, Bulletin du réseau de surveillance des infections invasives bactériennes / Infections invasives d'origine bactérienne -Réseau EPIBAC / Maladies à prévention vaccinale / Maladies infectieuses / Dossiers thématiques / Accueil [Internet]. [cité 30 juill, 2018.

, Bilan annuel 2016 : Impact de la vaccination par le vaccin pneumococcique conjugué 13-valent (VPC13) sur l'incidence des infections invasives à pneumocoques, Epibac et CNR des pneumocoques (réseau CNRP-ORP), 2016.

V. Emmanuelle and J. Claire, CNRP, 2015.

O. Launay, Prévention vaccinale grippe et pneumocoque : actualité. Cours de chimiothéraîe anti-infectieuse et de Vaccinologie présenté à, 2017.

, Avis du Conseil supérieur d'hygiène publique de France, du 8 mars 2002 relatif à la vaccination par le vaccin pneumococcique heptavalent conjugué (Prevenar®). HCSP, 2002.

, Avis du 19 mai 2006 relatif à la vaccination par le vaccin anti-pneumococcique conjugué chez les enfants de moins de deux ans et les enfants de deux à cinq ans. HCSP, 2006.

, Avis du Haut Conseil de la santé publique du 17 octobre 2008 relatif au schéma vaccinal de la vaccination par le vaccin anti-pneumococcique conjugué heptavalent. HCSP, 2008.

, HAS :COMMISSION DE LA TRANSPARENCE AVIS 10 mars 2010. HAS, 2010.

, Bulletin épidémiologique hebdomadaire :Le Calendrier des vaccinations et les recommandations vaccinales 2010 selon l'avis du Haut conseil de la santé publique

, HCSP. AVIS relatif aux recommandations de la vaccination pour les adultes et les enfants âgés de plus de 2 ans à risque d'infection, p.17, 2018.

, Avis du Haut Conseil de la Santé publique relatif aux recommandations vaccinales contre les infections à pneumocoque pour les adultes, HCSP, 2017.

E. Bouza, J. Moya, P. Muñoz, . Infections, . Systemic et al., Infect Dis Clin North Am. 1 juin, vol.15, issue.2, pp.335-61, 2001.

R. Cervera, M. A. Khamashta, J. Font, G. D. Sebastiani, A. Gil et al., Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore), vol.82, pp.299-308, 2003.

P. Duchet-niedziolka, T. Hanslik, A. Aouba, L. Guern, V. Guillevin et al., Risque d'infections à pneumocoque et prévention vaccinale au cours des maladies systémiques, Presse Médicale. 1 févr, vol.38, issue.2, pp.243-50, 2009.

T. Hanslik, J. C. Boulard, and A. Baglin, Vaccination et maladies immunologiques, Rev Médecine Interne. 1 janv, vol.17, issue.1, pp.17-20, 1996.

S. Bernatsky, M. Hudson, and S. Suissa, Anti-rheumatic drug use and risk of serious infections in rheumatoid arthritis, Rheumatol Oxf Engl. juill, vol.46, issue.7, pp.1157-60, 2007.

T. Glück, B. Kiefmann, M. Grohmann, W. Falk, R. H. Straub et al., Immune status and risk for infection in patients receiving chronic immunosuppressive therapy, J Rheumatol. août, vol.32, issue.8, pp.1473-80, 2005.

O. Elkayam, J. Ablin, and D. Caspi, Safety and efficacy of vaccination against streptococcus pneumonia in patients with rheumatic diseases, Autoimmun Rev. 1 avr, vol.6, issue.5, pp.312-316, 2007.

P. Nived, J. Nagel, T. Saxne, P. Geborek, G. Jönsson et al., Immune response to pneumococcal conjugate vaccine in patients with systemic vasculitis receiving standard of care therapy, Vaccine. 22 juin, vol.35, issue.29, pp.3639-3685, 2017.

M. F. Doran, C. S. Crowson, G. R. Pond, W. M. O'fallon, and S. E. Gabriel, Frequency of infection in patients with rheumatoid arthritis compared with controls: a population-based study, Arthritis Rheum. sept, vol.46, issue.9, pp.2287-93, 2002.

