Primary prevention

SLE is a multisystem autoimmune disease with unclear aetiology and complex immune dysregulation and, as yet, there are no preventive strategies.

European League Against Rheumatism guidelines suggest low-dose aspirin may be considered for prevention of thrombosis and miscarriage in patients with SLE and antiphospholipid antibodies.[47]

Secondary prevention

Immunisations have implications for people who have SLE.

  • Tetanus toxoid, pneumococcal, and Haemophilus influenzae B vaccines have been demonstrated to be safe and effective when given to patients with SLE.[176]

  • The influenza vaccine and pneumococcal vaccine have been shown to be safe but have reduced efficacy.[177][178] The immunogenicity of influenza vaccine in patients with SLE appears to vary with viral strain.[179][180]

  • Several case reports document concerns that hepatitis B vaccination may lead to an exacerbation of SLE, so it is not recommended.[181]

  • Live vaccines (shingles, yellow fever, intranasal influenza) are not to be used because of underlying or imposed immunosuppression.

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