D3.105 - Analysis of post-vaccination immunity in children with dermatology diseases receiving biologic and immunosuppressive therapy

Children on medication-induced immunosuppression are at high risk

of developing severe course infectious diseases.

Therefore, preventive vaccination is especially important for these children.

However, due to the immunosuppressive effects of treatment vaccination may

decrease below the protective level.

In a multidisciplinary children's medical Center, post-vaccination immunity was

studied in 93 children aged 1-17 years with dermatology diseases (Atopic dermatitis,

Psoriasis, Sclerodermia, Alopecia).The children were divided into 3 groups: group 1 children with moderate atopic dermatitis receiving topical therapy (20 - 21.5%), group 2 children with moderate atopic dermatitis receiving biologic therapy (dupilumab) for at least 1 year (48 - 51.6%), group 3 children with Psoriasis, Sclerodermia, Alopecia (25 - 26.8%). Among group 3, 16 patients (64%) received immunosuppressive therapy (prednisolone, methotrexate), while 9 patients (36%) were treated with biologic (tofacitinib, ustekinumab, secukinumab, upadacitinib).

More than 90% children were vaccinated according to the national vaccination calendar.Using the enzyme-linked immunosorbent assay method, specific IgG antibodies to vaccine-preventable infections were determined: measles, rubella, mumps, diphtheria, pertussis, tetanus, and

hepatitis B.

The study showed the percentage of children with positive IgG values for

vaccine-preventable infections. The highest percentage of children had

protective antibodies levels to rubella (79 - 84.9%) and measles (65 - 69.8%). The lowest

percentage of children with protective antibodies was for hepatitis B (43 - 46.2%).

Antibodies to mumps, diphtheria, pertussis, tetanus were found not in all

children (from 65.5% to 82.7%).

Not all children, despite the previous vaccination, preserved antibodies

unprotected by specific IgG antibodies. The issue of a booster vaccine dose

should be considered in the children without contraindications to vaccination.

Despite the fact that the children received biologic therapy and immunosuppressive therapy, the level of specific antibodies was comparable to children who received only topical therapy.

This may indicate that this therapy does not affect of a post-vaccination immune response.

However children receiving long-term immunosuppressive and biologic therapy require an individual vaccination approach vaccination.