T. Glück and U. Müller-ladner, Vaccination in patients with chronic rheumatic or autoimmune diseases, Clin Infect Dis Off Publ Infect Dis Soc Am. 1 mai, vol.46, issue.9, pp.1459-65, 2008.

M. Petri, . Infection, . Systemic, and . Erythematosus, Rheum Dis Clin N Am. 1 mai, vol.24, issue.2, pp.423-56, 1998.

V. Noël, O. Lortholary, P. Casassus, P. Cohen, T. Généreau et al., Risk factors and prognostic influence of infection in a single cohort of 87 adults with systemic lupus erythematosus, Ann Rheum Dis. déc, vol.60, issue.12, pp.1141-1145, 2001.

C. Naveau and F. A. Houssiau, Pneumococcal sepsis in patients with systemic lupus erythematosus, Lupus, vol.14, issue.11, pp.903-909, 2005.

M. H. Kyaw, C. E. Rose, A. M. Fry, J. A. Singleton, Z. Moore et al., The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults, J Infect Dis. 1 août, vol.192, issue.3, pp.377-86, 2005.

P. Klemets, O. Lyytikäinen, P. Ruutu, J. Ollgren, T. Kaijalainen et al., Risk of invasive pneumococcal infections among working age adults with asthma, Thorax. 1 août, vol.65, issue.8, pp.698-702, 2010.

K. A. Robinson, W. Baughman, G. Rothrock, N. L. Barrett, M. Pass et al., Epidemiology of invasive Streptococcus pneumoniae infections in the United States, 1995-1998: Opportunities for prevention in the conjugate vaccine era, JAMA. 4 avr, vol.285, issue.13, pp.1729-1764, 2001.

O. Elkayam, D. Paran, D. Caspi, I. Litinsky, M. Yaron et al., Immunogenicity and Safety of Pneumococcal Vaccination in Patients with Rheumatoid Arthritis or Systemic Lupus Erythematosus, Clin Infect Dis. 15 janv, vol.34, issue.2, pp.147-53, 2002.

I. Santé-publique-france and . Infections-À-pneumocoque, Point sur les connaissances, 2017.

J. E. Sisk, A. J. Moskowitz, W. Whang, J. D. Lin, D. S. Fedson et al., Cost-effectiveness of vaccination against pneumococcal bacteremia among elderly people, JAMA, vol.278, issue.16, pp.1333-1342, 1997.

K. L. Nichol, L. Baken, J. Wuorenma, and A. Nelson, The health and economic benefits associated with pneumococcal vaccination of elderly persons with chronic lung disease, Arch Intern Med, vol.159, issue.20, pp.2437-2479, 1999.

B. Cho, C. Stoecker, R. Link-gelles, and M. R. Moore, Cost-effectiveness of administering 13-valent pneumococcal conjugate vaccine in addition to 23-valent pneumococcal polysaccharide vaccine to adults with immunocompromising conditions, Vaccine. 5 déc, vol.31, issue.50, pp.6011-6032, 2013.

J. Chen, M. A. O'brien, H. K. Yang, J. D. Grabenstein, and E. J. Dasbach, Cost-effectiveness of pneumococcal vaccines for adults in the United States, Adv Ther. avr, vol.31, issue.4, pp.392-409, 2014.

, Haut conseil de la santé publique. Vaccination des personnes immunodéprimées ou aspléniques Recommandations, 2014.

J. Nagel, P. Geborek, T. Saxne, G. Jönsson, M. Englund et al., The risk of pneumococcal infections after immunization with pneumococcal conjugate vaccine compared to non-vaccinated inflammatory arthritis patients, Scand J Rheumatol, vol.44, issue.4, pp.271-280, 2015.

S. A. Moberley, J. Holden, D. P. Tatham, and R. M. Andrews, Vaccines for preventing pneumococcal infection in adults, Cochrane Database Syst Rev. 23 janv, issue.1, p.422, 2008.

S. Moberley, J. Holden, D. P. Tatham, and R. M. Andrews, Vaccines for preventing pneumococcal infection in adults, Cochrane Database Syst Rev. 31 janv, issue.1, p.422, 2013.

