanson S, Neumann L, et al. Influenza virus vaccination of patients with systemic lupus erythematosus: effects on disease activity. J Rheumatol. 2000;27(7):1681-5.Abu-Shakra M, Press J, Sukenik S, Buskila D. Influenza virus vaccination of patients with SLE: effects on generation of autoantibodies. Clin Rheumatol. 2002;21(5):369-72. doi: 10.1007/s100670200099Abu-Shakra M, Press J, Sukenik S, Buskila D. Influenza virus vaccination of patients with SLE: effects on generation of autoantibodies. Clin Rheumatol. 2002;21(5):369-72. doi: 10.1007/s100670200099Abu-Shakra M, Press J, Varsano N, et al. Specific antibody response after influenza immunization in systemic lupus erythematosus. J Rheumatol. 2002;29(12):2555-7.Abu-Shakra M, Press J, Varsano N, et al. Specific antibody response after influenza immunization in systemic lupus erythematosus. J Rheumatol. 2002;29(12):2555-7.Kostianovsky A, Charles P, Alves JF, et al. Immunogenicity and safety of seasonal and 2009 pandemic A/H1N1 influenza vaccines for patients with autoimmune diseases: a prospective, monocentre trial on 199 patients. Clin Exp Rheumatol. 2012 Jan–Feb;30(1 Suppl 70):S83-9.Kostianovsky A, Charles P, Alves JF, et al. Immunogenicity and safety of seasonal and 2009 pandemic A/H1N1 influenza vaccines for patients with autoimmune diseases: a prospective, monocentre trial on 199 patients. Clin Exp Rheumatol. 2012 Jan–Feb;30(1 Suppl 70):S83-9.Huang Y, Wang H, Wan L, et al. Is Systemic Lupus Erythematosus Associated With a Declined Immunogenicity and Poor Safety of Influenza Vaccination?: A Systematic Review and Meta-Analysis. Medicine (Baltimore). 2016 May;95(19):e3637. doi: 10.1097/MD.0000000000003637Huang Y, Wang H, Wan L, et al. Is Systemic Lupus Erythematosus Associated With a Declined Immunogenicity and Poor Safety of Influenza Vaccination?: A Systematic Review and Meta-Analysis. Medicine (Baltimore). 2016 May;95(19):e3637. doi: 10.1097/MD.0000000000003637Puges M, Biscay P, Barnetche T, et al. Immunogenicity and impact on disease activity of influenza and pneumococcal vaccines in systemic lupus erythematosus: a systematic literature review and meta-analysis. Rheumatology (Oxford). 2016 Sep;55(9):1664-72. doi: 10.1093/rheumatology/kew211Puges M, Biscay P, Barnetche T, et al. Immunogenicity and impact on disease activity of influenza and pneumococcal vaccines in systemic lupus erythematosus: a systematic literature review and meta-analysis. Rheumatology (Oxford). 2016 Sep;55(9):1664-72. doi: 10.1093/rheumatology/kew211Chang CC, Chang YS, Chen WS, et al. Effects of annual influenza vaccination on morbidity and mortality in patients with Systemic Lupus Erythematosus: A Nationwide Cohort Study. Sci Rep. 2016 Dec 2;6:37817. doi: 10.1038/srep37817Chang CC, Chang YS, Chen WS, et al. Effects of annual influenza vaccination on morbidity and mortality in patients with Systemic Lupus Erythematosus: A Nationwide Cohort Study. Sci Rep. 2016 Dec 2;6:37817. doi: 10.1038/srep37817Luijten RK, Cuppen BV, Bijlsma JW, Derksen RH. Serious infections in systemic lupus erythematosus with a focus on pneumococcal infections. Lupus. 2014;23(14):1512-6. doi: 10.1177/0961203314543918Luijten RK, Cuppen BV, Bijlsma JW, Derksen RH. Serious infections in systemic lupus erythematosus with a focus on pneumococcal infections. Lupus. 2014;23(14):1512-6. doi: 10.1177/0961203314543918Schurder J, Goulenok T, Jouenne R, et al. Pneumococcal infection in patients with systemic lupus erythematosus. Joint Bone Spine. 