Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology
Background: Serious infections are a major cause of morbidity and mortality in systemic inflammatory rheumatic disease (SIRD) patients. Although vaccination may prevent numerous infections, vaccination uptake rates are low in this group of patients. Objectives: To develop evidence-based recommend...
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Format: | Article |
Language: | English |
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Sociedade Portuguesa de Reumatologia
2016-04-01
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Series: | Acta Reumatológica Portuguesa |
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Online Access: | http://www.actareumatologica.com/files/article/1129_recommendations_for_vaccination_in_adult_patients_with_systemic_inflammatory_rheumatic_diseases_from_the_portuguese_society_of_rheumatology_file.pdf |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Inês Cordeiro Ana Catarina Duarte Joana Fonseca Ferreira Maria João Gonçalves Tiago Meirinhos Teresa Martins Rocha Vasco C Romão Sandra Sousa Margarida Guedes Marta Conde Cândida Abreu Maria João Aleixo Maria José Santos |
spellingShingle |
Inês Cordeiro Ana Catarina Duarte Joana Fonseca Ferreira Maria João Gonçalves Tiago Meirinhos Teresa Martins Rocha Vasco C Romão Sandra Sousa Margarida Guedes Marta Conde Cândida Abreu Maria João Aleixo Maria José Santos Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology Acta Reumatológica Portuguesa antirheumatic agents immunosuppressive agents biological products rheumatic diseases vaccination recommendations |
author_facet |
Inês Cordeiro Ana Catarina Duarte Joana Fonseca Ferreira Maria João Gonçalves Tiago Meirinhos Teresa Martins Rocha Vasco C Romão Sandra Sousa Margarida Guedes Marta Conde Cândida Abreu Maria João Aleixo Maria José Santos |
author_sort |
Inês Cordeiro |
title |
Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology |
title_short |
Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology |
title_full |
Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology |
title_fullStr |
Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology |
title_full_unstemmed |
Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology |
title_sort |
recommendations for vaccination in adult patients with systemic inflammatory rheumatic diseases from the portuguese society of rheumatology |
publisher |
Sociedade Portuguesa de Reumatologia |
series |
Acta Reumatológica Portuguesa |
issn |
0303-464X |
publishDate |
2016-04-01 |
description |
Background: Serious infections are a major cause of morbidity and mortality in systemic inflammatory rheumatic disease (SIRD) patients. Although vaccination may prevent numerous infections, vaccination uptake rates are low in this group of patients.
Objectives: To develop evidence-based recommendations for vaccination in SIRD patients.
Methods: We searched MEDLINE (until 31 October 2014) and EMBASE (until 14 December 2014) databases, as well as the ACR and EULAR congress abstracts (2011-2014). Patients with any systemic inflammatory rheumatic disease were included and all vaccines were considered. Any safety and efficacy outcomes were admitted. Search results were submitted to title and abstract selection, followed by detailed review of suitable studies. Data were subsequently pooled according to the type of vaccine and the SIRD considered. Results were presented and discussed by a multidisciplinary panel and systematic literature review (SLR)-derived recommendations were voted according to the Delphi method. The level of agreement among rheumatologists was assessed using an online survey.
Results: Eight general and seven vaccine-specific recommendations were formulated. Briefly, immunization status should routinely be assessed in all SIRD patients. The National Vaccination Program should be followed and some additional vaccines are recommended. To maximize the efficacy of vaccination, vaccines should preferably be administered 4 weeks before starting immunosuppression or, if possible when disease activity is controlled. Non-live vaccines are safe in SIRD, including immunosuppressed patients. The safety of live attenuated vaccines in immunosuppressed patients deserves further ascertainment, but might be considered in particular situations.
Discussion: The present recommendations combine scientific evidence with the multidisciplinary expertise of our taskforce panel and attained desirable agreement among Portuguese rheumatologists. Vaccination recommendations need to be updated on a regular basis, as more scientific data regarding vaccination efficacy and safety, emergent infectious threats, new vaccines as well as new immunomodulatory therapies become available. |
topic |
antirheumatic agents immunosuppressive agents biological products rheumatic diseases vaccination recommendations |
url |
http://www.actareumatologica.com/files/article/1129_recommendations_for_vaccination_in_adult_patients_with_systemic_inflammatory_rheumatic_diseases_from_the_portuguese_society_of_rheumatology_file.pdf |
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doaj-d916b4c864c540adbb64317d37477eff2020-11-24T23:01:13ZengSociedade Portuguesa de ReumatologiaActa Reumatológica Portuguesa0303-464X2016-04-0120162112130PC160005Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of RheumatologyInês Cordeiro0Ana Catarina Duarte1Joana Fonseca Ferreira2Maria João Gonçalves3Tiago Meirinhos4Teresa Martins Rocha5Vasco C Romão6Sandra Sousa7Margarida Guedes8Marta Conde9Cândida Abreu10Maria João Aleixo11Maria José Santos12Hospital Garcia de Orta, AlmadaHospital Garcia de Orta, AlmadaHospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, CoimbraHospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Lisboa.Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, AveiroHospital de São João, Centro Hospitalar São João, PortoHospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Lisboa.Hospital Garcia de Orta, AlmadaHospital Santo António, Centro Hospitalar do Porto, Porto.Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisboa.Hospital de São João, Centro Hospitalar São João, Porto. Faculdade de Medicina do Porto, Portugal. Instituto de Inovação e Investigação em Saúde [I3S], Grupo de IHospital Garcia de Orta, AlmadaHospital Garcia de Orta, Almada; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Lisboa.Background: Serious infections are a major cause of morbidity and mortality in systemic inflammatory rheumatic disease (SIRD) patients. Although vaccination may prevent numerous infections, vaccination uptake rates are low in this group of patients. Objectives: To develop evidence-based recommendations for vaccination in SIRD patients. Methods: We searched MEDLINE (until 31 October 2014) and EMBASE (until 14 December 2014) databases, as well as the ACR and EULAR congress abstracts (2011-2014). Patients with any systemic inflammatory rheumatic disease were included and all vaccines were considered. Any safety and efficacy outcomes were admitted. Search results were submitted to title and abstract selection, followed by detailed review of suitable studies. Data were subsequently pooled according to the type of vaccine and the SIRD considered. Results were presented and discussed by a multidisciplinary panel and systematic literature review (SLR)-derived recommendations were voted according to the Delphi method. The level of agreement among rheumatologists was assessed using an online survey. Results: Eight general and seven vaccine-specific recommendations were formulated. Briefly, immunization status should routinely be assessed in all SIRD patients. The National Vaccination Program should be followed and some additional vaccines are recommended. To maximize the efficacy of vaccination, vaccines should preferably be administered 4 weeks before starting immunosuppression or, if possible when disease activity is controlled. Non-live vaccines are safe in SIRD, including immunosuppressed patients. The safety of live attenuated vaccines in immunosuppressed patients deserves further ascertainment, but might be considered in particular situations. Discussion: The present recommendations combine scientific evidence with the multidisciplinary expertise of our taskforce panel and attained desirable agreement among Portuguese rheumatologists. Vaccination recommendations need to be updated on a regular basis, as more scientific data regarding vaccination efficacy and safety, emergent infectious threats, new vaccines as well as new immunomodulatory therapies become available.http://www.actareumatologica.com/files/article/1129_recommendations_for_vaccination_in_adult_patients_with_systemic_inflammatory_rheumatic_diseases_from_the_portuguese_society_of_rheumatology_file.pdfantirheumatic agentsimmunosuppressive agentsbiological productsrheumatic diseasesvaccinationrecommendations |