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Autoimmune disease activity was not adversely affected by vaccination. Expert opinion Current evidence indicates that administration of viral vaccines to children with autoimmune diseases receiving most systemic immunosuppressive drugs is immunogenic and safe. MMR can safely be given to most patients receiving biologics, but patients on high-dose prednisolone and pulse cyclophosphamide should avoid MMR and other live viral vaccines.Introduction In erythropoietic protoporphyria (EPP), an inherited disorder of heme biosynthesis, accumulat