2017 May 18. pii: S1297-319X(17)30103-3. doi: 10.1016/j.jbspin.2017.05.012Schurder J, Goulenok T, Jouenne R, et al. Pneumococcal infection in patients with systemic lupus erythematosus. Joint Bone Spine. 2017 May 18. pii: S1297-319X(17)30103-3. doi: 10.1016/j.jbspin.2017.05.012Pisoni C, Sarano J, Benchetrit G, et al. [Antipneumococcal vaccination in patient with systemic lupus erythematosus]. Medicina (B Aires). 2003;63(5):388-92.Pisoni C, Sarano J, Benchetrit G, et al. [Antipneumococcal vaccination in patient with systemic lupus erythematosus]. Medicina (B Aires). 2003;63(5):388-92.Tarasova GM, Belov BS, Sergeeva MS, et al. Tolerability, efficacy and immunogenicity of 23-valent pneumococcal vaccine in sle patients. Ann Rheum Dis. 2017;76(Suppl 2):1226. doi: 10.1136/annrheumdis-2017-eular.2347Tarasova GM, Belov BS, Sergeeva MS, et al. Tolerability, efficacy and immunogenicity of 23-valent pneumococcal vaccine in sle patients. Ann Rheum Dis. 2017;76(Suppl 2):1226. doi: 10.1136/annrheumdis-2017-eular.2347Centers for Disease Control and Prevention (CDC). Use of 13- valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012;61:816-9.Centers for Disease Control and Prevention (CDC). Use of 13- valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012;61:816-9.Вакцинопрофилактика пневмококковой инфекции. Федеральные клинические рекомендации. Москва; 2015. 24 с. [Vakcinoprofilaktika pnevmokokkovoj infekcii. Federal'nye klinicheskie rekomendacii [Vaccine prophylaxis of pneumococcal infection. Federal Clinical Recommendations]. Moscow; 2015. 24 p. (In Russ.)].Вакцинопрофилактика пневмококковой инфекции. Федеральные клинические рекомендации. Москва; 2015. 24 с. [Vakcinoprofilaktika pnevmokokkovoj infekcii. Federal'nye klinicheskie rekomendacii [Vaccine prophylaxis of pneumococcal infection. Federal Clinical Recommendations]. Moscow; 2015. 24 p. (In Russ.)].Grabar S, Groh M, Bahuaud M, et al. Pneumococcal vaccination in patients with systemic lupus erythematosus: A multicenter placebo-controlled randomized double-blind study. Vaccine. 2017;35(37):4877-85. doi: 10.1016/j.vaccine.2017.07.094Grabar S, Groh M, Bahuaud M, et al. Pneumococcal vaccination in patients with systemic lupus erythematosus: A multicenter placebo-controlled randomized double-blind study. Vaccine. 2017;35(37):4877-85. doi: 10.1016/j.vaccine.2017.07.094Nagel J, Saxne T, Geborek P, et al. Treatment with belimumab in systemic lupus erythematosus does not impair antibody response to 13-valent pneumococcal conjugate vaccine. Lupus. 2017 Sep;26(10):1072-81. doi: 10.1177/0961203317695465Nagel J, Saxne T, Geborek P, et al. Treatment with belimumab in systemic lupus erythematosus does not impair antibody response to 13-valent pneumococcal conjugate vaccine. Lupus. 2017 Sep;26(10):1072-81. doi: 10.1177/0961203317695465Chatham W, Chadha A, Fettiplace J, et al. A randomized, openlabel study to investigate the effect of belimumab on pneumococcal vaccination in patients with active, autoantibody-positive systemic lupus erythematosus. Lupus. 2017 Dec;26(14):1483-90. doi: 10.1177/0961203317703495Chatham W, Chadha A, Fettiplace J, et al. A randomized, openlabel study to investigate the effect of belimumab on pneumococcal vaccination in patients with active, autoantibody-positive systemic lupus erythematosus. Lupus. 2017 Dec;26(14):1483-90. doi: 10.1177/0961203317703495Mercado U. Why have rheumatologists been reluctant to vaccinate patients with systemic lupus erythematosus? J Rheumatol. 