Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid)

Abstract

Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.

Knowledge, Attitude and Behaviours towards Recommended Vaccinations among Healthcare Workers

“…In Europe, there are a lot of differences between the recommended vaccinations for HCWs, as well as differences in the implementation frame (mandatory or recommendation), target HCW groups and health-care settings [4,6,7,8]. …”

Prime-boost vaccination strategy enhances immunogenicity compared to single pneumococcal conjugate vaccination in patients receiving conventional DMARDs, to some extent in abatacept but not in rituximab-treated patients

“…Since 2012, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommendations for adults with immunocompromising conditions is to receive immunization with a dose of PCV13, followed after at least 8 weeks by a dose of PPV23, because of the wider serotype coverage [9]. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Vaccine Study Group (EVASG) also recommends that at-risk adults receive this vaccine schedule [10], which we refer to as the prime-boost pneumococcal vaccination strategy [11]. The European League Against Rheumatism (EULAR) strongly recommends pneumococcal vaccination in adult patients with autoimmune inflammatory rheumatic disease, but does not provide a specific recommendation due to the lack of evidence on the efficacy, immunogenicity, and safety of available pneumococcal vaccines [12].…”

Seroconversión de la vacuna anti- hepatitis B en el personal de salud

“…La vacuna contra la hepatitis B se debe administrar a todos los trabajadores de la salud con probabilidad de exposición a la sangre o fluidos corporales, con posterior realización de las pruebas serológicas para establecer los niveles de anticuerpos o seroconversión a la vacunación, dentro de los 30 a 60 días posteriores de la última dosis de la vacuna, considerándose protegidos con una seroconversión adecuada , la producción de anticuerpos de superficie de la hepatitis B (anti-HBs) ≥10 mIU/ml (9), pero un 5 % de trabajadores de salud inmunocompetentes no responden a la serie primaria de VHB porque tienen niveles de anti-HBs menores de 10 mIU/mL, por lo cual deben volver a vacunarse con una segunda serie, el motivo de esta falta de respuesta no está claro, pero se ha relacionado con predisposición genética, enfermedades crónicas y medicamentos inmunomoduladores (10,11,12,13).…”