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Safety of measles, mumps and rubella vaccination in juvenile idiopathic arthritis
  1. Marloes W Heijstek1,
  2. Gecilmara C S Pileggi1,2,
  3. Evelien Zonneveld-Huijssoon1,
  4. Wineke Armbrust3,
  5. Esther P A H Hoppenreijs4,
  6. Cuno S P M Uiterwaal5,
  7. Wietse Kuis1,
  8. Nico M Wulffraat1
  1. 1
    Department of Paediatric Immunology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands
  2. 2
    Department of Paediatric Rheumatology and immunology, School of Medicine of Ribeirão Preto, University of Sao Paulo, Brasil
  3. 3
    Department of Paediatric Rheumatolgy, Beatrix Children’s Hospital, University Medical Centre Groningen, The Netherlands
  4. 4
    Department of Paediatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  5. 5
    Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
  1. N M Wulffraat, Department of Paediatric Immunology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Room KC 03-0630, PO Box 85090, 3508 AB Utrecht, The Netherlands; n.wulffraat{at}


Objective: To assess the effect of measles, mumps and rubella (MMR) vaccination on disease activity in children with juvenile idiopathic arthritis (JIA).

Methods: A retrospective observational multicentre cohort study was performed in 314 patients with JIA, born between 1989 and 1996. Disease activity and medication use were compared during the period of 6 months before vaccination versus 6 months after vaccination. Disease activity was measured by joint counts, the Physician’s global assessment scale and erythrocyte sedimentation rate. Next, we compared disease activity in patients vaccinated between 8 and 9 years of age with the activity in patients who had not been vaccinated at this time (who received MMR between the ages of 9 and 10 years).

Results: No increase in disease activity or medication use was seen in the 6 months after MMR vaccination (n = 207), including in patients using methotrexate (n = 49). No overt measles infections were noted. When disease activity in vaccinated patients (n = 108) was compared with activity in those not yet vaccinated (n = 86), there were no significant differences.

Conclusions: The MMR booster vaccination does not seem to aggravate disease activity in JIA. This indicates that the most patients with JIA can be vaccinated safely with the MMR vaccine. A prospective study is recommended.

  • measles
  • mumps and rubella vaccination
  • juvenile idiopathic arthritis
  • methotrexate
  • disease activity parameters
  • flares

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  • Competing interests: None declared.

  • Abbreviations:
    Childhood Health Assessment Questionnaire
    disease-modifying anti-rheumatic drug
    erythrocyte sedimentation rate
    International League of Associations for Rheumatology
    juvenile idiopathic arthritis
    measles, mumps and rubella
    non-steroidal anti-inflammatory drug
    physician’s global assessment
    rheumatoid factor