Background/Purpose: Juvenile idiopathic arthritis (JIA) is one of the most frequent and most disabling rheumatic diseases in childhood. Children suffering from JIA receiving immunosuppressive and genetically engineered biological agents belong to the high risk group for the development of bacterial and viral infections, including those managed by vaccine preventive means.

Objectives: To evaluate the effectiveness of vaccination of 13-valent pneumococcal polysaccharide vaccine (PPV) in children with JIA for the level of specific anti-pneumoconve antibodies (anti-SPP) IgG for Streptococcus pneumonia in the blood serum in patients with JIA before and after vaccination, as well as by recording the number of infections of the upper respiratory tract and pneumonia.

Methods: In a prospective, open comparative study, the effectiveness of vaccination was determined by the level of specific anti-pneumoconve antibodies (anti-SPP) IgG to Streptococcus pneumonia in serum in patients with JIA, as well as by the number of adverse events, the number of infections of the upper respiratory tract and pneumonia. An open prospective comparative study was conducted, which included 42 children with JIA: 21 children with JIA in the active stage of the disease, 21 – in remission of the disease. Vaccination with 13-valent conjugated PPV vaccine was carried out once in a dose (0.5 ml) subcutaneously, against the background of therapy of the underlying disease with methotrexate or etanercept, or 3 weeks before the appointment of methotrexate or etanercept.

Results:

The study included 42 children with JIA: 21 with JIA in the active stage of the disease, 21 – in remission of the disease. As a result of vaccination of all patients, an increase in the level of anti-pneumococcal antibodies (anti-SPP) IgG in children with JIA in the active stage was observed from 23.9 to 51.6 mg /l, with JIA in the remission phase from 26.1 to 73.0 mg /l (p = 0.005). Episodes flare of of JIA were not detected in any subject patient. Analysis of the frequency of ENT organs infections (otitis, rhinitis, sinusitis, tonsillitis, adenoiditis) and lower respiratory tract before and 12 months after vaccination showed a statistically significant decrease in the incidence rate. In the JIA group at the stage of remission of the disease, this index was 4 (3, 7) cases per year, after vaccination, it was reduced to 2 (1; 2) (p = 0.001). A similar situation was observed in the group of children with exacerbation of the disease: before the vaccination, the median number of cases of infection with ENT organs was 4 (3; 4); within 12 months after the vaccination, the index decreased to 1 (1, 2) cases (p = 0.001). Pneumonia and / or bronchitis for 1 year after vaccination are not registered in any patient. Serious adverse events were not recorded during the study.

Conclusion: Thus, vaccination of 13-valent PPV of 13 PPV of children with JIA in the remission phase receiving MT or etanercept and children in the acute stage prior to the initiation of immunosuppressant or GIBP is highly effective, and is not accompanied by exacerbation / increase in the activity of the disease and the development of serious undesirable phenomena.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/analysis-of-the-effectiveness-of-immunization-with-pneumococcal-polysaccharide-vaccine-in-children-with-juvenile-idiopathic-arthritis/