Pediatric patients with autoinflammatory or rheumatic diseases are at increased risk of infections; therefore, safe and effective immunizations are crucial in the management of these group of patients. Current aggressive treatments involving the early use of immunosuppressive drugs and biological agents have further increased the susceptibility to infections in this group of patients. Therefore, effective and safe vaccination with adequate serological responses is important. In patients with rheumatic diseases, immunogenicity of a vaccine can differ from the healthy population, because of the disease itself or the immunosuppressive treatment received. Moreover, possible effects of vaccination on the underlying disease should be considered. In general, live attenuated vaccines should not be administered when high-dose immunosuppressive drugs are used for immunosuppressed patients. Inactivated vaccine agents have proven to be generally safe in patients with RD. The immune-modulating of biologic agents effects can last for weeks to months after discontinuation, depending on their half lifes. Also, live virus vaccines are contraindicated during therapy and for weeks to months following discontinuation of the biologics. The aim of this review is to cover the current information about vaccination practice in pediatric rheumatologic diseases and to give recommendations for future applications.

Keywords: biologicals, live-atenuated vaccine, pediatric rheumatic disease, vaccination