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Vaccination in adults with auto-immune disease and/or drug related immune deficiency: Results of the GEVACCIM Delphi survey

Authors :
Robin Dhote
Zoe Coutsinos
Bertrand Godeau
Odile Launay
Olivier Bouchaud
Gevaccim
J. Beytout
Cécile Goujard
Antoine Durrbach
P Morlat
P Brouqui
T. May
E Hachulla
T. Debord
J. Pouchot
R. Fior
B Marchou
P Arlet
Olivier Lortholary
O Fain
Thomas Hanslik
P Tattevin
Jean-Paul Viard
Xavier Mariette
Benoit Barrou
A Duboust
Agnes Buzyn
N Milpied
Paula Duchet-Niedziolka
Pierre Dellamonica
Christian Chidiac
Louis-Jean Couderc
F Ajana
O Meyer
Source :
Vaccine. 27:1523-1529
Publication Year :
2009
Publisher :
Elsevier BV, 2009.

Abstract

Introduction There are insufficient data regarding the efficacy and safety of vaccination in patients with auto-immune disease (AID) and/or drug-related immune deficiency (DRID). The objective of this study was to obtain professional agreement on vaccine practices in these patients. Methods A Delphi survey was carried out with physicians recognised for their expertise in vaccinology and/or the caring for adult patients with AID and/or DRID. For each proposed vaccination practice, the experts’ opinion and level of agreement were evaluated. Results The proposals relating to patients with AID specified: the absence of risk of AID relapse following vaccination; the possibility of administering live virus vaccines (LVV) to patients not receiving immunosuppressants; the pertinence of determining protective antibody titre before vaccination; the absence of need for specific monitoring following the vaccination. The proposals relating to patients with DRID specified that a 3–6 month delay is needed between the end of these treatments and the vaccination with LVV. There is no contraindication to administering LVV in patients receiving systemic corticosteroids prescribed for less than two weeks, regardless of their dose, or at a daily dose not exceeding 10 mg of prednisone, if this involves prolonged treatment. Out of 14 proposals, the level of agreement between the experts was “very good” for eleven, and “good” for the remaining three. Conclusion Proposals for vaccine practices in patients with AID and/or DRID should aid with decision-making in daily medical practice and provide better vaccine coverage for these patients.

Details

ISSN :
0264410X
Volume :
27
Database :
OpenAIRE
Journal :
Vaccine
Accession number :
edsair.doi.dedup.....3d5b24da3e7932a9e6fa7037bb823446
Full Text :
https://doi.org/10.1016/j.vaccine.2009.01.003