The incidence of vaccine-preventable infections in the context of systemic diseases is not quantified. Available data on immunogenicity and safety of vaccination in subjects treated for systemic disease are few and come from studies of low level of evidence. Keeping in mind these limitations, these studies show that the vaccines are well tolerated and often immunogenic, when administered in accordance with their contra-indications and the immunization schedule. These findings are an encouragement to properly immunize patients with systemic diseases. Measures should be taken to improve immunization coverage for these patients and their entourage.