M. Bonten, S. M. Huijts, M. Bolkenbaas, C. Webber, S. Patterson et al., Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults, N Engl J Med. 19 mars, vol.372, issue.12, pp.1114-1139, 2015.

N. J. Andrews, P. A. Waight, R. C. George, M. Slack, and E. Miller, Impact and effectiveness of 23-valent pneumococcal polysaccharide vaccine against invasive pneumococcal disease in the elderly in England and Wales. Vaccine, vol.30, pp.6802-6810, 2012.

G. Falkenhorst, C. Remschmidt, T. Harder, E. Hummers-pradier, O. Wichmann et al., Effectiveness of the 23-Valent Pneumococcal Polysaccharide Vaccine

, Pneumococcal Disease in the Elderly: Systematic Review and Meta-Analysis. PLOS ONE. 6 janv, vol.12, issue.1, p.169368, 2017.

H. Kraicer-melamed, O. Donnell, S. Quach, and C. , The effectiveness of pneumococcal polysaccharide vaccine 23 (PPV23) in the general population of 50 years of age and older: A systematic review and meta-analysis, Vaccine. 18 mars, vol.34, issue.13, pp.1540-50, 2016.

H. Kraicer-melamed, O. Quach, and C. Corrigendum, The effectiveness of pneumococcal polysaccharide vaccine 23 (PPV23) in the general population of 50years of age and older: A systematic review and meta-analysis, Vaccine. 25 juill, vol.34, issue.34, pp.4083-4087, 2016.

W. Diao, N. Shen, P. Yu, B. Liu, and B. He, Efficacy of 23-valent pneumococcal polysaccharide vaccine in preventing community-acquired pneumonia among immunocompetent adults: A systematic review and meta-analysis of randomized trials, Vaccine. 18 mars, vol.34, issue.13, pp.1496-503, 2016.

J. Schiffner-rohe, A. Witt, J. Hemmerling, C. Von-eiff, and F. Leverkus, Efficacy of PPV23 in Preventing Pneumococcal Pneumonia in Adults at Increased Risk--A Systematic Review and Meta-Analysis, PloS One, vol.11, issue.1, p.146338, 2016.

M. Suzuki, B. G. Dhoubhadel, T. Ishifuji, M. Yasunami, M. Yaegashi et al., Serotype-specific effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumococcal pneumonia in adults aged 65 years or older: a multicentre, prospective, test-negative design study, Lancet Infect Dis, vol.17, issue.3, pp.313-334, 2017.

M. C. Kapetanovic, C. Roseman, G. Jönsson, L. Truedsson, T. Saxne et al., Antibody response is reduced following vaccination with 7-valent conjugate pneumococcal vaccine in adult methotrexate-treated patients with established arthritis, but not those treated with tumor necrosis factor inhibitors, Arthritis Rheum. déc, vol.63, issue.12, pp.3723-3755, 2011.

M. C. Kapetanovic, T. Saxne, A. Sjöholm, L. Truedsson, G. Jönsson et al., Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis, Rheumatol Oxf Engl. janv, vol.45, issue.1, pp.106-117, 2006.

P. J. Mease, C. T. Ritchlin, R. W. Martin, A. B. Gottlieb, S. W. Baumgartner et al., Pneumococcal vaccine response in psoriatic arthritis patients during treatment with etanercept, J Rheumatol. juill, vol.31, issue.7, pp.1356-61, 2004.

J. L. Kaine, A. J. Kivitz, C. Birbara, and A. Y. Luo, Immune responses following administration of influenza and pneumococcal vaccines to patients with rheumatoid arthritis receiving adalimumab, J Rheumatol. févr, vol.34, issue.2, pp.272-281, 2007.

S. Visvanathan, G. F. Keenan, D. G. Baker, A. I. Levinson, and C. L. Wagner, Response to pneumococcal vaccine in patients with early rheumatoid arthritis receiving infliximab plus methotrexate or methotrexate alone, J Rheumatol. mai, vol.34, issue.5, pp.952-959, 2007.

O. Elkayam, D. Caspi, T. Reitblatt, D. Charboneau, and J. B. Rubins, The effect of tumor necrosis factor blockade on the response to pneumococcal vaccination in patients with rheumatoid arthritis and ankylosing spondylitis, Semin Arthritis Rheum. févr, vol.33, issue.4, pp.283-291, 2004.

