The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / From the Expert: Don’t Forget to Vaccinate Immuncompromised Patients

From the Expert: Don’t Forget to Vaccinate Immuncompromised Patients

April 8, 2016 • By Richard Quinn

  • Tweet
  • Email
Print-Friendly Version / Save PDF

GENERIC_Science_Research_500x270Rheumatologists can block pathways and manipulate the immune system in ways rarely imagined 30 years ago. But those advancements also raise serious concerns for immunocompromised patients, according to Nicolas Issa, MD, an infectious disease specialist at Brigham and Women’s Hospital and the Dana-Farber Cancer Institute in Boston.

You Might Also Like
  • Expert Says Vaccines Are Largely Safe for Rheumatology Patients
  • Immunizations in Immunocomprised Patients
  • Vaccines & Rheumatology Patients
Also By This Author
  • ACR Program Encourages Innovation & Opportunity

One area of specific concern is the herpes zoster virus. “We need better and safer vaccines that are effective in preventing zoster reactivation and can be administered safely in this population,” says Dr. Issa, an assistant professor of medicine at Harvard Medical School whose clinical trials include evaluating new candidate vaccines to prevent infections in immunocompromised patients.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Recently, he talked to The Rheumatologist about the subject:

Question: Why is zoster prevention and vaccination such a hot topic for rheumatologists?
Answer: Advances in science, especially the advent of new drugs that manipulate the immune system response and the increased use of biologics, have ushered in an era of excitement … but at the same time, we continue to map this new territory with still-unknown, downstream effects of these new drugs—in terms of potential infectious and non-infectious complications. Latent infections, such as zoster, can reactivate with the use some of these biologics, with [the] potential occurrence of serious complications.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Different strategies can be employed to prevent zoster reactivation. Vaccination is one strategy that could be employed, but [there is] concern about the safety of the currently available zoster vaccine [because] it is a live virus vaccine.

Q: What is the clinicians’ biggest challenge?
A: Zoster reactivation can be a very serious [complication of treatment]. Prevention is key. However, there is no universal, safe and effective approach to prevention. Prophylactic anti-virals to prevent zoster can be one strategy, but how [we] identify those patients who are at the highest risk and how long [we should] give prophylactic anti-virals remain challenging. There are also side effects, compliance issues, cost and risk of breakthrough resistance associated with this approach. Prevention using immunization is a better approach, but the currently approved vaccine is a live virus vaccine that is contraindicated in the setting of immunosuppression.

Q: Are new preventive treatments in the pipeline?
A: A new subunit, adjuvanted zoster vaccine, which is not a live virus vaccine and, thus, incapable of replicating in the immunocompromised host, is currently in Phase 3 trials in three different subpopulations: autologous stem cell transplant recipients, kidney transplant recipients and patients with HIV.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

In a Phase 2 trial, in autologous stem cell transplant recipients, the vaccine was shown to be both immunogenic and safe, even when given shortly after transplant—within two months. A Phase 3 trial in the same population to evaluate vaccine efficacy is complete, and patients are in follow-up.

Pages: 1 2 | Single Page

Filed Under: Conditions Tagged With: Biologics, herpes, Infection, prevention, vaccination

You Might Also Like:
  • Expert Says Vaccines Are Largely Safe for Rheumatology Patients
  • Immunizations in Immunocomprised Patients
  • Vaccines & Rheumatology Patients
  • Vaccinations for Immunocompromised Patients Are Shared Responsibility of Specialists, Primary Care Physicians

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.