Reduced Anti-Vaccine Antibody Levels seen in kids With Juvenile Idiopathic Arthritis: Study

In most of the kids affected with Juvenile Idiopathic Arthritis, immunosuppressive drugs, incomplete vaccine coverage, immune system dysregulation might be crucial causes for a low level of anti-vaccine antibodies.

A group of researchers from Russia conducted a cross-sectional study including 170 children diagnosed with Juvenile Idiopathic Arthritis (JIA) aged 2 to 17 years who had received routine vaccinations against measles, rubella, mumps (MMR), diphtheria, and hepatitis B national vaccine schedule.

In all patients, the levels of post-vaccination antibodies (IgG) for measles, rubella, mumps, hepatitis B, and diphtheria were measured with ELISA.

The results of the study are as follows:

The protective level of antibodies was: 50% against hepatitis B, 52% against diphtheria, 58% against measles, 80% against mumps, and 98% against rubella.

MMR's best coverage had patients with enthesitis-related arthritis-85%, compared to oligoarthritis-70%, polyarthritis-69%, systemic arthritis-63%. Diphtheria coverage was 50, 51, 46, 63%, respectively.

Incomplete MMR vaccination had 39% patients, treated with biologics, 22% with methotrexate and 14% with NSAID and 61, 46, 36% for diphtheria.

Incomplete vaccination was a risk factor of the non-protective level of antibodies against measles and diphtheria vaccines, as well as Juvenile Idiopathic Arthritis (JIA) category, biologics, corticosteroids and long-term methotrexate treatment for distinct vaccines.

One-third part of Juvenile Idiopathic Arthritis (JIA) patients continued vaccination against MMR and diphtheria without serious adverse events and JIA flare.

There were no differences between patients who continued MMR vaccination or denied in the means of Juvenile Idiopathic Arthritis (JIA) category and treatment options.

Patients continued diphtheria vaccination rare received methotrexate, biologics, but had higher anti-diphtheria antibodies compared to those who omitted vaccination.

Methotrexate and biologics were predictors of omitted diphtheria revaccination.

The researchers concluded that children with Juvenile Idiopathic Arthritis (JIA) may have lower anti-vaccine antibody levels and required routine checks, especially in children with incomplete vaccination, biologics, systemic arthritis, and long-term methotrexate treatment. And revaccination of Juvenile Idiopathic Arthritis (JIA) patients was safe and effective.

Reference:

The vaccine coverage and vaccine immunity status and risk factors of non-protective levels of antibodies against vaccines in children with juvenile idiopathic arthritis: cross-sectional Russian tertiary Centre study by Kostik M et. al published in the Pediatric Rheumatology.

DOI: 10.1186/s12969-021-00594-2