C. Hua, T. Barnetche, B. Combe, and J. Morel, Effect of methotrexate, anti-tumor necrosis factor ?, and rituximab on the immune response to influenza and pneumococcal vaccines in patients with rheumatoid arthritis: a systematic review and meta-analysis, Arthritis Care Res. juill, vol.66, issue.7, pp.1016-1042, 2014.

C. Kapetanovic, M. Saxne, T. Jönsson, G. Truedsson, L. Geborek et al., Rituximab and abatacept but not tocilizumab impair antibody response to pneumococcal conjugate vaccine in patients with rheumatoid arthritis, Arthritis Res Ther, vol.15, issue.5, p.171, 2013.

M. Nguyen, H. Lindegaard, O. Hendricks, C. S. Jørgensen, B. Kantsø et al., Initial Serological Response after Prime-boost Pneumococcal Vaccination in Rheumatoid Arthritis Patients: Results of a Randomized Controlled Trial, J Rheumatol. déc, vol.44, issue.12, pp.1794-803, 2017.

M. Nguyen, H. Lindegaard, O. Hendricks, C. S. Jørgensen, B. Kantsø et al., Initial Serological Response after Prime-boost Pneumococcal Vaccination in Rheumatoid Arthritis Patients: Results of a Randomized Controlled Trial, J Rheumatol. déc, vol.44, issue.12, pp.1794-803, 2017.

C. O. Bingham, R. J. Looney, A. Deodhar, N. Halsey, M. Greenwald et al., Immunization responses in rheumatoid arthritis patients treated with rituximab: results from a controlled clinical trial, Arthritis Rheum. janv, vol.62, issue.1, pp.64-74, 2010.

M. Rehnberg, M. Brisslert, S. Amu, K. Zendjanchi, G. Håwi et al., Vaccination response to protein and carbohydrate antigens in patients with rheumatoid arthritis after rituximab treatment, Arthritis Res Ther, vol.12, issue.3, p.111, 2010.

M. Heusele, P. Clerson, B. Guery, M. Lambert, D. Launay et al., Risk factors for severe bacterial infections in patients with systemic autoimmune diseases receiving rituximab, Clin Rheumatol. juin, vol.33, issue.6, pp.799-805, 2014.

M. H. Buch, J. S. Smolen, N. Betteridge, F. C. Breedveld, G. Burmester et al., Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis, Ann Rheum Dis. 1 juin, vol.70, issue.6, pp.909-929, 2011.

L. Tay, F. Leon, G. Vratsanos, R. Raymond, and M. Corbo, Vaccination response to tetanus toxoid and 23-valent pneumococcal vaccines following administration of a single dose of abatacept: a randomized, open-label, parallel group study in healthy subjects, Arthritis Res Ther, vol.9, issue.2, p.38, 2007.

R. Alten, C. O. Bingham, S. B. Cohen, J. R. Curtis, S. Kelly et al., Antibody response to pneumococcal and influenza vaccination in patients with rheumatoid arthritis receiving abatacept, BMC Musculoskelet Disord, vol.26, p.231, 2016.

K. Migita, Y. Akeda, M. Akazawa, S. Tohma, F. Hirano et al., Effect of abatacept on the immunogenicity of 23-valent pneumococcal polysaccharide vaccination (PPSV23) in rheumatoid arthritis patients, Arthritis Res Ther. 10 déc, vol.17, p.357, 2015.

S. Combe, Etude de la réponse au vaccin pneumococcique chez les patients ayant une polyarthrite rhumatoïde et traités par abatacept. Rev Rhum, vol.74, p.1066, 2007.

T. Tsuru, K. Terao, M. Murakami, T. Matsutani, M. Suzaki et al., Immune response to influenza vaccine and pneumococcal polysaccharide vaccine under IL-6 signal inhibition therapy with tocilizumab, Mod Rheumatol. mai, vol.24, issue.3, pp.511-517, 2014.

