Overall, IL-6 inhibition with TCZ did not hamper antibody response to influenza, pneumococcal and tetanus toxoid vaccines in patients with RA.126–128 Similarly, safety and efficacy of influenza vaccination did not differ significantly between patients with sJIA and healthy controls.129 One study reported a negative impact of MTX on pneumococcal antibody response, when TCZ was used in combination with MTX in patients with RA.130. Here, IL6 is linked to influenza.