Vaccination In Adult Patients Research Articles

COVID-19 Aşıları ve Anestezi

The immunization campaigns launched at the national and global level have been a hope to end the COVID-19 pandemic, which has threatened the whole world since December 2019 and left health systems in despair. However, adult vaccination campaigns, which were developed in a short time using new technologies and started with emergency use approval, confronted anesthesiologists with an obscurity. In this review; in general, the interactions of vaccination and anesthesia applications were reviewed, suggestions were made for anesthesia applications after COVID-19 vaccination in adult patients.

Severity of COVID-19 in bacillus Calmette-Guérin vaccinated population.

PurposeConsidering the cross-protection reported for bacillus Calmette-Guérin (BCG) vaccination on viral respiratory infections, it has been proposed that it could reduce the severity of coronavirus disease 2019 (COVID-19). The objective of the current study is to investigate the association between the severity of COVID-19 with prior BCG vaccination in adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.Materials and MethodsAdult patients (18 years or above) with positive SARS-CoV-2 polymerase chain reaction admitted in July 2020 were included in this cross-sectional study. Patients were classified into non-severe, severe, and critical diseases. History of prior BCG vaccination and the presence of a BCG vaccination scar were recorded.ResultsOut of 103 patients, 64 patients with prior history of BCG vaccinations were compared with 39 patients without BCG vaccination in childhood. The median age was 55 years and 64 years in BCG vaccinated & non-BCG vaccinated patients (p-value=0.002). There was male predominance in both groups and frequent comorbid illnesses were hypertension and diabetes mellitus. Severe COVID-19 was found in 91 patients (88.3%) followed by non-severe disease and critical diseases i.e., 7 (6.8%) and 5 (4.9%) patients, respectively. No association of prior BCG vaccination with disease severity of COVID-19 was found in this study and mortality was 8.7%. Out of nine patients who expired only 2 (22.2%) had a prior history of BCG vaccination (p-value=0.01). Secondary infections were present in 26 patients and the majority had pneumonia.ConclusionThe BCG vaccine has no impact on the severity of COVID-19 but could have a protective role with a low mortality rate in already infected patients.

Vaccination of adult patients living with chronic kidney disease against SARS-CoV-2: a position statement by the South African Nephrology Society

Safe and effective vaccination of patients living with chronic kidney disease requires an understanding of the unique immunological milieu of this population and of their potential for disease-specific side effects. This Position Statement, issued on behalf of the South African Nephrology Society, provides recommendations for local policy development and for individual practice administration and monitoring of SARS-CoV-2 vaccinations in patients living with chronic kidney disease.

PIN40 Influenza Vaccination in Adult Patients with Hypertension or Diabetes in South Korea: A CROSS-Sectional Study

PIN40 Influenza Vaccination in Adult Patients with Hypertension or Diabetes in South Korea: A CROSS-Sectional Study

Vaccination in Rheumatology: New Data (Based on Recommendations of the European League Against Rheumatism)

Comorbid infections have a significant effect on morbidity and mortality in modern rheumatology, especially in immune-mediated inflammatory rheumatic diseases (IMIRD). In this regard, vaccination is becoming increasingly important in the prevention of infections in IMIRD. The article analyzes an updated version of the recommendations for vaccination of adult patients with IMIRD, proposed by experts of the European League Against Rheumatism at the end of 2019. The safety and immunogenicity of vaccination associated with the prevention of various infections in patients with IMIRD are discussed. The main directions of future research on this issue are outlined.

Optimizing Vaccination in Adult Patients With Liver Disease and Liver Transplantation.

http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/15-2-reading-rhee a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/15-2-interview-rhee an interview with the author.

Pneumococcal vaccination in adult patients with comorbidities: a review of the clinical practice guidelines

The review discusses national clinical practice guidelines for pneumococcal vaccination in different countries, existing approaches to adult immunization, and highlights key results of the most significant clinical studies and metaanalyses on the effectiveness of 23-valent polysaccharide pneumococcal vaccine and 13-valent conjugated pneumococcal vaccine in adults, including the elderly and patients with comorbidities.

Vaccination in rheumatology (the 2019 update of EULAR recommendations)

In modern rheumatology, comorbid infections have a significant impact on morbidity and mortality, especially in immuneinflammatory rheumatic diseases (IRDs). One of the ways to solve this problem is to study and actively use various vaccines. This paper analyzes the 2019 updated version of the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with IRDs. It discusses the safety and immunogenicity of vaccination associated with the prevention of various infections in patients with IRDs. The basic directions of future investigations on this problem are outlined.

Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations

AimTo present a systematic literature review (SLR) on efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD), aiming to provide a basis for updating...

Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD

ObjectivesThe aims of this study were to update the evidence on the incidence and prevalence rates of vaccine preventable infections (VPI) in patients with autoimmune inflammatory rheumatic diseases (AIIRD) and...

