{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:42:27Z","timestamp":1791520947733,"version":"4.3.4"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Rigshospitalet Research Foundation"},{"DOI":"10.13039\/100008368","name":"Gigtforeningen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008368","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Foundation for Collaboration between Rigshospitalet and Odense University Hospital"},{"DOI":"10.13039\/100007403","name":"Dagmar Marshalls Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007403","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010358","name":"KV Fonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010358","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Prevention of illness due to infection by influenza viruses is important for children with rheumatic diseases. Biological disease modifying antirheumatic drugs have become increasingly important in the treatment of juvenile idiopathic arthritis, and combinations of immunosuppressive drugs are used for the treatment of systemic disorders, which increase the risk of secondary immunodeficiency. Therefore, we investigated whether children with rheumatic disease can mount a protective antibody response after influenza immunization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The prospective multicentre cohort study was conducted in Denmark during the influenza season 2015\u20132016. Children with rheumatic disease aged six months to 19\u00a0years were eligible. Controls were immunologically healthy children. A blood sample was collected before and after vaccination and analysed by haemagglutination inhibition (HI) assay for the 2015\u20132016 influenza vaccine-strains. In case of flu-like symptoms the child was tested for influenza. For statistical analyses the patients were grouped according to medical treatment or disease.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 226 patients and 15 controls were enrolled. No differences were found for the increase of antibodies from pre-vaccine to post-vaccine between the groups in our primary analyses: A\/Cal H1N1pdm09 (<jats:italic>p<\/jats:italic>\u2009=\u20090.28), A\/Swi H3N2 (<jats:italic>p<\/jats:italic>\u2009=\u20090.15) and B\/Phu Yamagata (<jats:italic>p<\/jats:italic>\u2009=\u20090.08). Only when combining patients across groups a lower increase in antibodies was found compared to controls. Among all patients the pre-vaccine rates for seroprotection using the HI-titer cut-off \u2265\u200940 were 93.1\u201397.0\u2009% for all three strains. For seroprotection using the HI-titer cut-off \u2265\u2009110 the pre-vaccine rates for all patients were 14.9\u201343.6\u2009% for all three strains and an increase in the proportions of patients being seroprotected after vaccination was found for A\/Cal H1N1pdm09 and A\/Swi H3N2. None of the children with flu-like symptoms tested positive for the vaccine strains.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Children with rheumatic diseases increase in antibody titres after influenza immunization, however, it remains uncertain whether a protective level is achieved.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12969-021-00518-0","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T12:06:50Z","timestamp":1615550810000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Response to influenza vaccination in immunocompromised children with rheumatic disease: a prospective cohort study"],"prefix":"10.1186","volume":"19","author":[{"given":"Lotte","family":"Jensen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Estmann","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddy Karup","family":"Pedersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Trebbien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thea K\u00f8lsen","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Rosth\u00f8j","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Toftedal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Helene","family":"Bohr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peder Skov","family":"Wehner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Poulsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"518_CR1","doi-asserted-by":"crossref","unstructured":"Beukelman T, Xie F, Chen L, Baddley JW, Delzell E, Grijalva CG, et al. Rates of hospitalized bacterial infection associated with juvenile idiopathic arthritis and its treatment. Arthritis & Rheumatism. 2012 Aug 1;64(8):2773\u201380.","DOI":"10.1002\/art.34458"},{"key":"518_CR2","doi-asserted-by":"crossref","unstructured":"Singh JA, Wells GA, Christensen R, Ghogomu ET, Maxwell LJ, MacDonald JK, et al. Adverse effects of biologics: a network meta-analysis and Cochrane overview. Cochrane Database of Systematic Reviews [Internet]. 2011 [cited 2018 Sep 17];(2). Available from: https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD008794.pub2\/abstract","DOI":"10.1002\/14651858.CD008794"},{"key":"518_CR3","doi-asserted-by":"crossref","unstructured":"Heijstek MW, Bruin LMO de, Bijl M, Borrow R, Klis F, van der, Kon\u00e9-Paut I, et al. EULAR recommendations for vaccination in paediatric patients with rheumatic diseases. Ann Rheum Dis. 2011 Jan 10;70(10):1704\u201312.","DOI":"10.1136\/ard.2011.150193"},{"key":"518_CR4","doi-asserted-by":"crossref","unstructured":"Pinto MV, Bihari S, Snape MD. Immunisation of the immunocompromised child. J Infect. 2016;72:13\u201322.","DOI":"10.1016\/j.jinf.2016.04.017"},{"issue":"5","key":"518_CR5","first-page":"589","volume":"19","author":"F Kanakoudi-Tsakalidou","year":"2001","unstructured":"Kanakoudi-Tsakalidou F, Trachana M, Pratsidou-Gertsi P, Tsitsami E, Kyriazopoulou-Dalaina V. Influenza vaccination in children with chronic rheumatic diseases and long-term immunosuppressive therapy. Clin Exp Rheumatol. 2001;19(5):589\u201394.","journal-title":"Clin Exp Rheumatol"},{"key":"518_CR6","doi-asserted-by":"crossref","unstructured":"Ogimi C, Tanaka R, Saitoh A, Oh-ishi T. Immunogenicity of Influenza Vaccine in Children With Pediatric Rheumatic Diseases Receiving Immunosuppressive Agents: The Pediatric Infectious Disease Journal. 2011;30(3):208\u201311.","DOI":"10.1097\/INF.0b013e3181f7ce44"},{"key":"518_CR7","doi-asserted-by":"crossref","unstructured":"Woerner A, Sauvain M-J, Aebi C, Otth M, Bolt IB. Immune response to influenza vaccination in children treated with methotrexate or\/and tumor necrosis factor-\u03b1 inhibitors. Human Vaccines. 2011 Dec 1;7(12):1293\u20138.","DOI":"10.4161\/hv.7.12.17981"},{"key":"518_CR8","doi-asserted-by":"crossref","unstructured":"Shinoki T, Hara R, Kaneko U, Miyamae T, Imagawa T, Mori M, et al. Safety and response to influenza vaccine in patients with systemic-onset juvenile idiopathic arthritis receiving tocilizumab. Mod Rheumatol. 2012;22(6):871\u20136.","DOI":"10.3109\/s10165-012-0595-z"},{"key":"518_CR9","doi-asserted-by":"crossref","unstructured":"Camacho-Lovillo MS, Bulnes-Ramos A, Goycochea-Valdivia W, Fern\u00e1ndez-Silveira L, N\u00fa\u00f1ez-Cuadros E, Neth O, et al. Immunogenicity and safety of influenza vaccination in patients with juvenile idiopathic arthritis on biological therapy using the microneutralization assay. Pediatr Rheumatol Online J [Internet]. 2017 Aug 7;15. Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5547451\/.","DOI":"10.1186\/s12969-017-0190-0"},{"key":"518_CR10","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1546-0096-12-13","volume":"12","author":"ML Stoll","year":"2014","unstructured":"Stoll ML, Cron RQ. Treatment of juvenile idiopathic arthritis: a revolution in care. 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Informed consent was obtained from participants and parents as relevant according to the age of the participant.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"26"}}