International travel considerations for patients with systemic autoimmune inflammatory diseases in the era of novel immunosuppressive therapies.

International travel, especially to areas with higher risk of infection, poses unique risks for infectious and non-infectious issues in patients with history of systemic autoimmune inflammatory diseases. We searched Medline, Scopus, and relevant rheumatology and other professional society guidelines for management of vaccinations and travel medications for immunocompromised travelers. The immune status of travelers with a history of systemic autoimmune inflammatory disease may have an impact on the safety and efficacy of vaccines, especially live-attenuated vaccines. For individuals on immunosuppressive medications, live vaccines are generally contraindicated. However, if safe intervals off immunosuppression are possible, live vaccines may be feasible. Chemoprophylaxis for malaria or acute mountain sickness may be indicated based on travel itinerary. Safe international travel is possible for patients with history of systemic autoimmune inflammatory diseases, including for those receiving immunosuppressive therapy, but may warrant coordination between a patient's rheumatologist and a travel medicine provider.