Italian recommendations for influenza and pneumococcal vaccination in adult patients with autoimmune rheumatic diseases

To provide evidence-based recommendations for vaccination against influenza virus and S. pneumoniae in patients with autoimmune rheumatic diseases (ARDs). A Consensus Committee including physicians with expertise in rheumatic and infectious diseases was established by two Italian scientific societies, Società Italiana di Reumatologia (SIR) and Società Italiana di Malattie Infettive e Tropicali (SIMIT). The experts were invited to develop evidence-based recommendations concerning vaccinations in ARDs patients, based on their clinical status before and after undergoing immunosuppressive treatments. Key clinical questions were formulated for the systematic literature reviews, based on the clinical pathway. A search was made in Medline (via PubMed) according to the original MeSH strategy from October 2009 and a keyword strategy from January 2016 up to December 2017, updating existing EULAR recommendations. Specific recommendations were separately voted and scored from 0 (no agreement with) to 100 (maximal agreement) and supporting evidence graded. The mean and standard deviation of the scores were calculated to determine the level of agreement among the experts' panel for each recommendation. Total cumulative agreement ≥70 defined consensus for each statement. Nine recommendations, based on 6 key clinical questions addressed by the expert committee, were proposed. The aim of this work is to integrate the 2011 EULAR recommendations on vaccination against influenza and S. pneumoniae in ARDs patients. An implementation plan was proposed to improve the vaccination status of these patients and their safety during immunosuppressive treatments. Influenza and pneumococcus vaccinations are effective and safe in patients with ARDs. More efforts should be made to translate the accumulated evidence into practice.

A systematic review of herpes zoster incidence and consensus recommendations on vaccination in adult patients on systemic therapy for psoriasis or psoriatic arthritis: From the Medical Board of the National Psoriasis Foundation

Herpes zoster (HZ) incidence is linked to immunosuppression. Patients with psoriasis or psoriatic arthritis (PsA) on systemic therapy might be at an increased risk for HZ. To assess HZ risk in patients with psoriasis and PsA by systemic treatment and provide recommendations regarding HZ vaccination. A systematic literature search was performed for HZ in patients with psoriasis and PsA. HZ vaccination guidelines were reviewed, and the medical board of the National Psoriasis Foundation made consensus recommendations in psoriasis and PsA patients using graded evidence. In total, 41 studies met inclusion criteria. Systemic corticosteroids (strong, 1), tofacitinib (strong, 1), and combination therapy with biologic and conventional synthetic disease-modifying antirheumatic drugs (weak, 2a) carry increased HZ risk while monotherapy does not. There is insufficient evidence to determine risk with interleukin 12/23, 17, and 23 inhibitors or apremilast (weak, 2a). Recombinant zoster vaccine is recommended for all psoriasis and PsA patients >50years old and patients <50years old on tofacitinib, systemic steroids, or combination systemic treatment. Vaccination of patients <50years old on other systemic therapies may be considered on a case-by-case basis. There was significant heterogeneity between studies. HZ risk depends on disease severity and treatment class. Recombinant zoster vaccine should be given to all psoriasis and PsA patients >50years old and younger patients at increased risk.

A Systematic Review and Metaanalysis of Antirheumatic Drugs and Vaccine Immunogenicity in Rheumatoid Arthritis.

Vaccination is a key strategy to reduce infection risk in patients with rheumatoid arthritis (RA) and is advocated in internationally recognized rheumatology society guidelines. The aim was to evaluate to the effect of antirheumatic drugs on influenza and pneumococcal vaccine immunogenicity. We conducted a systematic literature review and metaanalysis comparing the humoral response to influenza (pandemic and seasonal trivalent subunit vaccines) and pneumococcal (23-valent pneumococcal polysaccharide vaccine, 7- and 13-valent pneumococcal conjugated vaccines) vaccination in adult patients with RA treated with antirheumatic drugs. Vaccine immunogenicity was assessed by seroprotection rates measured 3 to 6 weeks postimmunization. Risk ratios (RR) and 95% CI were pooled. Nine studies were included in the metaanalysis (7 studies investigating antirheumatic drug exposures and influenza humoral response, 2 studies investigating pneumococcal vaccine response). Influenza vaccine responses to all subunit strains (H1N1, H3N2, B strain) were preserved with methotrexate (MTX) and tumor necrosis factor inhibitor (TNFi) drug exposure. MTX but not TNFi drug exposure was associated with reduced 6B and 23F serotype pneumococcal vaccine response (RR 0.42, 95% CI 0.28-0.63 vs RR 0.98, 95% CI 0.58-1.67); however, limited data were available to draw any firm conclusions. Combination of MTX with tocilizumab or tofacitinib was associated with reduced pneumococcal and influenza vaccine responses. Antirheumatic drugs may limit humoral responses to vaccination as evidenced by pneumococcal responses with MTX exposure; however, they are safe and should not preclude immunization against vaccine-preventable disease. Vaccination should be considered in all patients with RA and encouraged as part of routine care. (Systematic review registration number: PROSPERO 2016: CRD42016048093.).

Vaccination of Adult Patients with Systemic Lupus Erythematosus in Portugal.

