Vaccines and Chemo-prophylaxis in Rheumatoid Arthritis: Is a Vaccine Calendar Necessary?

a b s t r a c t Patients with rheumatoid arthritis (RA) are at increased risk of infection compared to healthy individuals. The increased risk may be associated with the underlying disease, comorbidities, and immunosuppressive therapy required to control RA activity. In several recent studies, influenza, pneumococcal, and hepatitis B vaccines administered to RA patients were reported to be safe and serologically effective. However, several lines of evidence suggest a possible aberrant immunologic response following vaccination due to the compromised immunity of these patients. Therefore, vaccination of RA patients prior to immunosuppressive treatment may serve as an alternative prophylactic approach and should be considered for future investigation. Besides, prophylactic health measures should be taken to avoid latent chronic infections as tuberculosis and hepatitis B, during therapy with biological agents. © 2010 Elsevier Espana, S.L. All rights reserved.