Download PDF
Arthritis und Rheuma 2017; 37(01): 39-58
DOI: 10.1055/s-0037-1618409
Kinder-rheumatologie: Übersichtsarbeit
Schattauer GmbH

Impfungen bei immunsupprimierten jungen Rheumatikern in der Transition

Vaccinations in immunosuppressed young rheumatics in transition
F. Speth
1   Kinder- und Jugendklinik, Universitätsmedizin Rostock
,
J.-P. Haas
2   Deutsches Zentrum für Kinder- und Jugendrheumatologie, Zentrum für Schmerztherapie junger Menschen, Garmisch-Partenkirchen
,
C. Kneitz
3   Klinik f. Innere Medizin II, Klinikum Südstadt Rostock
,
K. Warnatz
4   Universitätsklinikum Freiburg, Center for Chronic Immunodeficiency – CCI am Center for Translational Cell Research, Department of Rheumatology and Clinical Immunology, Freiburg
,
K. Minden
5   Deutsches Rheuma-Forschungszentrum Berlin und Charité Universitätsmedizin Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
27 December 2017 (online)

    Permissions and Reprints

Zusammenfassung

Häufig werden Nachhol-, Auffrisch- und Indikationsimpfungen bei Patienten mit Autoimmunerkrankungen insbesondere unter Immunsuppression in Sorge vor Schüben der Grunderkrankung oder aufgrund von Unwissenheit über die meist gute Impfantwort über Jahre hinweg verschoben. Zum Zeitpunkt der Transition in die Erwachsenenrheumatologie besteht die Gelegenheit, die Vorgeschichte des Patienten aufzuarbeiten und den aktuellen Impfstatus zu überprüfen. Mögliche neue Motivation für Impfungen in diesem Lebensabschnitt stellen geplante Auslandsaufenthalte, eine Ausbildung im Gesundheitssystem oder ein Kinderwunsch dar. Um die Akzeptanz für Impfungen zu erhöhen, empfiehlt sich eine individualisierte Impfberatung unter Berücksichtigung des persönlichen Risikos einer schwer verlaufenden Infektion, die Messung von Ausgangsimpftitern, um unnötige Boosterungen zu vermeiden und – im Falle von Lebendimpfungen – der Einsatz von Impfstrategien, die ermöglichen, das Risiko für einen Schub der Grunderkrankung bzw. eine Erkrankung durch den Impfstamm zu minimieren. Aus diesem Grund werden hier immunologisch basierte Algorithmen als Diskussionsgrundlage vorgeschlagen, damit auch Patienten mit seltenen Erkrankungen und/oder immunsuppressiver Therapie nicht durch das Raster der Impfempfehlungen fallen.

Summary

Patients with autoimmune diseases and immunosuppression often delay catch-up-, booster- and indication-appropriate immunizations due to worries about flares of the rheumatic disease or underestimation of the vaccine response. The patient's history should be carefully reviewed at the time of transition and the vaccination status checked. Possible new motivations for vaccinations, at this stage of life are planned travels, education in the health care or pregnancy. To increase the acceptance of immunizations, an individualized vaccination plan is recommended. It should take into account the personal risk of severe infections, individual immunization titers to determine necessary booster vaccines and, in the case of live vaccines, it needs to provide strategies that allow for minimizing the risk of flares or infection by the attenuated vaccine. Therefore we suggest an immunological-based algorithm for discussion so that also patients with rare diseases and/or under immunosuppressive medication are covered by the vaccination recommendations.

