Hepatitis A vaccine may be safely administered to children on biologic therapy

Paediatric patients with autoinflammatory diseases undergoing treatment with canakinumab and tocilizumab can be safely vaccinated against hepatitis A, according to a prospective interventional study.

The study included 24 children with autoinflammatory diseases being treated with canakinumab (mean age 14.1 years) and tocilizumab treatments and 39 healthy children (mean age 12.4 years), all of whom were seronegative for hepatitis A. All were given two doses of inactivated hepatitis A vaccine at 6-month intervals.

Researchers collected venous blood samples from each participant 1 month after the second dose to measure the anti-HAV IgM and IgG titres.

In the patient group, 19 children had systemic juvenile idiopathic arthritis (sJIA) and five had cryopyrin-associated periodic fever. Canakinumab treatment was reported in all five patients with cryopyrin-associated periodic fever and in 10 of those with sJIA. The remaining nine patients with sJIA were on tocilizumab. Among sJIA patients, 15 were also on methotrexate, while 14 were on prednisolone.

After receiving two doses of hepatitis A vaccine, anti-HAV IgG positivity was documented in all the patients with autoinflammatory diseases (100 percent) and 84.6 percent (33/39) of healthy controls (p=0.04). The mean anti-HAV Ig G titres were 5.25 IU/L in the patient group and 10.5 IU/L in the control group 1 month after the last dose of vaccination (p<0.001).

None of the children in the patient and control groups experienced disease flares or adverse effects related to vaccination.