Safety and efficiency of influenza vaccination in systemic lupus erythematosus patients.

INTRODUCTION: Systemic lupus erythematosus (SLE) patients have a higher infection rate than the general population. The role of influenza vaccination in SLE patients has been a matter of discussion due to the risk of disease exacerbation and to the influence of the disease and its treatment on vaccine efficacy. OBJECTIVE: To study safety and efficiency of influenza vaccination in SLE patients. METHODS: We studied 47 SLE patients and 27 healthy controls for influenza hemagglutinin titers before and 6 weeks after immunization. SLE patients were scored for disease activity by SLEDAI before and after receiving the vaccine. We also studied antibody titers in SLE patients according to the use of glucocorticoid, methotrexate and azathioprine. RESULTS: Seroprotection after vaccination was equal in SLE patients and healthy controls although seroconvertion was lower in SLE patients for one of the three antigens tested. No significant increase in SLEDAI was observed. Medications such as methotrexate and azathioprine did not change the mean titers of antibody response but glucocorticoids did affect the response to one of the antigens. CONCLUSIONS: Although immune response to influenza vaccine in SLE patients may be diminished it is safe and effective.