Soeiro Emília Maria Dantas, Penido Maria Goretti Moreira Guimarães, Palma Lilian Monteiro Pereira, Bresolin Nilzete Liberato, Lima Eduardo Jorge da Fonseca, Koch Vera Hermina Kalika, Tavares Marcelo de Sousa, Sylvestre Lucimary, Bernardes Rejane de Paula, Garcia Clotilde Druck, Andrade Maria Cristina de, Kaufman Arnauld, Chow Charles Yea Zen, Martins Suelen Bianca Stopa, Camargo Suzana Friedlander Del Nero
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil.
Santa Casa de Belo Horizonte, Centro de Nefrologia, Unidade de Nefrologia Pediátrica, Belo Horizonte, MG, Brazil.
J Bras Nefrol. 2023 Apr-Jun;45(2):244-251. doi: 10.1590/2175-8239-JBN-2022-0081en.
The covid-19 vaccine confers direct protection and reduces transmission rates of the virus and new variants. Vaccines from Pfizer/BioNTech and CoronaVac have been cleared for children in Brazil. They are safe, effective, and immunogenic. There are no known complications associated with the use of steroids or vaccines in pediatric patients with covid-19 and nephrotic syndrome. With or without immunosuppression, these patients are not at increased risk of severe covid-19, and steroids are safe for them. A milder form of covid-19 occurs in patients with chronic kidney disease without the need for hospitalization. The vaccine response may be reduced and/or the duration of antibodies after vaccination may be shorter than in the general population. However, considering risk of exposure, vaccination against covid-19 is recommended. It is believed that patients with hemolytic-uremic syndrome are at higher risk of severe covid-19. Vaccination is recommended, although specific data on the safety and efficacy of the covid-19 vaccine are limited. There is agreement that the benefits of induced immunity outweigh the risks of immunization. Vaccination against covid-19 is recommended for children and adolescents needing kidney transplantation or who have undergone transplantation. These patients present decreased immune response after vaccination, but immunization is recommended because the benefits outweigh the risks of vaccination. Current recommendations in Brazil stipulate the use of the messenger RNA vaccine. This paper aims to provide pediatric nephrologists with the latest knowledge about vaccination against covid-19 for children with kidney disease.
新冠疫苗可提供直接保护，并降低病毒及新变种的传播率。辉瑞/ BioNTech疫苗和科兴疫苗已在巴西获批用于儿童。它们安全、有效且具有免疫原性。在患有新冠和肾病综合征的儿科患者中，使用类固醇或疫苗不存在已知并发症。无论有无免疫抑制，这些患者患重症新冠的风险均未增加，类固醇对他们是安全的。慢性肾病患者感染新冠后症状较轻，无需住院治疗。疫苗反应可能会降低，和/或接种疫苗后抗体持续时间可能比普通人群短。然而，考虑到暴露风险，建议接种新冠疫苗。据信，溶血尿毒综合征患者患重症新冠的风险更高。尽管关于新冠疫苗安全性和有效性的具体数据有限，但仍建议接种疫苗。人们一致认为，诱导免疫的益处大于免疫接种的风险。对于需要肾移植或已接受移植的儿童和青少年，建议接种新冠疫苗。这些患者接种疫苗后免疫反应会降低，但由于接种疫苗的益处大于风险，仍建议进行免疫接种。巴西目前的建议规定使用信使核糖核酸疫苗。本文旨在为儿科肾病学家提供有关肾病儿童接种新冠疫苗的最新知识。