C. O. Bingham, W. Rizzo, A. Kivitz, A. Hassanali, R. Upmanyu et al., Humoral immune response to vaccines in patients with rheumatoid arthritis treated with tocilizumab: results of a randomised controlled trial (VISARA), Ann Rheum Dis. mai, vol.74, issue.5, pp.818-840, 2015.

C. Brodmerkel, E. Wadman, R. G. Langley, K. Papp, M. Bourcier et al., Immune response to pneumococcus and tetanus toxoid in patients with moderate-to-severe psoriasis following longterm ustekinumab use, J Drugs Dermatol JDD, vol.12, issue.10, pp.1122-1131, 2013.

E. V. Gomez, J. L. Bishop, K. Jackson, T. M. Muram, and D. Phillips, Response to Tetanus and Pneumococcal Vaccination Following Administration of Ixekizumab in Healthy Participants, Biodrugs, vol.31, issue.6, pp.545-54, 2017.

K. L. Winthrop, J. Silverfield, A. Racewicz, J. Neal, E. B. Lee et al., The effect of tofacitinib on pneumococcal and influenza vaccine responses in rheumatoid arthritis, Ann Rheum Dis. avr, vol.75, issue.4, pp.687-95, 2016.

J. Nagel, T. Saxne, P. Geborek, A. A. Bengtsson, S. Jacobsen et al., Treatment with belimumab in systemic lupus erythematosus does not impair antibody response to 13-valent pneumococcal conjugate vaccine, Lupus. sept, vol.26, issue.10, pp.1072-81, 2017.

W. Chatham, A. Chadha, J. Fettiplace, C. Kleoudis, D. Bass et al., A randomized, open-label study to investigate the effect of belimumab on pneumococcal vaccination in patients with active, autoantibody-positive systemic lupus erythematosus, Lupus. déc, vol.26, issue.14, pp.1483-90, 2017.

J. O'dell, J. Gilg, and P. , Pneumococcal vaccine in rheumatoid arthritis. Decreased response while on methotrexate, J Clin Rheumatol, 1996.

C. R. Holroyd, R. Seth, M. Bukhari, A. Malaviya, C. Holmes et al., The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis, Rheumatology, p.16, 2018.

D. Sur,

. Snowden, IMMUNISATION OF IMMUNOSUPPRESSED PATIENTS WITH RHEUMATIC DISEASES. Top Rev. juin, vol.12, 2007.

G. Fiorino, L. Peyrin-biroulet, P. Naccarato, H. Szabò, O. R. Sociale et al., Effects of Immunosuppression on Immune Response to Pneumococcal Vaccine in Inflammatory Bowel Disease: A Prospective Study, Inflamm Bowel Dis. 1 juin, vol.18, issue.6, pp.1042-1049, 2012.

R. N. Lipnick, J. Karsh, N. I. Stahl, W. C. Blackwelder, G. Schiffman et al., Pneumococcal immunization in patients with systemic lupus erythematosus treated with immunosuppressives, J Rheumatol. déc, vol.12, issue.6, pp.1118-1139, 1985.

G. H. Struijk, R. C. Minnee, S. D. Koch, A. H. Zwinderman, K. Van-donselaar-van-der-pant et al., Maintenance immunosuppressive therapy with everolimus preserves humoral immune responses, Kidney Int, vol.78, issue.9, pp.934-974, 2010.

T. J. Dengler, N. Strnad, I. Bühring, R. Zimmermann, O. Girgsdies et al., Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation, Transplantation, vol.66, issue.10, pp.1340-1347, 1998.

L. Fischer, P. F. Gerstel, A. Poncet, C. Siegrist, E. Laffitte et al., Pneumococcal polysaccharide vaccination in adults undergoing immunosuppressive treatment for inflammatory diseases--a longitudinal study, Arthritis Res Ther. 6 juin, vol.17, p.151, 2015.

T. Ulinski, S. Leroy, M. Dubrel, S. Danon, and A. Bensman, High serological response to pneumococcal vaccine in nephrotic children at disease onset on high-dose prednisone, Pediatr Nephrol. 7 mars, vol.23, issue.7, p.1107, 2008.

N. Lahood, S. S. Emerson, P. Kumar, and R. U. Sorensen, Antibody levels and response to pneumococcal vaccine in steroid-dependent asthma, Ann Allergy. avr, vol.70, issue.4, pp.289-94, 1993.

