This book provides cutting-edge information on the vaccination of children treated with various immunosuppressive regimens. The latest literature and recommendations on vaccination in immunosuppressed children are discussed in detail, providing practical guidelines on vaccination for specialists caring for immunosuppressive paediatric patients.
Vaccination of Immunosuppressed Children in Clinical Practice is a clinically-focused synthesis for a wide audience of paediatricians around the world. Paediatricians (including rheumatologists, gastroenterologists, immunologists, neurologists, nephrologists, oncologists, haematologists) will find this book to be an essential resource for their daily clinical practice.
Author(s): Geraldine Blanchard-Rohner, Laure F. Pittet
Publisher: Springer
Year: 2022
Language: English
Pages: 224
City: Cham
Preface
Contents
Abbreviations
Chapter 1: Importance of Vaccinating Immunocompromised Children
1.1 Overview of the Immune System
1.2 Definitions of Immunodeficiency and Immunosuppressive Regimens
1.3 Risk of Infections
1.4 Burden of Vaccine-Preventable Diseases in Immunocompromised Children
1.4.1 Viral Diseases
1.4.2 Bacterial Diseases
1.4.3 Vaccine-Preventable Diseases
1.5 Challenges in the Vaccination of Immunocompromised Children
References
Chapter 2: Immune Responses to Vaccination
2.1 Antigen-Induced Immune Responses
2.2 Vaccines
2.3 General Principles of the Effect of Underlying States or Immunosuppressive Drugs on the Immune Response to Vaccination
2.4 Mode of Action of Various Immunosuppressive Drugs, Effects on Vaccine Responses and Recommendations
2.4.1 Introduction
2.4.2 Glucocorticoids (GCs)
2.4.2.1 Mode of Action
2.4.2.2 Safety and Immunogenicity Data
2.4.2.3 Recommendations
2.4.3 csDMARDs
2.4.3.1 Drugs That Destroy Dividing Cells Through the Inhibition of DNA Synthesis of Nitrogen Base: Pyrimidine (MTX, Leflunomide) or Purine (AZT, 6-MP, MMF) or by Alkylation of DNA (Cyclophosphamide)
2.4.3.1.1 MTX
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.3.1.2 Leflunomid (Arava®)
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.3.1.3 AZT and 6-MP
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.3.1.4 MMF
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.3.1.5 Cyclophosphamide (Endoxan®)
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.3.1.6 Drugs That Inhibit the Intracellular Signal Transduction from the Antigen-Recognizing TCR Through the Inhibition of Calcineurine Pathways (Cyclosporine, Tac) or the mTOR Pathway (Sirolimus, Everolimus)
Cyclosporine and Tac
Mode of Action
Safety and Immunogenicity Data
Recommendations
Sirolimus and Everolimus
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.3.1.7 Other Molecules Considered as csDMARDs, with Little or No Immunosuppressive Effect
Inhibitors of PGL Synthesis: Derivatives of 5-ASA: Sulfasalazine (Salazopyrin®), Mesalazine (Pentasa®, Asacol®, Salofalk®)
Mode of Action
Safety and Immunogenicity Data
Recommendations
Antimalarials: HCQ
Mode of Action
Safety and Immunogenicity Data
Recommendations
Colchicine
Mode of Action
Recommendations
Thalidomide
Mode of Action
Recommendations
2.4.4 bDMARDs
2.4.4.1 Anti-TNFα
2.4.4.1.1 Adalimumab, Golimumab, Certolizumab, Infliximab, Etanercept
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.4.2 Anti-IL-1
2.4.4.2.1 Anakinra, Canakinumab, Rilonacept
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.4.3 Anti-IL6
2.4.4.3.1 Tocilizumab
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.4.4 CTLA-4 Analogue
2.4.4.4.1 Abatacept
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.4.5 B-Cell Targeting Drugs
2.4.4.5.1 Rituximab (MabThera®), Ocrelizumab (Ocrevus®), Belimumab (Benlysta®)
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.4.6 Anti-CD52 Receptor
2.4.4.6.1 Alemtuzumab (Lemtrada®/Campath®)
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.4.7 Anti-C5
2.4.4.7.1 Eculizumab
Mode of Action
Recommendations
2.4.4.8 Anti-integrin α4β7
2.4.4.8.1 Vedolizumab (Entyvio®)
Recommendations
2.4.4.9 Anti-IL-17A
2.4.4.9.1 Ixekizumab (Cosentyx®), Secukinumab
Mode of Action
Recommendations
2.4.4.10 Anti-IL-12 and IL-23
2.4.4.10.1 Usterkinumab (Stelara®)
Mode of Action
Safety and Immunogenicity Data
Recommendations
2.4.5 tsDMARDs
2.4.5.1 Janus Kinase (JAK) Inhibitors
2.4.5.1.1 Mode of Action
2.4.5.1.2 Recommendations
2.4.5.2 Phosphodiesterase Inhibitors
2.4.5.2.1 Apremilast
Mode of Action
Recommendations
References
Chapter 3: Vaccination with Live Vaccines
3.1 Introduction
3.2 Safety and Immunogenicity Data
3.2.1 Measles, Mumps, Rubella (MMR)
3.2.2 Other Vaccines
3.2.3 Conclusions
3.3 Recommendations
3.3.1 VZV and MMR
3.3.2 Other Live Vaccines
3.3.3 Treatment with Intravenous Immunoglobulin (IVIg)
3.3.4 Infants Born to Mothers Who Received Immunosuppressive Treatment During Pregnancy
References
Chapter 4: Vaccination with Non-live Vaccines
4.1 Introduction
4.2 Influenza
4.3 Hepatitis A
4.4 Hepatitis B
4.5 HPV
4.6 Pneumocococcal Vaccines
4.7 Meningococcal Vaccines
4.8 Tetanus-Diphtheria-Acellular Pertussis-Polio Vaccines
4.9 Hib
4.10 Other Vaccines: Rabies, Japanese Encephalitis, Parenteral Typhoid Vaccines, Tick-Borne Encephalitis
References
Chapter 5: Vaccination Schedules in Immunocompromised Children
5.1 Introduction
5.2 Supplementary Non-live Vaccines
5.3 Supplementary Dose
References
Chapter 6: Practical Approach to the Vaccination of Children with Dysimmune Disorders Before the Introduction of Immunosuppression or Already Under Immunosuppressive Treatment
Chapter 7: Discussion
References
Chapter 8: Conclusions and Future Perspectives
Index
