[Should we vaccinate patients with systemic lupus].

Controversies regarding the safety and efficacy of immunization in patients with SLE have persisted for over 60 years. However infections are the main threat in these patients. There are concerns that immunization may cause SLE exacerbation. Evidence from prospective trials suggests that inactivated vaccines are probably safe in patients with stable or inactive disease. Live vaccines are contraindicated in immunocompromised hosts and patients on high dose steroids. Data regarding efficacy of vaccinations are scarce, mainly concerning influenza and pneumoccocal vaccine. Majority of patients have appropriate immunological response, but there are group without serological response after immunization. Risk factors for impaired response are not clear. In same cases it seems reasonable to assess protective antibody titer post vaccination. In this review we would like to present data concerning safety and efficacy of vaccines in patients with SLE to help doctor to decide when vaccination is advisable and when should be avoided.