S. Dufour, S. Rivière, R. Goulabchand, J. Broner, A. Konaté et al., Couverture vaccinale et facteurs influençant le comportement vaccinal des patients atteints de maladies auto-immunes et des professionnels de santé dans un service de médecine interne, Rev Médecine Interne. 1 juin, vol.38, pp.130-131, 2017.

T. Goulenok, D. Chopin, D. Lastours, V. Zarrouk, V. Lepeule et al., Couverture vaccinale antigrippale et antipneumococcique dans un service de médecine interne, Rev Médecine Interne. 1 juin, vol.39, issue.6, pp.386-92, 2018.

K. Risso, A. Naqvi, S. Pillet, A. Leplatois, and C. Pulcini,

, Med Mal Infect. juin, vol.40, issue.6, pp.341-347, 2010.

O. Brocq, E. Acquacalda, F. Berthier, C. Albert, G. Bolla et al., Influenza and pneumococcal vaccine coverage in 584 patients taking biological therapy for chronic inflammatory joint: A retrospective study, Jt Bone Spine Rev Rhum. mars, vol.83, issue.2, pp.155-164, 2016.

D. B. Middleton, D. E. Fox, M. P. Nowalk, S. J. Skledar, D. R. Sokos et al., Overcoming barriers to establishing an inpatient vaccination program for pneumococcus using standing orders, Infect Control Hosp Epidemiol, vol.26, issue.11, pp.874-81, 2005.

M. Assala, M. Groh, P. Blanche, C. Vinter, P. Cohen et al., Pneumococcal and influenza vaccination rates in patients treated with corticosteroids and/or immunosuppressive therapies for systemic autoimmune diseases: A cross-sectional study, Jt Bone Spine Rev Rhum. mai, vol.84, issue.3, pp.365-371, 2017.

E. F. Lawson, L. Trupin, E. H. Yelin, and J. Yazdany, Reasons for failure to receive pneumococcal and influenza vaccinations among immunosuppressed patients with systemic lupus erythematosus, Semin Arthritis Rheum. juin, vol.44, issue.6, pp.666-71, 2015.

J. Nagel, P. Geborek, T. Saxne, G. Jönsson, M. Englund et al., The association between antibody levels before and after 7-valent pneumococcal conjugate vaccine immunization and subsequent pneumococcal infection in chronic arthritis patients, Arthritis Res Ther. 19 mai, vol.17, p.124, 2015.

F. Vandenbos, J. Gal, and B. Radicchi, Couverture vaccinale grippale et pneumococcique dans un SSR de pneumologie. Revue des Maladies Respiratoires, vol.30, pp.746-51, 2013.

A. S. Delelis-fanien, F. Séité, M. Priner, and M. Paccalin, Vaccine coverage against influenza and pneumococcal infections in patients aged 65 and over: a survey on 299 outpatients, Rev Med Interne. août, vol.30, issue.8, pp.656-60, 2009.

G. Gavazzi, B. Wazieres, and B. Lejeune, Rothan-Tondeur M. Influenza and Pneumococcal Vaccine Coverages in Geriatric Health Care Settings in France, GER, vol.53, issue.6, pp.382-389, 2007.

, Vaccinations des personnes immunodéprimées ou aspléniques Recommandations Rapport, 2012.

V. I. Serment-d'hippocrate,

, Au moment d'être admis(e) à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité

, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux, individuels et sociaux

, Je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte

, Je ne tromperai jamais leur confiance et n'exploiterai pas le pouvoir hérité des circonstances pour forcer leurs consciences

, Je ne me laisserai pas influencer par la soif du gain ou la recherche de la gloire

, Reçu(e) à l'intérieur des maisons, je respecterai les secrets des foyers et ma conduite ne servira pas à corrompre les moeurs

, Je ne prolongerai pas abusivement les agonies. Je ne provoquerai jamais la mort délibérément

, Je n'entreprendrai rien qui dépasse mes compétences. Je les entretiendrai et les perfectionnerai pour assurer au mieux les services qui me seront demandés

, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité

, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes promesses : que je sois déshonoré(e) et méprisé(e) si j'y manque