Recomendações de Vacinação no Doente Adulto Imunocomprometido
DOI:
https://doi.org/10.20344/amp.22966Palavras-chave:
Hospedeiro Imunocomprometido, Recetores de Transplante, Vacinação, VacinasResumo
O manuscrito reúne indicações de vacinação para adultos imunocomprometidos com base nas recomendações das principais instituições de referência internacional. Estes indivíduos apresentam maior vulnerabilidade a doenças infeciosas preveníveis por vacinas e a proteção vacinal é frequentemente inferior à dos imunocompetentes. Por isso, é importante avaliar a resposta à vacina (serológica ou outra) sempre que possível. Salienta-se a importância de adaptar a vacinação ao net state of immunosuppression precedida por avaliação cuidadosa do risco, indicações, contraindicações e momento ideal de administração. Sempre que possível, a vacinação deve ser efetuada antes do início da imunossupressão farmacológica, antes de esplenectomia ou antes de receber um transplante de órgão sólido. Os imunocomprometidos são categorizados em grupos como: portadores de doenças inflamatórias imunomoduladas, esplenectomizados, recetores de transplantes de órgãos sólidos ou hematopoiéticos, indivíduos com infeção por HIV e aqueles com imunodeficiências congénitas (erros inatos) e são detalhadas as indicações de vacinação em diferentes situações clínicas e tipos de imunossupressão. Abordam-se as vacinas para doenças virais respiratórias como gripe, COVID-19, vírus sincicial respiratório, as vacinas da hepatite A e B, varicela-zoster e a proteção vacinal contra bactérias encapsuladas como pneumococos, meningococos e Haemophilus influenzae. Incluem-se ainda algumas recomendações de vacinação em contexto de viagem e profilaxia pós-exposição para situações de elevado risco. Aborda-se a vacinação dos conviventes e dos profissionais de saúde para proteção adicional. Destaca-se que a evolução das vacinas e das recomendações vacinais obriga a uma atualização constante.
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