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J Autoimmun. 2017 Jun;80:10-27. doi: 10.1016/j.jaut.2017.03.011. Epub 2017 Apr 2.

Vaccination recommendations for the adult immunosuppressed patient: A systematic review and comprehensive field synopsis.

Author information

1
Department of Gastroenterology and Hepatology and Inserm U954, Nancy University Hospital, Lorraine University, Vandoeuvre-lès-Nancy, France.
2
Université Paris Sud, INSERM, U1184, Center for Immunology of Viral Infections and Autoimmune Diseases, AP-HP, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, Paris, France.
3
Sorbonne Paris Cité Université Paris Diderot, INSERM U1163, Institut Imagine, Service de Dermatologie, AP-HP Hôpital Saint-Louis, Paris, France.
4
Pediatric Nephrology, Rheumatology, Dermatology Unit, Femme Mère Enfant Hospital, INSERM U1111, Hospices Civils de Lyon, Université Lyon 1, France.
5
Department of Internal Medicine and Clinical Immunology, Dijon University Hospital and INSERM U1098, University of Bourgogne-Franche Comté, Dijon, France.
6
Service de Médecine Interne et Immunologie Clinique, Université de Lille, Centre national de référence Maladies systémiques et auto-immunes rares, Lille, France.
7
Dermatologist, 6, Rue du Helder, 64200, Biarritz, France.
8
University Paris Descartes, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, AP-HP, Paris, France.
9
Cochin Teaching Hospital, AP-HP, 75014, Paris, France.
10
Laboratory of Immunology and Immunomonitoring, CIC 1408 INSERM, GIMAP EA3064, University Hospital of Saint-Etienne, France.
11
Service de Gastroentérologie, CHU de Saint-Etienne, France.
12
Department of Rheumatology, Reference Center for Rare Autoimmune Diseases, Division of Internal Medicine, Hautepierre Hospital, University Hospital of Strasbourg, France.
13
Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
14
Department of Gastroenterology and Department of Biomedical Sciences, Humanitas Research Hospital, Rozzano, Milan, Italy.
15
IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy.
16
Department of Gastroenterology and Hepatology and Inserm U954, Nancy University Hospital, Lorraine University, Vandoeuvre-lès-Nancy, France. Electronic address: peyrinbiroulet@gmail.com.

Abstract

BACKGROUND:

Immunosuppressed patients are at risk of severe viral infections-related complications. National and international vaccination guidelines have been developed to decrease the mortality risk associated with these infections. However, a summary of these guidelines and the value of immunisation in this population is missing.

OBJECTIVES:

To summarize specific guidelines regarding vaccination in immunosuppressed patients.

METHODS:

We performed a literature search based on last update vaccine guidelines in immunosuppressed adult patients published between 1/1/2005-1/31/2016 in English or French language using PubMed, Cochrane and Embase, as well as relevant medical society websites.

RESULTS:

Of the 389 citations identified, 12 guidelines were selected Three additional guidelines were selected by searching on the websites from medical societies of each specialty. 15 guidelines were included, involving 19 medical societies issued from the US (n = 6), international collaboration (n = 3), UK (n = 2), Canada (n = 1), Australia (n = 1), France (n = 1), and Germany (n = 1). These guidelines provide recommendations on vaccination in asplenic patients (n = 5), cancer patients (n = 4), HIV patients (n = 5), hematopoietic stem cell recipients (n = 4), inflammatory bowel diseases patients (n = 5), psoriasis patients (n = 4), primary immunocompromised patients (n = 3), inflammatory rheumatic diseases patients (n = 6), and solid organ transplant recipients (n = 5). All guidelines recommended pneumococcal and injectable influenza vaccines. Other inactivated vaccines were recommended only in high risk patients. Live vaccines were usually contraindicated in patients under immunosuppressive therapy and/or in HIV patients with a CD4 count under 200/mm3.

CONCLUSION:

Pneumococcal and injectable influenza are the two essential vaccines recommended in all immunocompromised patients. Other inactivated vaccines are only indicated in high risk patients. Live vaccines are usually contraindicated.

KEYWORDS:

Guideline; Immunocompromised; Vaccine

PMID:
28381345
DOI:
10.1016/j.jaut.2017.03.011
[Indexed for MEDLINE]

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