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德国原发性免疫缺陷患者的疫苗接种状况——一项多中心流行病学分析

Vaccination status of patients with primary immunodeficiencies in Germany-a multicentric epidemiologic analysis.

作者信息

Schwaneck Eva C, Harasim Anna S, Tony Hans-Peter, Gawlik Micha, Witte Torsten, Joos Stefanie, Gernert Michael, Schmalzing Marc, Morbach Henner, Fröhlich Matthias, Krone Manuel

机构信息

Division of Rheumatology/Immunology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.

MVZ Rheumatologie und Autoimmunmedizin, Mönckebergstraße 27, 20095, Hamburg, Germany.

出版信息

Z Rheumatol. 2025 Feb;84(1):68-74. doi: 10.1007/s00393-024-01549-0. Epub 2024 Aug 22.

Abstract

BACKGROUND

Vaccinations represent an easily accessible, safe, and important method for preventing infections. Patients with primary immunodeficiencies (PID) are more susceptible to infections and should receive an extended spectrum of immunizations in many countries.

METHODS

Between January 2019 and May 2020, vaccination certificates of 70 patients with PID from the regions of Würzburg and Hanover in Germany were evaluated. The patients were additionally surveyed regarding their attitude towards vaccinations and the communication with their physicians. Medical records were analyzed.

RESULTS

Of the 70 patients, 54 (77%) suffered from common variable immunodeficiency, 30 (43%) were diagnosed with accompanying autoimmunity, 62 (89%) had an increased susceptibility to infections, and 56 (80%) were on immunoglobulin substitution therapy. Seven patients (10%) had neither a vaccination certificate nor were they able to recollect of their last vaccination. Only 55 (79%) and 43 (61%) patients stated that their rheumatologist or immunologist had recommended an influenza and a pneumococcal vaccination, respectively. When asked about their overall trust in vaccinations on a scale of 0 to 10 (0 = very low, 10 = very high), the mean value was 7.8. The most common vaccination was against tetanus in 63 (90%) patients, 49 (70%) had received vaccination against pneumococci, and 39 (56%) had received an influenza vaccination. Interestingly, 26 patients (37%) were vaccinated against measles, even though this is contraindicated in most PID patients.

CONCLUSION

Our data suggest that vaccination rates in this at-risk population are insufficient. Healthcare providers should emphasize vaccinations routinely when caring for these patients.

摘要

背景

疫苗接种是预防感染的一种易于获得、安全且重要的方法。在许多国家,原发性免疫缺陷(PID)患者更容易感染,因此应该接种更多种类的疫苗。

方法

2019年1月至2020年5月期间,对德国维尔茨堡和汉诺威地区70例PID患者的疫苗接种证书进行了评估。此外,还对患者对疫苗接种的态度以及与医生的沟通情况进行了调查,并分析了病历。

结果

70例患者中,54例(77%)患有常见变异型免疫缺陷,30例(43%)被诊断伴有自身免疫性疾病,62例(89%)感染易感性增加,56例(80%)接受免疫球蛋白替代治疗。7例患者(10%)既没有疫苗接种证书,也记不起上次接种疫苗的时间。只有55例(79%)和43例(61%)患者表示,他们的风湿病学家或免疫学家分别推荐了流感疫苗和肺炎球菌疫苗。当被问及对疫苗接种的总体信任度(0至10分,0=非常低,10=非常高)时,平均值为7.8。最常见的疫苗接种是破伤风疫苗,63例(90%)患者接种了该疫苗,49例(70%)接种了肺炎球菌疫苗,39例(56%)接种了流感疫苗。有趣的是,26例患者(37%)接种了麻疹疫苗,尽管大多数PID患者接种麻疹疫苗是禁忌的。

结论

我们的数据表明,这一高危人群的疫苗接种率不足。医疗保健提供者在照顾这些患者时应常规强调疫苗接种。

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