Efficacy of inactivated vaccines in patients treated with immunosuppressive drug therapy

Abstract

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. K E Y W O R D S antirheumatic agents, immunosuppressive agents, inactivated vaccine, vaccine | 335 BEMBEN aNd BERG over 10 kg], as defined by the Advisory Committee on Immunization Practices [ACIP]), were considered to be immunosuppressive agents. 4 How to cite this article: Bemben NM, Berg ML. Efficacy of inactivated vaccines in patients treated with immunosuppressive drug therapy. Pharmacotherapy.

SARS-CoV-2 infection risk is higher in vaccinated patients with inflammatory autoimmune diseases or liver transplantation treated with mycophenolate due to an impaired antiviral immune response: results of the extended follow up of the RIVALSA prospective cohort

“…Several studies showed an impaired vaccine immunogenicity in patients under immunosuppressive therapy, suggesting the need of a “drug washout” period or drug suspension prior to the vaccine administration. As the temporal window between the last immunosuppressive drug dose and vaccine administration is variable according to the ongoing pharmacological therapy, and could be as long as 6-12 months for rituximab, vaccination schedule should be tailored to the patient clinical context, according to the treating physician judgement, with the aim to achieve the better balance between individual patient risk of contracting vaccine preventable infections and the risk of under-treating the underlying autoimmune disease ( 80 , 81 ).…”

Vaccines and use of immunosuppressive and immunomodulatory therapy in a pediatric dermatology clinic—A single institution experience

“…In contrast, inactivated vaccines are safe to deliver while taking immunosuppressives or immunomodulators and should be encouraged. 8 However, vaccine response may be compromised. 5 In this study, we investigate vaccination status and documentation of vaccine counseling in an academic pediatric dermatology practice before prescribing immunosuppressives or immunomodulators.…”

“…In contrast, inactivated vaccines are safe to deliver while taking immunosuppressives or immunomodulators and should be encouraged 8 . However, vaccine response may be compromised 5 .…”

Transcriptome Analysis of the Cultured Hybrid Grouper (♀Epinephelus fuscoguttatus×♂E. lanceolatus) Immunized with Vibrio harveyi formalin-killed cells vaccine (FKC) combined with chitosan oligosaccharide

“…18,19 Inactivated vaccines comprise killed pathogens losing pathogenicity and retaining antigenicity, activating a hu-moral immune response against the corresponding pathogens. 20,21 Our previous study showed that COS as an adjuvant of the Vibrio harveyi formalin-killed cells (FKC) vaccine notably enhanced the immune protective effect of FKC. 22,23 However, the mechanism of COS enhancing FKC effectiveness against V. harveyi in grouper is unclear.…”