The Italian Society of Rheumatology appeals to patients with autoimmune diseases: “still too many are not vaccinated”
The Italian Society of Rheumatology appeals to patients with autoimmune diseases: “Still too many are not vaccinated”
Insights
June 29, 2024
June 29, 2024
Rome – There are still too many rheumatology patients who are not vaccinated for Herpes Zoster, Covid-19, influenza, HPV and pneumococcus: this is the appeal of the Italian Society of Rheumatology (Sir), which underlines the need for immunization for people with autoimmune rheumatological diseases, such as rheumatoid arthritis, systemic lupus erythematosus, vasculitis, autoinflammatory diseases. These are diseases on the rise, often chronic, which frequently affect people of working age and with young children, with a severe impact on the quality of life and on direct and indirect costs for the community. Furthermore, they cause an increase in morbidity and mortality, also due to an increased risk of infections. Patients therefore need the protection offered by vaccines. To promote the importance of vaccinations at a national level and suggest standardized recommendations for clinical practice, Sir has created the “recommendations on vaccinations in patients affected by rheumatological diseases”, presented in recent days at an event in Rome. The recommendations were created according to the “Grade-Adolopment” methodology in compliance with the requirements of the National Guidelines System of the Istituto Superiore di Sanità and are therefore available on the ISS website.
“Rheumatological diseases are a heterogeneous group that includes around 200 pathologies, capable of affecting different age groups – explained Gian Domenico Sebastiani, president of SIR -. For patients, the risk of contracting infections is higher than in the general population, due both to the immunosuppression caused by some of these pathologies and to the effects of therapies. The dangers associated with vaccine-preventable diseases are too often underestimated. For example, Herpes Zoster or Shingles infection can be aggressive, manifest in an atypical way and cause complications that worsen the quality of life. Even a simple seasonal flu can have serious respiratory consequences. Regarding Covid-19, the scientific literature is still constantly growing, but here too we wanted to indicate vaccination as good practice for all patients. Like Sir, in 2020 we published recommendations for influenza and pneumococcal vaccinations in patients with autoimmune rheumatological diseases, but there were no comprehensive guidelines on vaccinations in rheumatological patients yet. For this reason we have decided to create a single document, which can act as a national guideline and direct healthcare personnel in the best way.”
“Today there is still an unjustified mistrust towards vaccines, which must be countered through correct information – said Massimo Andreoni, scientific director of Simit (Italian Society of Infectious and Tropical Diseases) -. For this reason, having created the first recommendations for rheumatology patients is an important step, which will allow us to increase knowledge of infectious diseases in rheumatology and the benefits that can be obtained thanks to vaccines. The recipients of the guidelines are in fact specialists in rheumatology, internal medicine, clinical immunology and allergology, hygiene, public health, infectious diseases, general practitioners and all health professionals involved in the management of patients with rheumatological disease in primary, secondary and tertiary care at both the territorial and hospital levels.”
“The guidelines on vaccinations of rheumatology patients contain useful indications for Seasonal influenza, Pneumococcus, Human papilloma virus, Haemophilus influenzae b, Hepatitis A, Hepatitis B, Inactivated polio, Meningococcus B, Conjugated meningococcus ACWY, Tetanus, Diphtheria and Pertussis, Typhoid, Zoster and good practices for Covid-19 – added Giovanni Gabutti of Siti (Italian Society of Hygiene, Preventive Medicine and Public Health). – These are the most common infections for immunocompromised patients, from which it is important to protect them. Joint work, online, is necessary so that patients are always informed about the protection opportunities offered by vaccines and how to participate in vaccination campaigns”.
“Immunization against the most widespread viruses in the population is essential,” continued Laura Sticchi, of Siti. “For example, seasonal influenza can cause fatal consequences in immunocompromised or elderly patients. In Italy, especially in the elderly, immunization rates are seriously declining: today only 56% of over-65s are vaccinated. As for Covid-19, the number of vaccinations administered in 2023 is among the lowest in Europe. These numbers clearly show the importance of intervening with information and awareness campaigns on this issue.”
“It is important to remember that many rheumatic diseases are chronic, and therefore require the prolonged use of immunosuppressive drugs, which expose patients to an increased risk of developing infections,” said Fabrizio Conti, SIR advisor. “Vaccines are able to reduce the risk of infection and, if this were to occur, to reduce its consequences. For this reason, it is important that patients and referring physicians become aware of their importance, to eliminate the risk of serious outcomes due to the combination of rheumatic disease and infections.”
“We are very proud of the work done in drafting the new guidelines,” concluded Carlo Scirè, of the Sir Study Center, “it was a complex process that required the involvement of numerous professionals, and that from today will allow all specialists and general practitioners to accompany their patients in a standardized manner. With a view to correct information, our goal is for the recommendations to also reach those responsible for policies and the organization of care within the Italian National Health System, so that they can be widely disseminated.”
