Letter to the Editor
Pneumococcal Vaccine in Patients With Rheumatoid Arthritis
Vacuna frente al neumococo en pacientes con artritis reumatoide
Ignacio Hernández-García
, Alfonso Escribano Hernández
Corresponding author
Servicio de Medicina Preventiva y Salud Pública, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
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In it the authors present a vaccination schedule that included the 23-valent pneumococcal polysaccharide vaccine with booster shots every 3–5 years.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">RA patients are treated with immunosuppressive drugs and this fact determines that such persons are already included in the population group that has the indication for the administration of this vaccine in our country.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However, revaccination is not routinely recommended, so the Ministry of Health<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> has established only 1 booster dose in persons vaccinated more than 5 years prior under the following circumstances: (a) people over 65, who received the first dose before age 65, (b) people at high risk of serious pneumococcal infection (asplenia, chronic renal failure, nephrotic syndrome, or other conditions associated with immunosuppression). Similarly, various international institutions such as the Advisory Committee on Immunization Practices recommended revaccination no more than once because there is insufficient data regarding its clinical benefit, the degree and duration of protection, and safety of administering this vaccine on more than 3 occasions.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In the studies reviewed by Lopez Garrido on pneumococcal vaccination in patients with RA4-10, 1 of the exclusion criterion considered was having previously received the vaccine without specifying the number of years<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and the receipt in the 3<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and 5 years prior to beginning of the study<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a>; there was also had 3 studies where such vaccination history was not described as an exclusion criteria.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8–10</span></a> In any case, none of the works provide specific results in terms of immunogenicity and safety of the pneumococcal vaccine in patients with a history of receiving such a vaccination.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–10</span></a> Therefore, and in the absence of evidence from the literature reviewed by Lopez Garrido on the efficacy and safety of pneumococcal vaccination administered every 3–5 years in patients with RA, the authors consider it necessary to modify the proposed immunization schedule and assume the current official recommendations to administer a single booster dose 5 years after being given the first.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Hernández-García I, Escribano Hernández A. Vacuna frente al neumococo en pacientes con artritis reumatoide. Reumatol Clin. 2012;8:229.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vacunas y quimioprofilaxis en artritis reumatoide: ¿podría plantearse un calendario de vacunación?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.C. Garrido López" 1 => "M.V. Navarro Compain" 2 => "F. 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| 2021 December | 38 | 40 | 78 |
| 2021 November | 48 | 40 | 88 |
| 2021 October | 48 | 55 | 103 |
| 2021 September | 55 | 41 | 96 |
| 2021 August | 51 | 34 | 85 |
| 2021 July | 45 | 29 | 74 |
| 2021 June | 62 | 34 | 96 |
| 2021 May | 72 | 49 | 121 |
| 2021 April | 209 | 93 | 302 |
| 2021 March | 136 | 53 | 189 |
| 2021 February | 86 | 28 | 114 |
| 2021 January | 65 | 25 | 90 |
| 2020 December | 47 | 24 | 71 |
| 2020 November | 61 | 19 | 80 |
| 2020 October | 47 | 16 | 63 |
| 2020 September | 71 | 28 | 99 |
| 2020 August | 32 | 22 | 54 |
| 2020 July | 25 | 31 | 56 |
| 2020 June | 34 | 30 | 64 |
| 2020 May | 37 | 25 | 62 |
| 2020 April | 31 | 14 | 45 |
| 2020 March | 17 | 2 | 19 |
| 2020 February | 1 | 0 | 1 |
| 2020 January | 4 | 0 | 4 |
| 2019 September | 4 | 0 | 4 |
| 2019 June | 1 | 0 | 1 |
| 2019 March | 1 | 0 | 1 |
| 2019 January | 1 | 0 | 1 |
| 2018 December | 1 | 0 | 1 |
| 2018 November | 1 | 0 | 1 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 52 | 5 | 57 |
| 2018 March | 33 | 10 | 43 |
| 2018 February | 23 | 1 | 24 |
| 2018 January | 16 | 4 | 20 |
| 2017 December | 20 | 3 | 23 |
| 2017 November | 36 | 8 | 44 |
| 2017 October | 21 | 4 | 25 |
| 2017 September | 21 | 8 | 29 |
| 2017 August | 16 | 7 | 23 |
| 2017 July | 22 | 9 | 31 |
| 2017 June | 48 | 7 | 55 |
| 2017 May | 51 | 6 | 57 |
| 2017 April | 26 | 7 | 33 |
| 2017 March | 33 | 3 | 36 |
| 2017 February | 26 | 3 | 29 |
| 2017 January | 30 | 6 | 36 |
| 2016 December | 59 | 15 | 74 |
| 2016 November | 47 | 10 | 57 |
| 2016 October | 47 | 9 | 56 |
| 2016 September | 70 | 6 | 76 |
| 2016 August | 81 | 9 | 90 |
| 2016 July | 46 | 11 | 57 |
| 2016 March | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 4 | 0 | 4 |
| 2015 July | 36 | 7 | 43 |
| 2015 June | 51 | 6 | 57 |
| 2015 May | 56 | 12 | 68 |
| 2015 April | 54 | 11 | 65 |
| 2015 March | 35 | 6 | 41 |
| 2015 February | 47 | 6 | 53 |
| 2015 January | 42 | 7 | 49 |
| 2014 December | 54 | 7 | 61 |
| 2014 November | 44 | 12 | 56 |
| 2014 October | 40 | 7 | 47 |
| 2014 September | 27 | 7 | 34 |
| 2014 August | 41 | 14 | 55 |
| 2014 July | 30 | 10 | 40 |
| 2014 June | 47 | 12 | 59 |
| 2014 May | 32 | 10 | 42 |
| 2014 April | 38 | 7 | 45 |
| 2014 March | 44 | 18 | 62 |
| 2014 February | 40 | 19 | 59 |
| 2014 January | 41 | 15 | 56 |
| 2013 December | 34 | 11 | 45 |
| 2013 November | 30 | 14 | 44 |
| 2013 October | 45 | 14 | 59 |
| 2013 September | 37 | 8 | 45 |
| 2013 August | 53 | 15 | 68 |
| 2013 July | 34 | 12 | 46 |
| 2013 June | 49 | 15 | 64 |
| 2013 May | 39 | 15 | 54 |
| 2013 April | 42 | 9 | 51 |
| 2013 March | 50 | 17 | 67 |
| 2013 February | 34 | 6 | 40 |
| 2013 January | 53 | 22 | 75 |
| 2012 December | 27 | 13 | 40 |
| 2012 November | 29 | 14 | 43 |
| 2012 October | 31 | 11 | 42 |
| 2012 September | 18 | 9 | 27 |
Show all
