Vaccination Guidelines for Patients with Immune-mediated Disorders Taking Immunosuppressive Therapies: Executive Summary

Kim A Papp; Boulos Haraoui; Deepali Kumar; John K Marshall; Robert Bissonnette; Alain Bitton; Brian Bressler; Melinda Gooderham; Vincent Ho; Shahin Jamal; Janet E Pope; A Hillary Steinhart; Donald C Vinh; John Wade

doi:10.3899/jrheum.180784

Vaccination Guidelines for Patients with Immune-mediated Disorders Taking Immunosuppressive Therapies: Executive Summary

J Rheumatol. 2019 Jul;46(7):751-754. doi: 10.3899/jrheum.180784. Epub 2019 Feb 1.

Authors

Kim A Papp^{1

2}, Boulos Haraoui^{3

4}, Deepali Kumar^{3

4}, John K Marshall^{3

4}, Robert Bissonnette^{3

4}, Alain Bitton^{3

4}, Brian Bressler^{3

4}, Melinda Gooderham^{3

4}, Vincent Ho^{3

4}, Shahin Jamal^{3

4}, Janet E Pope^{3

4}, A Hillary Steinhart^{3

4}, Donald C Vinh^{3

4}, John Wade^{3

4}

Affiliations

¹ From K. Papp Clinical Research; Probity Medical Research, Waterloo; University Health Network; Faculty of Medicine, University of Toronto; Mount Sinai Hospital, Toronto; Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton; Faculty of Medicine, Queen's University, Kingston; Faculty of Medicine, University of Western Ontario; St. Joseph's Health Care, London, Ontario; Centre Hospitalier de l'Université de Montréal; Innovaderm Research Inc.; McGill University Health Centre; Research Institute - McGill University Health Centre, Montreal, Quebec; Faculty of Medicine, University of British Columbia; St. Paul's Hospital; Vancouver Coastal Health; Vancouver General Hospital, Vancouver, British Columbia, Canada. kapapp@probitymedical.com.
² K.A. Papp, MD, PhD, FRCPC, K. Papp Clinical Research, and Probity Medical Research; B. Haraoui, MD, FRCPC, Centre Hospitalier de l'Université de Montréal; D. Kumar, MD, MSc, FRCPC, University Health Network, and Faculty of Medicine, University of Toronto; J.K. Marshall, MD, MSc, FRCPC, AGAF, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University; R. Bissonnette, MD, Innovaderm Research Inc.; A. Bitton, MD, FRCP, McGill University Health Centre; B. Bressler, MD, MS, FRCPC, Faculty of Medicine, University of British Columbia, and St. Paul's Hospital; M. Gooderham, MSc, MD, FRCPC, Probity Medical Research, and Faculty of Medicine, Queen's University; V. Ho, MD, FRCPC, Faculty of Medicine, University of British Columbia; S. Jamal, MD, FRCPC, MSc, Vancouver Coastal Health; J.E. Pope, MD, MPH, FRCPC, Faculty of Medicine, University of Western Ontario, and St. Joseph's Health Care; A.H. Steinhart, MD, FRCP(C), Faculty of Medicine, University of Toronto, and Mount Sinai Hospital; D.C. Vinh, MD, McGill University Health Centre, and Research Institute - McGill University Health Centre; J. Wade, MD, FRCP(C), Faculty of Medicine, University of British Columbia, and Vancouver General Hospital. kapapp@probitymedical.com.
³ From K. Papp Clinical Research; Probity Medical Research, Waterloo; University Health Network; Faculty of Medicine, University of Toronto; Mount Sinai Hospital, Toronto; Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton; Faculty of Medicine, Queen's University, Kingston; Faculty of Medicine, University of Western Ontario; St. Joseph's Health Care, London, Ontario; Centre Hospitalier de l'Université de Montréal; Innovaderm Research Inc.; McGill University Health Centre; Research Institute - McGill University Health Centre, Montreal, Quebec; Faculty of Medicine, University of British Columbia; St. Paul's Hospital; Vancouver Coastal Health; Vancouver General Hospital, Vancouver, British Columbia, Canada.
⁴ K.A. Papp, MD, PhD, FRCPC, K. Papp Clinical Research, and Probity Medical Research; B. Haraoui, MD, FRCPC, Centre Hospitalier de l'Université de Montréal; D. Kumar, MD, MSc, FRCPC, University Health Network, and Faculty of Medicine, University of Toronto; J.K. Marshall, MD, MSc, FRCPC, AGAF, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University; R. Bissonnette, MD, Innovaderm Research Inc.; A. Bitton, MD, FRCP, McGill University Health Centre; B. Bressler, MD, MS, FRCPC, Faculty of Medicine, University of British Columbia, and St. Paul's Hospital; M. Gooderham, MSc, MD, FRCPC, Probity Medical Research, and Faculty of Medicine, Queen's University; V. Ho, MD, FRCPC, Faculty of Medicine, University of British Columbia; S. Jamal, MD, FRCPC, MSc, Vancouver Coastal Health; J.E. Pope, MD, MPH, FRCPC, Faculty of Medicine, University of Western Ontario, and St. Joseph's Health Care; A.H. Steinhart, MD, FRCP(C), Faculty of Medicine, University of Toronto, and Mount Sinai Hospital; D.C. Vinh, MD, McGill University Health Centre, and Research Institute - McGill University Health Centre; J. Wade, MD, FRCP(C), Faculty of Medicine, University of British Columbia, and Vancouver General Hospital.

PMID: 30709945
DOI: 10.3899/jrheum.180784

Abstract

The use of immunosuppressive therapies for immune-mediated disease is associated with an elevated risk of infections and related comorbidities. While many infectious diseases can generally be prevented by vaccines, immunization rates in this specific patient population remain suboptimal, due in part to uncertainty about their efficacy or safety under these clinical situations. To address this concern, a multidisciplinary group of Canadian physicians with expertise in dermatology, gastroenterology, infectious diseases, and rheumatology developed evidence-based clinical guidelines on vaccinations featuring 13 statements that are aimed at reducing the risk of preventable infections in individuals exposed to immunosuppressive and immunomodulatory agents.

Keywords: IMMUNE-MEDIATED DISEASE; IMMUNOSUPPRESSION; VACCINATION.

Publication types

Practice Guideline

MeSH terms

Adult
Autoimmune Diseases / drug therapy*
Canada
Humans
Immunocompromised Host*
Immunosuppressive Agents / adverse effects
Immunosuppressive Agents / therapeutic use*
Infant
Infection Control / methods*
Inflammation / drug therapy
Patient Care Team
Vaccination / adverse effects*
Vaccination / methods*

Substances

Immunosuppressive Agents