2006;33(8):1469-71.Mercado U. Why have rheumatologists been reluctant to vaccinate patients with systemic lupus erythematosus? J Rheumatol. 2006;33(8):1469-71.Curtis JR, Yang S, Chen L, et al. Herpes zoster infection across auto-immune and inflammatory diseases: implications for vaccination. Ann Rheum Dis. 2014;73Suppl 2:452. doi: 10.1136/annrheumdis-2014-eular.5983Curtis JR, Yang S, Chen L, et al. Herpes zoster infection across auto-immune and inflammatory diseases: implications for vaccination. Ann Rheum Dis. 2014;73Suppl 2:452. doi: 10.1136/annrheumdis-2014-eular.5983Chakravarty EF, Michaud K, Katz R, Wolfe F. Increased incidence of herpes zoster among patients with systemic lupus erythematosus. Lupus. 2013;22(3):238-44. doi: 10.1177/0961203312470186Chakravarty EF, Michaud K, Katz R, Wolfe F. Increased incidence of herpes zoster among patients with systemic lupus erythematosus. Lupus. 2013;22(3):238-44. doi: 10.1177/0961203312470186Guthridge JM, Cogman A, Merrill JT, et al. Herpes zoster vaccination in SLE: a pilot study of immunogenicity. J Rheumatol. 2013 Nov;40(11):1875-80. doi: 10.3899/jrheum.130170Guthridge JM, Cogman A, Merrill JT, et al. Herpes zoster vaccination in SLE: a pilot study of immunogenicity. J Rheumatol. 2013 Nov;40(11):1875-80. doi: 10.3899/jrheum.130170Hales CM, Harpaz R, Ortega-Sanchez I, et al. Update on recommendations for use of herpes zoster vaccine. MMWR Morb Mortal Wkly Rep. 2014;63(33):729-31.Hales CM, Harpaz R, Ortega-Sanchez I, et al. Update on recommendations for use of herpes zoster vaccine. MMWR Morb Mortal Wkly Rep. 2014;63(33):729-31.Chakravarty EF. Incidence and Prevention of Herpes Zoster Reactivation in Patients with Autoimmune Diseases. Rheum Dis Clin North Am. 2017 Feb;43(1):111-21. doi: 10.1016/j.rdc.2016.09.010Chakravarty EF. Incidence and Prevention of Herpes Zoster Reactivation in Patients with Autoimmune Diseases. Rheum Dis Clin North Am. 2017 Feb;43(1):111-21. doi: 10.1016/j.rdc.2016.09.010Raposo A, Tani C, Costa J, Mosca M. Human papillomavirus infection and cervical lesions in rheumatic diseases: a systematic review. Acta Reumatol Port. 2016 Jul-Sep;41(3):184-90.Raposo A, Tani C, Costa J, Mosca M. Human papillomavirus infection and cervical lesions in rheumatic diseases: a systematic review. Acta Reumatol Port. 2016 Jul-Sep;41(3):184-90.Klumb EM, Pinto AC, Jesus GR, et al. Are women with lupus at higher risk of HPV infection? Lupus. 2010;19(13):1485-91. doi: 10.1177/0961203310372952Klumb EM, Pinto AC, Jesus GR, et al. Are women with lupus at higher risk of HPV infection? Lupus. 2010;19(13):1485-91. doi: 10.1177/0961203310372952Lyrio LD, Grassi MF, Santana IU, et al. Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus. Rheumatol Int. 2013;33(2):335-40. doi: 10.1007/s00296-012-2426-0Lyrio LD, Grassi MF, Santana IU, et al. Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus. Rheumatol Int. 2013;33(2):335-40. doi: 10.1007/s00296-012-2426-0Mok CC, Ho LY, Fong LS, To CH. Immunogenicity and safety of a quadrivalent human papillomavirus vaccine in patients with systemic lupus erythematosus: a case-control study. Ann Rheum Dis. 2013;72(5):659-64. doi: 10.1136/annrheumdis-2012-201393Mok CC, Ho LY, Fong LS, To CH. Immunogenicity and safety of a quadrivalent human papillomavirus vaccine in patients with systemic lupus erythematosus: a case-control study. Ann Rheum Dis. 2013;72(5):659-64. doi: 10.1136/annrheumdis-2012-201393Moraes-Fontes MF, Antunes AM, Gruner H, Riso N. Vaccination of Adult Patients with Systemic Lupus Erythematosus in Portugal. Int J Rheumatol. 