To update the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD) published in 2011. Four systematic literature reviews were performed regarding the incidence/prevalence of vaccine-preventable infections among patients with AIIRD; efficacy, immunogenicity and safety of vaccines; effect of anti-rheumatic drugs on the response to vaccines; effect of vaccination of household of AIIRDs patients. Subsequently, recommendations were formulated based on the evidence and expert opinion. The updated recommendations comprise six overarching principles and nine recommendations. The former address the need for an annual vaccination status assessment, shared decision-making and timing of vaccination, favouring vaccination during quiescent disease, preferably prior to the initiation of immunosuppression. Non-live vaccines can be safely provided to AIIRD patients regardless of underlying therapy, whereas live-attenuated vaccines may be considered with caution. Influenza and pneumococcal vaccination should be strongly considered for the majority of patients with AIIRD. Tetanus toxoid and human papilloma virus vaccination should be provided to AIIRD patients as recommended for the general population. Hepatitis A, hepatitis B and herpes zoster vaccination should be administered to AIIRD patients at risk. Immunocompetent household members of patients with AIIRD should receive vaccines according to national guidelines, except for the oral poliomyelitis vaccine. Live-attenuated vaccines should be avoided during the first 6 months of life in newborns of mothers treated with biologics during the second half of pregnancy. These 2019 EULAR recommendations provide an up-to-date guidance on the management of vaccinations in patients with AIIRD.

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2019 年 EULAR 成人自身免疫性炎症性风湿病疫苗接种建议更新

更新欧洲抗风湿病联盟 (EULAR) 于 2011 年发布的关于成年自身免疫性炎症风湿病 (AIIRD) 患者接种疫苗的建议。 对 AIIRD 患者中疫苗可预防感染的发生率/流行率进行了四项系统文献综述；疫苗的功效、免疫原性和安全性；抗风湿药物对疫苗反应的影响；AIIRDs 患者家庭接种疫苗的效果。随后，根据证据和专家意见制定了建议。更新后的建议包括六项总体原则和九项建议。前者解决了对年度疫苗接种状况评估、共同决策和疫苗接种时间的需求，有利于在静止期进行疫苗接种，优选在免疫抑制开始之前。无论基础治疗如何，非活疫苗都可以安全地提供给 AIIRD 患者，而减毒活疫苗可以谨慎考虑。大多数 AIIRD 患者应强烈考虑接种流感和肺炎球菌疫苗。应按照对一般人群的建议，向 AIIRD 患者提供破伤风类毒素和人乳头瘤病毒疫苗接种。有风险的 AIIRD 患者应接种甲型肝炎、乙型肝炎和带状疱疹疫苗。AIIRD 患者的免疫功能正常的家庭成员应根据国家指南接种疫苗，但口服脊髓灰质炎疫苗除外。对于在妊娠后半期接受生物制剂治疗的母亲的新生儿，在出生后的前 6 个月内应避免接种减毒活疫苗。这些 2019 EULAR 建议提供了 AIIRD 患者疫苗接种管理的最新指南。