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Updated immunization guidelines
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DOI：10.1136/lupus-2023-la.10.png)
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Abstract
En 中文
Vaccination prevents infectious diseases by inducing/enhancing protective immunity, potentially translating into a lower rate of invasive infections and hospital admissions. Patients with autoimmune inflammatory rheumatic diseases (AIIRD), and particularly systemic lupus erythematosus (SLE) are at increased risk of vaccine-preventable infections, attributed to the underlying autoimmune disease, additional comorbidities and immunosuppressive therapies. Yet, this population of patients is generally sub-optimally immunized due to concerns about efficacy, immunogenicity, and safety of vaccines shared both by patients and their treating physicians. In this regard, vaccination may be less efficacious in subgroups of patients with AIIRD, such as SLE and could potentially be associated with temporal (usually mild) exacerbation of the underlying autoimmune disease. Immunization protocols which take into consideration the AIIRD itself, timing of immunization and the number of vaccines doses may enable safe and efficacious immunization.(1-6) In recent years updated recommendations for immunization of AIIRD patients were issued. These recommendations comprise several overarching principles as: annual vaccination status assessment, shared decision-making, timing of vaccination (e.g. favoring vaccination during quiescent disease, preferably prior to initiation of immunosuppression), and avoidance of some live-attenuated vaccines both for patients and their household members. Additionally, new data suggest that increasing the doses of vaccine (e.g. anti-COVID vaccines) may overcome lower immunogenicity among SLE and other AIIRD patients. Herein, an up-to-date guidance for immunization of SLE patients in 2023 will be reviewed.
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