Imunização anti-influenza: universal ou selecionada?

Abstract

Dear Editor, Our recently published article in the Brazilian Archives of Cardiologia1 aimed to evaluate the implementation of vaccination against influenza (INF) and Pneumococcus virus (pneumonia) in a specific subgroup of patients with heart failure (HF), due to consensus recommendation of the NorthAmerican, European and Brazilian guidelines on HF. The increased susceptibility to respiratory infections in patients with heart failure is attributed to pulmonary congestion. Dear Editor, Martins et al1 recommend measures for increasing influenza and pneumococcal immunization based on the reduced rates detected in patients with heart failure in the city of Teresopolis. We understand that, in spite of the benefit of this strategy at the population level to prevent infections and complications, we must evaluate mass vaccination and immunization extended to special groups such as immunologically susceptible individuals and those with comorbidities2. Even vaccines made from inactivated agents may trigger important and unpredictable reactions, such as, for instance, Guillain-Barre syndrome. We recently reported a case series of symptomatic pericardial effusion with increased incidence in patients who received influenza vaccine. The patients, mostly elderly and individuals with compensated diseases, showed viral symptoms, increased incidence in the peri-immunization period and resolution of the clinical draw with anti-inflammatory drug use3. Post-vaccination myopericarditis has been reported and may be underdiagnosed and sub-notified4,5.