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肾移植受者中黄热病疫苗误用情况的知晓度

Awareness of Inadvertent Use of Yellow Fever Vaccine Among Recipients of Renal Transplant.

作者信息

Miranda Lara Judith Cabral, Agena Fabiana, Sartori Ana Marli Christovam, David-Neto Elias, Azevedo Luiz Sergio, Pierrotti Lígia Camera

机构信息

Student at University of São Paulo Medical School, São Paulo, Brazil.

Renal Transplantation Service, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil.

出版信息

Transplant Proc. 2020 Jun;52(5):1291-1293. doi: 10.1016/j.transproceed.2020.02.182. Epub 2020 Jun 3.

Abstract

Yellow fever (YF) is a vaccine-preventable disease, but live attenuated YF vaccine (YFV) is contraindicated in immunosuppressed patients due to the risk of life-threatening YFV-associated side effects. This study aimed to evaluate 1. the knowledge of renal transplant recipients (RTRs) about the contraindication and risks of YFV; 2. the prevalence of inadvertent vaccination of RTRs against YF; and 3. the outcome of these patients. A cross-sectional telephone contact study was conducted with 200 RTRs selected from the outpatient clinic of our transplantation unit. There were 116 successful telephone contacts (58%). A total of 11 vaccinated patients were identified: 5 received YFV in the pretransplant period and 6 in the post-transplant period. All patients received the full dose of the vaccine. Among those vaccinated after transplant, only 1 reported a mild adverse event (nausea) after receiving the vaccine. All vaccinated patients who were post-transplant did not know about vaccine contraindications as a result of their clinical condition. Among the unvaccinated patients, this rate was 12.4%. YFV is the main tool for disease prevention and control as there is no specific antiviral treatment for YF. Our results confirm the evidence that transplant recipients tolerate YFV well. However, data are not strong enough to recommend this vaccine in transplant recipients. Counseling RTRs on the contraindications of YFV is important to prevent inadvertent use of this vaccine in this population.

摘要

黄热病(YF)是一种可用疫苗预防的疾病,但由于存在危及生命的黄热病疫苗(YFV)相关副作用风险,减毒活YFV疫苗在免疫抑制患者中是禁忌的。本研究旨在评估:1. 肾移植受者(RTRs)对YFV禁忌和风险的了解情况;2. RTRs意外接种YFV疫苗的发生率;3. 这些患者的结局。我们对从移植科门诊选取的200名RTRs进行了一项横断面电话联系研究。成功进行了116次电话联系(58%)。共识别出11名接种疫苗的患者:5名在移植前接种了YFV,6名在移植后接种。所有患者均接种了全剂量疫苗。在移植后接种疫苗的患者中,只有1名在接种疫苗后报告了轻微不良事件(恶心)。所有移植后接种疫苗的患者因自身临床状况均不知道疫苗禁忌。在未接种疫苗的患者中,这一比例为12.4%。由于没有针对黄热病的特异性抗病毒治疗,YFV是疾病预防和控制的主要手段。我们的结果证实了移植受者对YFV耐受性良好的证据。然而,数据还不够充分,不足以推荐在移植受者中使用这种疫苗。向RTRs提供关于YFV禁忌的咨询对于防止该人群意外使用这种疫苗很重要。

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