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-rubellavaricella
(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 receivedMMR/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-attenuatedMMR/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.
- Rheumatic diseases