Abstract
Objective
To develop an evidence-based vaccination guideline that incorporates expert opinions on vaccine-preventable diseases for adult rheumatology patients, taking into account their medical conditions.
Methods
The team appointed by the Turkish Society for Rheumatology developed clinical questions related to rheumatic diseases, their treatments, vaccine-preventable diseases, and vaccines in the format of population, intervention, comparison, and outcome (PICO). Systematic literature reviews were conducted for each PICO question. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the quality of evidence and to formulate recommendations.
Results
The appointed team developed vaccination recommendations with evidence levels for rheumatology patients aged 18 years and older based on the medical conditions (disease, medications, pregnancy, breastfeeding, travel, etc.). Recommendations were developed under the headings including the general approach recommendations, usage of each vaccine, recommendations for live and inactivated vaccines, timing of administration, and vaccination of infants born to pregnant rheumatology patients on immunosuppressive therapy. Most of the recommendations are conditional, with low supporting evidence levels. Some of the recommended vaccines were not included in the Turkish Ministry of Health’s National Vaccination Schedules at the time of the guideline’s development or were unavailable within our country; however, they are included in the guideline with the understanding that updates may occur over time or that these vaccines may become accessible.
Conclusion
Adult rheumatology patients should be vaccinated for vaccine-preventable diseases based on their individual risks. The attending physician and the patient should make a joint decision regarding vaccination. The patient should be informed about the importance of vaccination (recommended vaccines, timing, and side effects) and encouraged accordingly, with any hesitations addressed through scientific evidence.
Keywords:
Antirheumatic treatments, vaccine recommendations, immunization, rheumatic diseases
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