Journal
PHARMACOTHERAPY
Volume 42, Issue 4, Pages 334-342Publisher
WILEY
DOI: 10.1002/phar.2671
Keywords
antirheumatic agents; immunosuppressive agents; inactivated vaccine; vaccine
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This review evaluates the efficacy of inactivated vaccines in immunocompromised patients treated with immunosuppressive drugs for various conditions. The majority of studies suggest an attenuated immune response to inactivated vaccines, with anti-B-cell antibodies having a more severe and prolonged negative effect on vaccine efficacy.
Inactivated vaccines are generally considered safe in immunocompromised patients but the ability of immunocompromised patients to generate an effective immune response to vaccines is uncertain. Although recent reviews have focused on the effects of vaccines in patients who are immunocompromised due to various disease states (primary immunodeficiency), the effects of immunosuppressive drug therapy (secondary immunodeficiency) has received relatively less attention. This review evaluates evidence regarding the efficacy of inactivated vaccines against influenza, COVID-19, and other diseases in patients treated with immunosuppressive oncologic agents, immunosuppressants used for transplant recipients, and immunosuppressants used for autoimmune disorders. Although evidence is mixed for many immunosuppressive agents and vaccines, most studies have found an attenuated immune response to inactivated vaccines, with the majority of data indicate anti-B-cell antibodies have a more severe and prolonged negative effect on vaccine efficacy.
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