In the wake of the Portuguese vaccination program 50th anniversary it seems appropriate to review vaccination in patients with systemic lupus erythematosus. Controversial issues as regards the association between autoimmune diseases, infections, and vaccines are discussed as well as vaccine safety and efficacy issues as regards chronic immunosuppressant (IS) drug therapy. After a brief overview of national policies, specific recommendations are made as regards vaccination for adult patients with SLE with a particular focus on current IS therapy and unmet needs.

AB0313 Audit Cycle of Influenza Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases

BackgroundIt is well known that there is an increased risk of infection in autoimmune inflammatory rheumatic diseases (AIIRD). Influenza vaccine is thus recommended for patients with AIIRD in EULAR guidelines...

AUTOIMUNINĖS UŽDEGIMINĖS REUMATINĖS LIGOS IR SKIEPIJIMO TIKSLINGUMAS

Pasaulyje yra net dvidešimt aštuonios infekcinės ligos, nuo kurių efektyviausia apsaugos priemonė yra skiepijimas [1]. Lietuvoje Nacionalinė imunoprofilaktikos programa įgyvendinama nuo 1992 m., vaikų profilaktinių skiepijimų kalendorius Lietuvoje patvirtintas 2007 m. Šiuo metu didžiausias dėmesys skiriamas suaugusiųjų skiepijimo rekomendacijų kūrimui ir patvirtinimui. Suaugusiųjų skiepijimo rekomendacijos apima visų suaugusiųjų skiepijimus ir suaugusiųjų, priklausančių tam tikroms rizikos grupėms, skiepijimus [2]. Šiuo metu vienas svarbiausių ir sudėtingiausių uždavinių – rizikos grupių pacientų skiepijimo rekomendacijų sukūrimas, apimantis rizikos grupių identifikavimą, vakcinų, kuriomis galėtų būti taikoma imunoprofilaktika, parinkimas, rekomendacijų, kada imunoprofilaktika turėtų būti taikoma, patvirtinimas, bei naudos-rizikos santykio įvertinimas. Viena sudėtingiausių identifikuojamų rizikos grupių – autoimuninėmis uždegiminėmis reumatinėmis ligomis (AURL) sergantys žmonės, kurie turi padidėjusią riziką sirgti infekcinėmis ligomis, jų eiga dažnai yra sunkesnė, komplikacijos dažnesnės, todėl tai lemia padidėjusį pacientų sergamumą ir mirtingumą. Nustatyta, kad reumatoidiniu artritu (RA) sergantys pacientai turi du kartus didesnę riziką sirgti sunkiomis infekcinėmis ligomis, o tarp sergančių sistemine raudonaja vilklige (SRV) pacientų apie 25 proc. mirties atvejų yra sąlygoti infekcinių ligų [3,4]. Skiriamos kelios padidėjusio imlumo infekcinėms ligoms priežastys: imunodeficitinė būklė dėl autoimuninio uždegiminio proceso, skiriamo gydymo ligos eigą modifikuojančiais medikamentais (LMV), slopinančiais imuninę sistemą, gydymo biologine terapija, ilgalaikio gliukokortikosteroidų vartojimo, gretutinių ligų kiekio, organų ir organų sistemų pažeidimo. Būtina paminėti, jog vakcinos efektyvumas šios rizikos grupės pacientams gali būti sumažėjęs ar net sukelti ligos paūmėjimus.

Comparison of national clinical practice guidelines and recommendations on vaccination of adult patients with autoimmune rheumatic diseases

The aim of the study is to identify and compare national recommendations on vaccination of adult patients with autoimmune rheumatic diseases (ARDs) in Europe, North America, and Australia. We conducted a search for recommended immunizations in adult patients with ARDs in the Medline database and the Web sites of National Rheumatologic Societies, Ministries of Health, National Advisory Committees on Immunization, and other relevant National Scientific Societies. We compared national guidelines and identified points of agreement and differences. Guidelines on vaccination of adult patients with ARDs were identified in 21 countries. Points of agreement include administering influenza and pneumococcal vaccines in addition to inactivated age-appropriate or travel-related vaccines, and avoiding the use of live vaccines in immunocompromised patients with ARDs. The most important differences concern the steroid dose that induces immunosuppression, the time interval between live vaccines and the initiation of immunosuppressive treatment, herpes zoster vaccination, and the preferred pneumococcal vaccine in patients with ARDs. We observed significant differences among national recommendations on immunizations in patients with ARDs, reflecting the lack of evidence-based data.

AB0235 Low vaccination status of patients with ra treated by biological drugs and dmards in czech republic

BackgroundThe risk of infections is increased by patients with RA. There is increasing evidence, that biological agents can contribute to risk of both non serious and serious infections. Vaccination is...

AB0249 Audit on awareness and uptake of influenza and pneumococcal vaccines in rheumatology outpatients

BackgroundRheumatology patients with autoimmune inflammatory rheumatic diseases on major DMARDs and/or biologics are at increased risk of infection because of ill-defined immunoregulatory state as well as immunosuppressive drugs. Vaccination against...

AB0377 The knowledge and practice in vaccination of irish rheumatologists

BackgroundPatients with inflammatory arthritis are at increased risk of infection. Despite increased attention to the topic of infection in the rheumatology literature, vaccination rates remain poor. Recently EULAR have published...