2016;2016:2845617. doi: 10.1155/2016/2845617Moraes-Fontes MF, Antunes AM, Gruner H, Riso N. Vaccination of Adult Patients with Systemic Lupus Erythematosus in Portugal. Int J Rheumatol. 2016;2016:2845617. doi: 10.1155/2016/2845617Mathian A, Arnaud L, Adoue D, et al. [Prevention of infections in adults and adolescents with systemic lupus erythematosus: Guidelines for the clinical practice based on the literature and expert opinion]. Rev Med Interne. 2016;37(5):307-20. doi: 10.1016/j.revmed.2016.01.005Mathian A, Arnaud L, Adoue D, et al. [Prevention of infections in adults and adolescents with systemic lupus erythematosus: Guidelines for the clinical practice based on the literature and expert opinion]. Rev Med Interne. 2016;37(5):307-20. doi: 10.1016/j.revmed.2016.01.005Kuruma KA, Borba EF, Lopes MH, et al. Safety and efficacy of hepatitis B vaccine in systemic lupus erythematosus. Lupus. 2007;16(5):350-4. doi: 10.1177/0961203307078225Kuruma KA, Borba EF, Lopes MH, et al. Safety and efficacy of hepatitis B vaccine in systemic lupus erythematosus. Lupus. 2007;16(5):350-4. doi: 10.1177/0961203307078225Kashef S, Ghazizadeh F, Derakhshan A, et al. Antigen-specific antibody response in juvenile-onset SLE patients following routine immunization with tetanus toxoid. Iran J Immunol. 2008 Sep;5(3):181-4. doi: IJIv5i3A7Kashef S, Ghazizadeh F, Derakhshan A, et al. Antigen-specific antibody response in juvenile-onset SLE patients following routine immunization with tetanus toxoid. Iran J Immunol. 2008 Sep;5(3):181-4. doi: IJIv5i3A7Battafarano DF, Battafarano NJ, Larsen L, et al. Antigen-specific antibody responses in lupus patients following immunization. Arthritis Rheum. 1998 Oct;41(10):1828-34. doi: 10.1002/1529- 0131(199810)41:103.0.CO;2-TBattafarano DF, Battafarano NJ, Larsen L, et al. Antigen-specific antibody responses in lupus patients following immunization. Arthritis Rheum. 1998 Oct;41(10):1828-34. doi: 10.1002/1529- 0131(199810)41:103.0.CO;2-TGrimaldi-Bensouda L, Le Guern V, Kone-Paut I, et al. The risk of systemic lupus erythematosus associated with vaccines: an international case-control study. Arthritis Rheum. 2014;66(6):1559-67. doi: 10.1002/art.38429Grimaldi-Bensouda L, Le Guern V, Kone-Paut I, et al. The risk of systemic lupus erythematosus associated with vaccines: an international case-control study. Arthritis Rheum. 2014;66(6):1559-67. doi: 10.1002/art.38429Grimaldi-Bensouda L, Rossignol M, Kone-Paut I, et al. Risk of autoimmune diseases and human papilloma virus (HPV) vaccines: Six years of case-referent surveillance. J Autoimmun. 2017 May;79:84-90. doi: 10.1016/j.jaut.2017.01.005Grimaldi-Bensouda L, Rossignol M, Kone-Paut I, et al. Risk of autoimmune diseases and human papilloma virus (HPV) vaccines: Six years of case-referent surveillance. J Autoimmun. 2017 May;79:84-90. doi: 10.1016/j.jaut.2017.01.005Pellegrini M, Nicolay U, Lindert K, et al. MF59-adjuvanted versus non-adjuvanted influenza vaccines: integrated analysis from a large safety database. Vaccine. 2009;27(49):6959-65. doi: 10.1016/j.vaccine.2009.08.101Pellegrini M, Nicolay U, Lindert K, et al. MF59-adjuvanted versus non-adjuvanted influenza vaccines: integrated analysis from a large safety database. Vaccine. 2009;27(49):6959-65. doi: 10.1016/j.vaccine.2009.08.101

The authors declare that there are no conflicts of interest present.