TY - JOUR
T1 - Vaccination recommendations for the adult immunosuppressed patient
T2 - A systematic review and comprehensive field synopsis
AU - Lopez, Anthony
AU - Mariette, Xavier
AU - Bachelez, Hervé
AU - Belot, Alexandre
AU - Bonnotte, Bernard
AU - Hachulla, Eric
AU - Lahfa, Morad
AU - Lortholary, Olivier
AU - Loulergue, Pierre
AU - Paul, Stéphane
AU - Roblin, Xavier
AU - Sibilia, Jean
AU - Blum, Mariela
AU - Danese, Silvio
AU - Bonovas, Stefanos
AU - Peyrin-Biroulet, Laurent
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/6
Y1 - 2017/6
N2 - 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.
AB - 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.
KW - Guideline
KW - Immunocompromised
KW - Vaccine
UR - http://www.scopus.com/inward/record.url?scp=85016423023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016423023&partnerID=8YFLogxK
U2 - 10.1016/j.jaut.2017.03.011
DO - 10.1016/j.jaut.2017.03.011
M3 - Review article
C2 - 28381345
AN - SCOPUS:85016423023
SN - 0896-8411
VL - 80
SP - 10
EP - 27
JO - Journal of Autoimmunity
JF - Journal of Autoimmunity
ER -