THU0551\u2005VACCINATION COVERAGE IN FRENCH CHILDREN WITH AUTO-INFLAMMATORY DISEASES : PRELIMINARY DATA FROM THE JIRCOHORTE

Abstract

Background: Autoinflammatory diseases (AID) comprise a large number of rare diseases that manifest as recurrent sterile inflammation or disproportionate infection-induced inflammatory symptoms. Vaccine relation to AID is complex: on one hand the susceptibility to infections vary with the treatment options of the patient, on the other hand the disease activity may be triggered by vaccination. Nevertheless, effective immunization is crucial in this population. Up to know very little is known about vaccination coverage in AID children. Objectives: To determine vaccination coverage in French children with an autoinflammatory disease. Methods: Patients between 2 and 18 years with autoinflammatory diseases followed at the French Reference Center for Auto-Inflammatory Diseases-Versailles Hospital and included to the Juvenile Inflammatory Rheumatism cohort (JIRcohorte) network - an international multicenter prospective cohort for children with inflammatory and rheumatological diseases - were included in this retrospective monocentric observational study. Vaccination coverage of each disease and complete status of vaccination was assessed at the last out-patient visit, according to the national immunization program. Detail of every vaccine received (number of doses and date of administration) were collected by a pediatrician from written immunization record (vaccination card). Demographic data, disease and medications used since diagnosis were also assessed. Patients with no available immunization record were excluded. Results: 128 patients met the inclusion criteria. Sex ratio was 1.2 (70/58). Median age at the last out-patient visit was 8.4 years (2.5-17.9 years). 53 children (41%) presented periodic fever with aphtous stomatitis, pharyngitis and adenitis (PFAPA) syndrome, 30 familial mediterranean fever, 29 unexplained autoinflammatory recurrent fevers, 8 TNF receptor associated periodic syndrome (TRAPS), 8 other autoinflammatory diseases. 68 patients (53%) were treated by on-demand corticosteroids, nine patients (0.7%) by biological agents, the other patients did not receive any immunosuppressive treatment. At the last clinic visit, only 49% (n=63) of our entire cohort had a complete vaccination status (human papilloma virus and tuberculosis excluded). Coverage rates was superior to 85% for diphtheria/tetanus/poliomyelitis (89%), pertussis (95%), haemophilus influenza type B (94%) and measles/mumps/rubella (89%). 84% of the children were well-vaccinated against pneumococcus. Lowest individual vaccination coverage rates were observed for hepatitis B at 77% and for meningococcus C at 77%. Only one girl received complete vaccination against human papilloma virus. Conclusion: Vaccination coverage in children with autoinflammatory diseases appears suboptimal. Measures to optimize vaccination coverage in these children should be implemented. References: [1] Jaeger VK, et al. Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study. Rheumatology (Oxford). 2017Sep1;56(9):1484-1491 [2] Jeyaratnam J. et al. The safety of live-attenuated vaccines in patients using IL-1 or IL-6 blockade: an international survey. Pediatr Rheumatol Online J. 2018Mar21;16(1):19 Disclosure of Interests: Virginie Rollet-Cohen: None declared, Justine Mirete: None declared, Glory Dingulu: None declared, Andreas Wörner: None declared, Marie-Aliette Dommergues Grant/research support from: Pfizer, MSD, GSK (travel grant for medical congress), Consultant for: Pfizer, MSD, GSK (scientific board participation), Speakers bureau: Pfizer, MSD, GSK, Véronique Hentgen Consultant for: SOBI, Novartis, Abbvie, Speakers bureau: Novartis