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

• Published in: Vaccine Vol. 27; no. 10; pp. 1523 - 1529
• Main Authors: Duchet-Niedziolka, P, Launay, O, Coutsinos, Z, Ajana, F, Arlet, P, Barrou, B, Beytout, J, Bouchaud, O, Brouqui, P, Buzyn, A, Chidiac, C, Couderc, L.J, Debord, T, Dellamonica, P, Dhote, R, Duboust, A, Durrbach, A, Fain, O, Fior, R, Godeau, B, Goujard, C, Hachulla, E, Marchou, B, Mariette, X, May, T, Meyer, O, Milpied, N, Morlat, P, Pouchot, J, Tattevin, P, Viard, J.P, Lortholary, O, Hanslik, T
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 04.03.2009; Elsevier; Elsevier Limited
• Subjects: Adrenal Cortex Hormones - adverse effects; Adult; Agreements; Allergy and Immunology; Antineoplastic Agents - adverse effects; Applied microbiology; Auto-immune disease; Autoimmune diseases; Autoimmune Diseases - immunology; Autoimmune Diseases - therapy; Biological and medical sciences; Bone marrow; Chemotherapy; Corticoids; Data processing; Delphi survey; Disease; Drug dosages; Expert Testimony; Experts; Fundamental and applied biological sciences. Psychology; Hepatitis; Humans; Immunocompromised adults; Immunologic Deficiency Syndromes - chemically induced; Immunologic Deficiency Syndromes - immunology; Immunologic Deficiency Syndromes - therapy; Immunosuppressants; Immunosuppression - adverse effects; Immunosuppressive Agents - adverse effects; Infections; Microbiology; Proposals; Questionnaires; Surveys and Questionnaires; Transplants & implants; Tropical diseases; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Vaccination; Vaccination - adverse effects; Vaccination - methods; Vaccination - utilization; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Delphi survey; Immunosuppressants; Auto-immune disease; Vaccination; Immunocompromised adults; Immunopathology; Autoimmune disease; Immune deficiency
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2009.01.003

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.