G.I. NURULLINA, T.N. KHALFINA, E.R. ABDULLINA, D.M. SHAIDULLINA

 Kazan State Medical University, Kazan

 Contact details:

Nurullina G.I. — PhD (medicine), Assistant Lecturer of the Department of Hospital Therapy

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7 (843) 290-18-20, e-mail: nurguzel@yandex.ru

 The purpose — to study the features of vaccination, including against COVID-19, in patients with immune-mediated rheumatoid inflammatory diseases (IMRID).

Material and methods. A review of the scientific literature about vaccination, including vaccination against COVID-19, in patients with immune-mediated inflammatory rheumatoid diseases.

Results. Patients with IMRID are at risk of infectious diseases with a more severe course and outcome. This problem has become more urgent with the emergence of COVID-19 and the need for vaccination against it. Infectious diseases in IMRID patients may have a more severe source, thus, their vaccination is recommended. However, introduction of DMARDs and GEBDs into clinical practice leads to a decrease in the vaccination effectiveness. The specific role of vaccines in the induction of autoimmune diseases has been actively discussed over the past decade. However, apart from some specific vaccine complications, this role has not been established.

COVID-19 can also exacerbate IMRID. Therefore, vaccination should be recommended to these patients. The increase in IMRID symptoms after the vaccine introduction did not in all cases reflect a true exacerbation and cannot serve as a basis for refusing to vaccinate. The preserved sensibility to the disease may be explained by the lack of humoral response combined with insufficient T-cell response.

Conclusions. Therefore, vaccination is recommended for patients with IMRID. At the same time, vaccination is recommended against the background of low activity or remission of IMRID 6 months after and 4 weeks before the course of B-cell therapy. Immunological complications after vaccination are relatively rare, but they should not be underestimated, in this regard, it is necessary to carefully monitor patients in the post-vaccination period.

Key words: immune-mediated inflammatory diseases, vaccination, influenza, meningococcal infection, COVID-19.

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