@article{2976717,
    title = "Live attenuated MMR/V booster vaccines in children with rheumatic diseases on immunosuppressive therapy are safe: Multicenter, retrospective data collection",
    author = "Uziel, Y. and Moshe, V. and Onozo, B. and Kulcsár, A. and Tróbert-Sipos, D. and Akikusa, J.D. and Salviato Pileggi, G. and Maritsi, D. and Kasapcopur, O. and Rodrigues, M. and Smerla, R. and Rigante, D. and Makay, B. and Atsali, E. and Wulffraat, N. and Toplak, N. and for the PReS working party of Vaccination Study Group",
    journal = "Vaccine",
    year = "2020",
    volume = "38",
    number = "9",
    pages = "2198-2201",
    publisher = "ELSEVIER SCIENCE LTD.",
    issn = "0264-410X",
    doi = "10.1016/j.vaccine.2020.01.037",
    keywords = "adalimumab;  anakinra;  biological product;  canakinumab;  chickenpox measles mumps rubella vaccine;  cyclosporine;  disease modifying antirheumatic drug;  etanercept;  glucocorticoid;  infliximab;  interleukin 1 antibody;  leflunomide;  live vaccine;  methotrexate;  salazosulfapyridine;  tocilizumab;  tumor necrosis factor antibody;  chickenpox vaccine;  immunosuppressive agent;  live vaccine;  measles mumps rubella vaccine;  measles, mumps, rubella, varicella vaccine;  methotrexate;  vaccine, Article;  chickenpox;  child;  disease activity;  disease exacerbation;  disease severity;  drug safety;  female;  fever;  human;  immunosuppressive treatment;  juvenile rheumatoid arthritis;  major clinical study;  male;  measles;  multicenter study (topic);  mumps;  pain;  priority journal;  remission;  retrospective study;  rheumatic disease;  rheumatology;  rubella;  skin manifestation;  vaccination;  clinical trial;  information processing;  multicenter study;  preschool child;  secondary immunization, Chickenpox Vaccine;  Child;  Child, Preschool;  Data Collection;  Female;  Humans;  Immunization, Secondary;  Immunosuppressive Agents;  Male;  Measles-Mumps-Rubella Vaccine;  Methotrexate;  Retrospective Studies;  Rheumatic Diseases;  Vaccines, Attenuated;  Vaccines, Combined",
    abstract = "Purpose: To collect retrospective data of patients with Juvenile Idiopathic Arthritis (JIA) and other rheumatic diseases who received live attenuated booster measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMR/V) during treatment with immunosuppressive therapy. Results: Data from 13 pediatric rheumatology centers in 10 countries, including 234 patients, were collected. Mean age at diagnosis was 5 ± 2.7 years, 67% were girls. Among them, 211 (90.2%) had JIA and 110 (47%) were in remission on medication. Disease activity was low in 37%, high in 8%, and moderate in 8%. One hundred-twenty-four received MMR/V booster while on methotrexate (MTX); 3 reported local mild adverse events (AE). Among 62 on MTX + biologics and 9 patients who received a combination of 2 disease modifying antirheumatic drugs (DMARDs), 9 reported mild AE. Among 39 on biologics, 1 reported fever one day after booster vaccination. No vaccine-related infection of measles, rubella, mumps or varicella was reported, none of the patients developed disease flare, including those with high disease activity. Conclusions: In this retrospective study, live-attenuated MMR/V booster vaccines were safe for children with rheumatic diseases, on immunosuppressive therapies. This strengthens the Paediatric Rheumatology European Society (PReS) recommendation that vaccination with live attenuated vaccines in patients on immunosuppressive therapies can be considered individually, weighing the benefit of vaccination against the risk of inducing infection through vaccination. These data provide the basis for a prospective data collection study, planned by the PReS vaccination study group. © 2020 Elsevier Ltd"
}