Background The different drug treatments in rheumatic patients can lead to situations of immunosuppression and predispose to infection by immunization.
Objectives To present preliminary results of antibody response of immunisation with a double-doses recombinant hepatitis B vaccine and its effectiveness in these patients.
Methods Of the 532 adult patients referred by the Department of Rheumatology at the Immunization Unit of Preventive Medicine of this hospital to assess their vaccination status from the beginning of the protocol in January 2010, 55 correspond to diagnoses of PA. We have studied the variables of sex, treatment with corticosteroids (yes/no), and other treatments such as methotrexate, anti-TNF monotherapy, MTX and anti-TNF. Patients in whom vaccination was indicated (negative antibody level against HBsAg) were vaccinated with a double dose.
Results Of the patients diagnosed with PA (55), 12 were not vaccinated (background infection, previously vaccinated, elderly, etc.). Of the remaining 43, 1 left the vaccination and 10 were pending completion of the vaccination schedule. Of the remaining 32, 6 were pending serological testing postvaccination. 26 patients completed vaccination and postvaccination control anti-HBs. Of these 22 (84.6%) patients we given a double-dose schedule. 9 (39%) of them presented a positive control and 13 post-vaccination negative serology. Among patients with positive results, 4 were women and 5 were men.
Of the 9 patients with positive results, 7 (77.7%) were not administered corticosteroids. Of the13 patients with negative serology, 77.0% were not administered corticosteroids.
Of the 9 patients with positive results, only 3 were treated with MTX.
Of the 6 patients treated with anti-TNF, 4 were positive in the post-vaccination control.
In 2 patients treated with MTX and anti-TNF postvaccination the control was positive.
No significant adverse effects have been detected and no exacerbation of their disease
Conclusions 39% of postvaccination patients screened serologically were positive. Of the patients with positive results, 77.7% were not administered corticosteroids. We understand the need to increase vaccination policies from the time of their diagnosis before the patients begin with immunosupressive treatment.
Beck CR, McKenzie BC, Hashim AB, Harris RC, Zanuzdana A, Agboado G, et al. Influenza Vaccination for Immunocompromised Patients: Systematic Review and Meta-Analysis from a Public Health Policy Perspective PloS One 2011; 6(12). E29249.
Disclosure of Interest None Declared