Vaccination and inflammatory arthritis: overview of current vaccines and recommended uses in rheumatology.

Patients with autoimmune inflammatory rheumatic diseases are prone to infectious complications during the course of their disease. The underlying disease with an impaired immune system and additional different immunosuppressive medication render patients more susceptible to infections, some of which are potentially preventable with vaccination. Since it is not clear how strongly the underlying and medication-induced immunosuppression interferes with vaccination, a lot of questions remain about its indications, efficacy and safety . Due to these unresolved questions, in 2011, EULAR published general guidelines about vaccination in patients with autoimmune rheumatic diseases. These guidelines provide a basis for patient care and are also the basis of the following review article. With more available and earlier used immunosuppressive medications, a lot of questions still remain about optimal use of vaccines, the role of different medication combinations on efficacy and safety of vaccinations especially of the actual prevention of disease, the role of age, gender, disease activity and duration, and optimal revaccination schedules in this patient group. Actual studies elute the role of different medication combinations on efficacy and safety mainly addressing influenza and pneumococcal vaccination. In addition, interesting new data on basic immunological processes during TNF-α-blockade open up questions for further research.