MMR appears safe in children with arthritis
Juvenile arthritis symptoms do not worsen after MMR booster
Wednesday, 19 June 2013
Children with juvenile idiopathic arthritis (JIA) who have already had their primary measles-mumps-rubella immunisation and then have the MMR booster do not appear to experience worse disease activity than those who don’t have the booster, research published today in JAMA has shown.
Because children with JIA may be immunocompromised as a result of their immunosuppressive treatment, it is important that they can have safe and effective vaccinations to protect them from infection. But the rubella component of MMR had been suspected, in small uncontrolled studies, of being associated with induction of arthritis.
Researchers in Utrecht, the Netherlands, studied 137 children aged 4-9 years who had JIA. They randomly assigned half (68 children) to receive the MMR booster vaccination, and half to not have the booster.
They measured disease activity using the juvenile arthritis disease activity score (JADAS-27), which ranged from 0 (no activity) to 57 (high activity).
There was no significant difference during follow up between the JADAS-27 scores of 63 children who had their MMR booster (mean score 2.8) and the scores of 68 controls (mean 2.4). Nor was there a significant difference between the groups in the average number of disease flares that occurred during follow up (0.44 and 0.34 respectively).
All the children who had the booster were afterwards found to be seroprotected against measles and rubella. After 12 months, revaccinated children had higher rates of seroprotection than controls against measles (100% vs. 92%), mumps (97% vs. 81%) and rubella (100% vs. 94%), as well as higher concentrations of antibodies against all three diseases.
The study’s authors concluded: “The safety of MMR vaccination has been questioned because disease flares have been described after MMR vaccination. Our trial does not show an effect of vaccination on disease activity.” But they do call for larger studies to look at the effects of MMR in patients who are using biologic agents.