Wolters Kluwer Clinical Effectiveness, Chicago, Illinois, USA.
American Society of Health-System Pharmacists, Bethesda, Maryland, USA.
Pharmacotherapy. 2022 Apr;42(4):334-342. doi: 10.1002/phar.2671. Epub 2022 Feb 18.
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.
灭活疫苗在免疫功能低下患者中通常被认为是安全的，但免疫功能低下患者对疫苗产生有效免疫反应的能力尚不确定。尽管最近的综述重点关注了因各种疾病状态（原发性免疫缺陷）而免疫功能低下的患者疫苗的作用，但免疫抑制药物治疗（继发性免疫缺陷）的作用相对较少受到关注。本综述评估了关于接受抗肿瘤免疫抑制剂、用于移植受者的免疫抑制剂和用于自身免疫性疾病的免疫抑制剂治疗的患者接种流感、COVID-19 和其他疾病的灭活疫苗的疗效的证据。尽管许多免疫抑制剂和疫苗的证据存在差异，但大多数研究发现灭活疫苗的免疫反应减弱，大多数数据表明抗 B 细胞抗体对疫苗疗效的负面影响更严重且持续时间更长。
