Rosamilia Francesca, Noberasco Giovanni, Olobardi Dario, Orsi Andrea, Icardi Giancarlo, Lantieri Francesca, Murdaca Giuseppe
Biostatistics Unit, Health Science Department (DISSAL), University of Genova, Via Pastore 1, 16132 Genova, Italy.
Vaccines and Clinical Trials Unit, Department of Health Sciences, University of Genova, 16132 Genova, Italy.
Vaccines (Basel). 2021 Nov 15;9(11):1330. doi: 10.3390/vaccines9111330.
Systemic sclerosis (scleroderma, SSc) is an autoimmune connective tissue disease characterized by excessive production of collagen and multiorgan involvement. Scleroderma patients are at increased risk of influenza complications and pneumonia; thus, vaccinations are recommended. This systematic review evaluated the influenza and pneumococcus vaccination coverage for SSc patients. We included all studies from Pubmed reporting on influenza and pneumococcal vaccination rate in Scleroderma patients up to May 2021. The 14 studies thus selected identified a suboptimal vaccination rate in autoimmune and SSc patients, ranging from 28 to 59% for the flu vaccine, and from 11 to 58% for the pneumo vaccine in absence of specific vaccination campaigns, variously considering also other variables such as age, gender, vaccination settings, and possible vaccination campaigns. We also considered the reasons for low coverage and the approaches that might increase the vaccination rates. A lack of knowledge about the importance of vaccination in these patients and their doctors underlined the need to increase the awareness for vaccination in this patients' category. Current guidelines recommend vaccination in elderly people and people affected by particular conditions that widely overlap with SSc, yet autoimmune diseases are not always clearly mentioned. Improving this suboptimal vaccination rate with clear guidelines is crucial for SSc patients and for clinicians to immunize these categories based principally on the pathology, prior to the age. Recommendations by the immunologist and the direct link to the vaccine providers can highly improve the vaccine coverage.
系统性硬化症（硬皮病，SSc）是一种自身免疫性结缔组织疾病，其特征是胶原蛋白过度产生和多器官受累。硬皮病患者发生流感并发症和肺炎的风险增加；因此，建议接种疫苗。本系统评价评估了SSc患者的流感和肺炎球菌疫苗接种率。我们纳入了截至2021年5月发表在PubMed上的所有关于硬皮病患者流感和肺炎球菌疫苗接种率的研究。如此选择的14项研究确定了自身免疫性疾病和SSc患者的疫苗接种率不理想，在没有特定疫苗接种活动的情况下，流感疫苗接种率为28%至59%，肺炎疫苗接种率为11%至58%，同时还不同程度地考虑了其他变量，如年龄、性别、疫苗接种环境以及可能的疫苗接种活动。我们还考虑了低接种率的原因以及可能提高接种率的方法。这些患者及其医生对疫苗接种重要性的认识不足凸显了提高这类患者疫苗接种意识的必要性。目前的指南建议老年人以及患有与SSc广泛重叠的特定疾病的人接种疫苗，但自身免疫性疾病并不总是被明确提及。制定明确的指南以改善这种不理想的疫苗接种率对于SSc患者以及临床医生根据主要病理情况而非年龄对这些人群进行免疫接种至关重要。免疫学家的建议以及与疫苗供应商的直接联系可以显著提高疫苗接种率。
