Abstract
The benefit of vaccination is to reduce the number, or severity of various infectious diseases, knowing that the immune response in this group of patients is often reduced, and there is a risk of dissemination of live vaccinal agents in severely immunocompromised persons. The use of live attenuated vaccines is very limited in patients with primary immunodeficiencies or in patients receiving immunosuppressive therapy with corticosteroids, cytostatics, antimetabolites and biological therapy.
This mainly concers patients with inflammatory bowel diseases, rheumatic diseases and cancer. A wide range of patients with frequent internal diseases of the heart, lungs and kidney without immunosuppressive therapy is also indicated for vaccination against influenza, pneumococcal infections, pertussis and hepatitis B.
Prevention also includes vaccination against varicella in susceptible persons, and vaccination against herpes zoster in the elderly. In patients after hematopoietic stem cell transplantation revaccination is necessary in the case of diseases against which they were vaccinated in childhood, as well as vaccination against invasive bacterial infections and the flu.
Travel options for immunocompromised individuals are not limited in relation to vaccination against hepatitis A, typhoid fever, meningococcus and polio (inactivated vaccine); vaccination against yellow fever under simultaneous immunosuppresive therapy with corticosteroid dose exceeding 20 mg prednisone / day is problematic. The protection of immunocompromised patients is improved by vaccination against influenza and pertussis conducted among people in close contact and vaccination against varicella, rotavirus and pneumococcal infections in children living in a household with immunocompromised patients.
The real effectiveness of vaccines is not known in the majority situations and is based on epidemiological considerations and assumption of at least partial protective effect.