Immunogenicity and safety of pneumococcal vaccination in patients with rheumatoid arthritis or systemic lupus erythematosus

Clin Infect Dis. 2002 Jan 15;34(2):147-53. doi: 10.1086/338043. Epub 2001 Dec 4.


Prevention of bacterial infection, which is a leading cause of morbidity in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), is a priority. However, the safety and immunogenicity of the pneumococcal vaccine in such patients remain controversial. We evaluated the currently available pneumococcal vaccine in patients with RA or SLE. Pneumococcal vaccination was not associated with an appreciable deterioration in any clinical or laboratory measure of disease activity in either group. One month after vaccination, patients in both groups had significant increases in geometric mean concentrations of pneumococcal polysaccharide-specific IgG to all 7 serotypes tested, as did control subjects. However, 14 (33.3%) of 42 patients with RA and 5 (20.8%) of 24 patients with SLE responded either to none or to only 1 of the 7 polysaccharides. Pneumococcal vaccination is generally safe and immunogenic in patients with RA or SLE, but a subset of patients may remain unprotected by the currently available vaccine.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / blood
  • Arthritis, Rheumatoid / immunology*
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Lupus Erythematosus, Systemic / immunology*
  • Middle Aged
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines / adverse effects*
  • Pneumococcal Vaccines / immunology*
  • Pneumococcal Vaccines / therapeutic use


  • Antibodies, Bacterial
  • Immunoglobulin G
  • Pneumococcal Vaccines