Vaccination in patients from Brasília cohort with early rheumatoid arthritis

Muniz, Luciana Feitosa; Silva, Carolina Rocha; Costa, Thaís Ferreira; Mota, Lícia Maria Henrique da

doi:10.1016/j.rbre.2014.04.002

Cited by 4 publications

(6 citation statements)

References 27 publications

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“…As recommended, only ARD patients under low immunosuppression were included in the present study in order to minimize risks of severe vaccine-related adverse events [9,23]. Nonetheless, previous studies suggested that this vaccination was safe in other potential immunodeficiency conditions, such as HIV infection [24][25][26], solid organ transplantation or hematopietic stem cell transplantation patients [27][28][29], and even in rheumatological patients under immunosuppressive therapy that were inadvertently subjected to YF vaccination or in a prospective full dose vaccination group [11,12,14].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

“…In this context, the Brazilian Society of Rheumatology has proposed a recommendation for YF vaccination for patients with chronic immune-mediated inflammatory diseases living or traveling to YF endemic areas [ 10 ]. However, there are scarce studies assessing the safety and immunogenicity of primary YFV in ARD, and most reports were of ARD patients who were inadvertently revaccinated in endemic areas with full YFV dose [ 11 , 12 ]. Since severe complications are known to be associated with the primary dose and not with the booster dose [ 13 ], these studies were not helpful in clarifying the safety of the primary YF vaccine.…”

Section: Introductionmentioning

confidence: 99%

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Immunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases

et al. 2021

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Background Brazil faced a yellow fever(YF) outbreak in 2016–2018 and vaccination was considered for autoimmune rheumatic disease patients(ARD) with low immunosuppression due to YF high mortality. Objective This study aimed to evaluate, prospectively for the first time, the short-term immunogenicity of the fractional YF vaccine(YFV) immunization in ARD patients with low immunossupression. Objective Methodology and principal findings: A total of 318 participants(159 ARD and 159 age- and sex-matched healthy controls) were vaccinated with the fractional-dose(one fifth) of 17DD-YFV. All subjects were evaluated at entry(D0), D5, D10, and D30 post-vaccination for clinical/laboratory and disease activity parameters for ARD patients. Post-vaccination seroconversion rate(83.7%vs.96.6%, p = 0.0006) and geometric mean titers(GMT) of neutralizing antibodies[1143.7 (95%CI 1012.3–1292.2) vs.731 (95%CI 593.6–900.2), p<0.001] were significantly lower in ARD compared to controls. A lower positivity rate of viremia was also identified for ARD patients compared to controls at D5 (53%vs.70%, p = 0.005) and the levels persisted in D10 for patients and reduced for controls(51%vs.19%, p = 0.0001). The viremia was the only variable associated with seroconvertion. No serious adverse events were reported. ARD disease activity parameters remained stable at D30(p>0.05). Objective Conclusion: Fractional-dose 17DD-YF vaccine in ARD patients resulted in a high rate of seroconversion rate(>80%) but lower than controls, with a longer but less intense viremia. This vaccine was immunogenic, safe and did not induce flares in ARD under low immunosuppression and may be indicated in YF outbreak situations and for patients who live or travel to endemic areas. Trial registration This clinical trial was registered with Clinicaltrials.gov (#NCT03430388).

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Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Immunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases

et al. 2021

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“…Notably, only one published cross‐sectional report in Brazil has examined vaccination coverage in 68 adults with RA for up to 1 year and reported 42% had been vaccinated (19). Around the time of diagnosis, there is an optimal opportunity to verify vaccination history and ensure patients are aware of the importance of preventive measures.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Influenza Vaccination in Early Rheumatoid Arthritis 2017‐2021: Results From the Canadian Early Arthritis Cohort

