Dr. Gewanter says the greatest chance of a vaccine not working or causing the disease it is meant to prevent is with these live attenuated vaccines. They include those given to prevent chicken pox (varicella); measles, mumps, rubella (MMR); and rotavirus; and the nasal flu vaccine, FluMist.

Although you might need to be cautious about giving your child live vaccines, he will likely be able to get inactivated vaccines. They are made from a killed viruses or bacteria, or parts of these killed diseases. Inactivated vaccines make up the bulk of required vaccines and are safe and effective for all children, including those with arthritis or who are on various medications. They are important for your child to receive because they will help protect him as well as those around him.

Weighing the Risk

While there are reasons for exercising caution when it comes to live vaccines, increasingly, research is starting to put some of the fears about them to rest. For example, in a study published a few years back in the Annals of the Rheumatic Diseases, researchers from the Netherlands found no overt measles infection nor increase in arthritis activity in 314 children with juvenile arthritis given the MMR vaccination.

Another study published earlier in the same journal by researchers in Turkey showed that children with juvenile arthritis produced an adequate response to the hepatitis B vaccination – even if they were receiving immunosuppressive therapy.

Although these and other studies have shown that children with arthritis usually respond well to most vaccines, some pediatric rheumatologists remain wary of giving live attenuated vaccines to children on immunosuppressive therapy, especially biologic agents and corticosteroids.

“It may be OK, [but] we just don’t have enough data yet to say for sure that it is sufficiently safe and effective,” says Dr. Gewanter. “So, for a lot of these kids we will choose to hold those vaccines.”

But for optimal protection of your child and those around him or her, it’s important to get needed immunizations as soon as your child’s doctors thinks it’s safe, he says.

“Immunizations are probably the greatest medical advance we have,” says Dr. Gewanter. “They are the only true preventive medicine out there. The diseases we are immunizing children against can be devastating in healthy individuals, much less someone with a chronic disease. Further, since many people with arthritis will have a flare of their disease during or just after an illness, it is worth it to try to prevent as many of these diseases as possible.”