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10/07/2018

Update in vaccination guidelines for immunocompromised patients

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10/07/2018

The amount of immunocompromised patients has increased during the last years because of the treatments used against oncologic diseases, inflammatory diseases mediated by immune mechanisms and transplants.

Researchers at the Preventive Medicine and Epidemiology and Clinical Pharmacology group of Vall d'Hebron Hospital together with the Foundation Catalan Institute of Pharmacology, published at https://www.sciencedirect.com/science/article/pii/S0025775318303075" Medicina Clínica magazine a review paper on the vaccination guidelines for immunocompromised patients.The amount of immunocompromised patients has increased during the last years because of the treatments used against oncologic diseases, inflammatory diseases mediated by immune mechanisms and transplants. The immunity of this patients is essential as the treatment itself increases their risk to be infected, and for these infections to get even more serious.The paper published is a review on the guidelines for the vaccination of these patients. It states the criteria to take into account on safety, immunogenicity, and the moment to supply the vaccine, as several recommendations and guidelines for the optimal vaccination procedures. It serves as a guide for any health professional that has to attend these patients.This is the first review published that is concerned on its practicality. Dr. Paula Peremiquel-Trillas and Dr. Xavier Martínez-Gómez, two of the authors of the study and researchers at the http://en.vhir.org/portal1/grup-equip.asp?t=epidemologia-i-salut-publica&s=recerca&contentid=186985 Epidemiology and Public Health group of VHIR, remark its usefulness: "there is a lot of health professionals that deal with this collective, but many of them are not aware of the special risks that represent. This guideline can be useful for the doctors to consider the benefits for these patients when obtaining immunization and, by this means, establish a vaccine circuit that will keep them properly protected".ConclusionsThe experts have stated three recommendations for the professionals aimed by this study.Firstly, whenever possible, the patients should be vaccine before starting a drug treatment. If it is not possible, the risk-benefit on doing it during the treatment will be valued, considering the usage of inactive vaccines in stable stages of the disease, and monitoring the reactions with serologies.Secondly, it is highly recommended to vaccinate against Hepatitis A and B, papilloma virus, and herpes zoster virus, in case of susceptibility or presenting some sort of risk factors.Lastly, the attenuated vaccines, because they are used on living beings, they are contraindicated for this group of patients. It is recommended to delay the application of these vaccines at least 3 months after finalizing the treatment, to guarantee the restitution of their immune system.

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