Schieir

Valois

et al. 2022

ACR Open Rheumatology

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Objective. Adults with rheumatoid arthritis (RA) are at a higher risk for infections, including influenza and related complications. We identified influenza vaccination coverage in adults newly diagnosed with RA and examined sociodemographic RA characteristics and attitudes associated with vaccination.Methods. We used data from patients enrolled in the Canadian Early Arthritis Cohort between September 2017 and February 2021. At enrollment, participants reported their vaccination status in the previous year and completed the Beliefs About Medicines Questionnaire (BMQ). Clinical data were obtained from medical records. Logistic regression was used to identify predictors of vaccination in the year after RA diagnosis.Results. The baseline analytic sample of 431 patients were mostly White (80%) women (67%) with a mean age of 56 (SD 14) years. Prediagnosis, influenza vaccine coverage was 38%, increasing to 46% post diagnosis in the longitudinal sample (n = 229). Participants with previous influenza vaccination (odds ratio [OR] 15.33; 95% confidence interval [CI] 6.37-36.90), on biologics or JAKs (OR 5.42; 95% CI 1.72-17.03), and with a higher change in BMQ Necessity-Concerns Differential scores (OR 1.08; 95% CI 1.02-1.15) had greater odds, whereas women (OR 0.32; 95% CI 0.14-0.71), participants with a non-White racial background (OR 0.13; 95% CI 0.04-0.51), and participants currently smoking (OR 0.09; 95% CI 0.02-0.37) had lower odds of influenza vaccine coverage.Conclusion. Influenza vaccination coverage in patients with early RA remains below national targets in adults living with a chronic condition. Discussing vaccine history and medication attitudes at initial clinic visits with new patients with RA may enhance vaccine acceptance and uptake.with combinations of pharmacotherapies, with the aim of reaching a state of remission or low disease activity within 6 months toThe Canadian Early Arthritis Cohort study was independently designed and is implemented by the investigators. It has been financially supported through unrestricted research grants from Amgen,

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“…A study conducted with rheumatological patients from Brasília showed that only 7% the sample received orientation regarding vaccination from the specialist, however, 47% have inadvertently received a live component vaccine while using immunosuppressant therapy [14]. The lack of recommendation by health providers was also indicated as a reason for people living with HIV/AIDS low adherence to vaccination, in another study from Ceará [10].…”

Section: Discussionmentioning

confidence: 99%

The journey of special population to vaccination centers in Brazil: knowledge and perceptions

Petraglia

Spinardi

Almeida

2020

Preprint

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Background: Vaccination is one of the most effective public health strategies to control and prevent diseases. The Brazilian National Immunization Program is an international reference of public healthcare policy. Since 1993 Reference Centers for Special Immunobiologicals (CRIE) were implemented in order to facilitate the access to immunobiologicals, especially for those with congenital or acquired immunodeficiencies and other special morbidity conditions, or subjects exposed to risk situations. To assess knowledge and perceptions concerning the relevance of special patients’ vaccination and the immunization centers (CRIE) structure from patients, physicians and CRIE professional perspectives.Methods: An opinion survey was carried out in 2018 from June to July, including patients, physicians and CRIE professionals. A structured questionnaire was applied in a single interview to each interest group through phone calls. All instruments contained questions on general information, individuals’ profile, and knowledge and perceptions concerning CRIE. Results were obtained from the compilation of each groups’ answers. Data analysis was carried out in a descriptive approach, through measures of central tendency and dispersion for continuous variables, and measures of frequency for categorical variables.Results: The sample was composed by 280 individuals: 135 physicians; 135 patients; and 10 CRIE professionals. Regarding physician’s perspective, most of them reported to know CRIE (79%) and to refer patients (64%), and agreeing that a good quality service with well-trained professionals is offered (91%). Patients reported to receive the recommendation for vaccination by attending physician (91%), and to have never experienced the unavailability of a vaccine (91%) at CRIE. Analysis from CRIE professional’s perspective showed that patients are most frequently referred to CRIE by infectologists (33%) and that vaccination campaigns have a huge influence on demand. However, they also reported that there is no disclosure about CRIE service for population and physicians.Conclusions: Physicians classify vaccination as extremely important and all patients reported to follow recommendation. About immunization centers, a great perception about the service provided by CRIE was reported, but there is still place for uptake the patient journey.

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Vaccination in patients from Brasília cohort with early rheumatoid arthritis

Cited by 4 publications

References 27 publications

Immunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases

Immunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases

Predictors of Influenza Vaccination in Early Rheumatoid Arthritis 2017‐2021: Results From the Canadian Early Arthritis Cohort

The journey of special population to vaccination centers in Brazil: knowledge and perceptions

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