Primary prevention
SLE is a multisystem autoimmune disease with unclear etiology 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
Immunizations 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.[180]
The influenza vaccine and pneumococcal vaccine have been shown to be safe but have reduced efficacy.[181][182] The immunogenicity of influenza vaccine in patients with SLE appears to vary with viral strain.[183][184]
Several case reports document concerns that hepatitis B vaccination may lead to an exacerbation of SLE, so it is not recommended.[185]
Live vaccines (shingles, yellow fever, intranasal influenza) are not to be used because of underlying or imposed immunosuppression.
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