Letter to the Editor: Bridging the immunization gap in pediatric autoimmune disorders - insights from inflammatory bowel disease and vaccine response patterns

Abstract

Autoimmune diseases represent serious conditions characterized by immune dysregulation, which compromises the body’s defense mechanisms and affects responses to infections and Vaccines. In addition to this, the treatment of these diseases involves mostly immunosuppressant’s. I read with great interest the study published in the World Journal of Clinical Pediatrics by Makarova et al, examining vaccines and antibody levels in children with inflammatory bowel disease (IBD), with a focus on enhancing children’s immune responses. Children with autoimmune diseases often show poor response to vaccines, which is attributed to their health condition and the immunosuppressive drugs used in treatment. One of the effective ways to protect these people in general and the children in specific is to follow personalized vaccination plans, or as mentioned in the research being discussed, to carry out revaccination and conduct serology tests and immunoglobulin G to ensure the effectiveness of vaccination plans. Those with diseases similar to IBD, and related diseases should conduct periodic checks after vaccination.

Key Words: Autoimmune diseases; Immunosuppressive; Vaccination; Immunization; Vaccines

Core Tip: Children with inflammatory bowel disease (IBD) may be more susceptible to other autoimmune diseases. They may also not get an adequate response to vaccines because of the medications they take to suppress their immunity. Recent studies have addressed this issue, especially in people with IBD, antibody levels, and vaccines, and their potential effectiveness, particularly against rubella and hepatitis B.

TO THE EDITOR

I recently read the article published in the World Journal of Clinical Pediatrics by Makarova et al[1], which is very important research that makes us rethink the issue of vaccine effectiveness. Makarova et al[1] examined vaccine efficacy by measuring immunoglobulin G (IgG) antibodies after vaccination against Measles, mumps, and hepatitis B in children with inflammatory bowel disease (IBD) as compared to healthy volunteers the author of the research found that several children with IBD have low IgG antibody level that normal effective vaccinaton for example in Rubella the level of IgG should be more than 10 IU/mL to ensure the effectiveness of the vaccine and this study show that lower IgG values with Protective titer About 74.4% in IBD kids with 89.7% in healthy volantes[2,3].

It is worth noting that the effectiveness of vaccines decreased, except for mumps, which was not greatly affected. The effect is most evident in measles, rubella, and hepatitis B vaccines. Similar findings were observed across all vaccine effectiveness studies. Several studies have discussed the health state of patients with autoimmune diseases, their response to vaccines, and their susceptibility to other diseases, such as other autoimmune diseases[4]. However, there is no direct link between autoimmune diseases such as IBD, rheumatoid arthritis, and the immune state.

Despite that, autoimmune diseases are usually treated with immunosuppressants, such as a range of steroids, including hydrocortisone, prednisolone, azathioprine, and methotrexate. All these medications have a negative effect on the human immune system, thus altering the individual's response to disease and reducing the effectiveness of vaccines in IBD patients, whether they have Crohn’s disease or ulcerative colitis[5,6].

CONCLUSION

All of these findings confirm the researchers’ conclusion regarding the limited effectiveness of vaccines and the urgent need for revaccination[7]. International organizations that develop vaccination plans should establish specific guidelines for vaccination in patients with IBD and related autoimmune diseases. Attachments Video support the importance of the article.