2012 Brazilian Society of Rheumatology Consensus on vaccination of patients with rheumatoid arthritis.

Abstract

OBJECTIVE:

To elaborate recommendations to the vaccination of patients with rheumatoid arthritis (RA) in Brazil.

METHOD:

Literature review and opinion of expert members of the Brazilian Society of Rheumatology Committee of Rheumatoid Arthritis and of an invited pediatric rheumatologist.

RESULTS AND CONCLUSIONS:

The following 12 recommendations were established: 1) Before starting disease-modifying anti-rheumatic drugs, the vaccine card should be reviewed and updated; 2) Vaccines against seasonal influenza and against H1N1 are indicated annually for patients with RA; 3) The pneumococcal vaccine should be indicated for all patients with RA; 4) The vaccine against varicella should be indicated for patients with RA and a negative or dubious history for that disease; 5) The HPV vaccine should be considered for adolescent and young females with RA; 6) The meningococcal vaccine is indicated for patients with RA only in the presence of asplenia or complement deficiency; 7) Asplenic adults with RA should be immunized against Haemophilus influenzae type B; 8) An additional BCG vaccine is not indicated for patients diagnosed with RA; 9) Hepatitis B vaccine is indicated for patients with RA who are negative for antibodies against HBsAg; the combined hepatitis A and B vaccine should be considered; 10) Patients with RA and at high risk for tetanus, who received rituximab in the preceding 24 weeks, should undergo passive immunization with tetanus immunoglobulin in case of exposure; 11) The YF vaccine is contraindicated to patients with RA on immunosuppressive drugs; 12) The above described recommendations should be reviewed over the course of RA.

• Authors: Claiton Viegas Brenol, Licia Maria Henrique da Mota, Bóris Afonso Cruz, Gecilmara Salviato Pileggi, Ivânio Alves Pereira, Lucila Stange Rezende, Manoel Barros Bertolo, Max Victor Carioca Freitas, Nilzio Antônio da Silva, Paulo Louzada-Junior, Rina Dalva Neubarth Giorgi, Rodrigo Aires Corrêa Lima, Geraldo da Rocha Castelar Pinheiro, Brazilian Society of Rheumatology
• Journal: Revista brasileira de reumatologia (Rev Bras Reumatol) Vol. 53 Issue 1 Pg. 4-23 (Feb 2013) ISSN: 1809-4570 [Electronic] Brazil
• PMID: 23588512 (Publication Type: Consensus Development Conference, Journal Article, Practice Guideline)

Topics

• Arthritis, Rheumatoid
• Humans
• Vaccination