Table 5.
Vaccination recommendation in ARDs [265].
| Vaccines | Recommended | Not recommended | Special 5emarks | |
|---|---|---|---|---|
| Live | BCG | X | ||
| Herpes zoster | Previous contact with varicella (vaccine/infection) | Highly immunosuppressed patientsa | Single dose >50 y | |
| Yellow fever | Endemic areas [266] | Routine immunization not recommended | ||
| MMR | X | |||
| Non-live | Influenza | X | Allergy to egg or the vaccine itself; GBS up to 6 weeks after vaccination | Annual Rituximab: before starting/6 mts after 1st infusion/4 wks before next dose [148], [267] |
| Pneumococcal | X | 1 Initial dose + 1 booster (5 y later) | ||
| DTaP and DT | X | DTaP every 10 y Tetanus Igb if exp |
||
| Meningococcal | X | Low data support [268] | ||
| Hep A | X | |||
| Hep B | Neg HBsAg in serum | |||
| HPV | Adolescents and young women | Preferably before initiating sexual activity | ||
| Hib | X |
X – for all ARDs patients; MMR: measles, mumps and rubella; Hib: haemophilus Influenza type B; DTaP: diphteria, tetanus and pertussis; DT: diphteria and tetanus; Hep: hepatitis; Igb: immunoglobulin; y: years; mts: months; wks: weeks; HPV: human papilloma virus; GBS: guillain barré syndrome; exp: exposure; Neg HBsAG: negative hepatitis B antigen.
a
Highly immunosuppressed patients: high doses of corticosteroids (>20 mg of prednisone per day or equivalent) for 2 weeks or longer, pulse therapy, cytotoxic or alkylating agents, synthetic DMARDs at doses above those recommended, or immunobiological therapy [264].