Schlüsselwörter

Transition - Impfungen - junge Rheumatiker - Immunsuppression - immunologische PreVaccination Checkliste

Keywords

Transition - vaccination - young people with rheumatic disease - immunosuppression - immunological pre-vaccination checklist
 

  • Literatur

  • 1 Weigel M, Bruns R, Weitmann K, Hoffmann W. Immunization rates at the school entry in 2012. Nationwide German data with regional and local breakdown.. Dtsch Ärztebl Int 2014; 111 (46) 788-794.
    PubMedGoogle Scholar
  • 2 Krasselt M, Ivanov JP, Baerwald C, Seifert O. Low vaccination rates among patients with rheumatoid arthritis in a German outpatient clinic.. Rheumatol Int 2016; DOI: 10.1007/s 00296-016-3608-y [doi].
    CrossrefGoogle Scholar
  • 3 Pädiatrische Rheumatologie. Berlin: Heidelberg; 2016. Report No.: 2. [im Druck]
  • 4 Feuchtenberger M, Kleinert S, Schwab S. et al. Vaccination survey in patients with rheumatoid arthritis: a cross-sectional study.. Rheumatol Int 2012; 32 (06) 1533-1539.
    CrossrefPubMedGoogle Scholar
  • 5 Minden K, Niewerth M, Borte M. et al. Impfungen bei rheumatischen Erkrankungen des Kindes- und Jugendalters.. Z Rheumatol 2007; 66 (02) 111-118. 120
    CrossrefPubMedGoogle Scholar
  • 6 Ellsäßer G, Trost-Brinkhues G. Impfungen bei Jugendlichen in den 6. bis 10. Klassen 2011 - ein Ländervergleich http://www impfbrief de/?nav=5&unav=1&uunav=2013#id139 2013
  • 7 Robert Koch-Institut. Begründung zur generellen Empfehlung für Windpockenimpfung der STIKO Epidemiologisches Bulletin. 2004; 49: 421-432.
    PubMedGoogle Scholar
  • 8 Horn J, Damm O, Kretzschmar M. et al. STIKO: Mathematische Modellierung der Effekte des Variziellen-Impfprogramms in Deutschland.. Braunschweig, Bielefeld, Utrecht, Berlin. 2014 Report No.: http://www.rki.de/DE/Content/Infekt/Impfen/Forschungsprojekte/Varizellen-Impfung/Abschlussbericht.pdf?__blob=publicationFile
    Google Scholar
  • 9 Heijstek MW, Ott de Bruin LM, Bijl M. et al. EULAR recommendations for vaccination in paediatric patients with rheumatic diseases.. Ann Rheum Dis 2011; 70 (10) 1704-1712.
    CrossrefPubMedGoogle Scholar
  • 10 Bijlsma J W, Buttgereit F. Adverse events of glucocorticoids during treatment of rheumatoid arthritis: lessons from cohort and registry studies.. Rheumatology (Oxford) 2016; 55 (02) ii3-ii5.
    CrossrefPubMedGoogle Scholar
  • 11 Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking glucocorticosteroids.. Rev Infect Dis 1989; 11 (06) 954-963.
    CrossrefPubMedGoogle Scholar
  • 12 Warnatz K, Goldacker S. Impfungen bei rheumatischen Erkrankungen. Aktuelle Empfehlungen der STIKO und DGRh.. arthritis + rheuma 2014; 3: 140-149.
    Google Scholar
  • 13 Bühler S. Vaccination recommendations for adult patients with autoimmune inflammatory rheumatic diseases.. Swiss Med Wkly 2015; 145.
    Google Scholar
  • 14 Winthrop KL, Silverfield J, Racewicz A. et al. The effect of tofacitinib on pneumococcal and influenza vaccine responses in rheumatoid arthritis.. Ann Rheum Dis 2016; 75 (04) 687-695.
    CrossrefPubMedGoogle Scholar
  • 15 Crnkic KM, Saxne T, Jonsson G. et al. Rituximab and abatacept but not tocilizumab impair antibody response to pneumococcal conjugate vaccine in patients with rheumatoid arthritis.. Arthritis Res Ther 2013; 15 (05) R171.
    CrossrefPubMedGoogle Scholar
  • 16 Accortt N, Schenfeld J, Trivedi M. Dose relationship between oral glucocorticoids and TNF Inhibitors and the risk of hospitalized infectious events among patients with rheumatoid arthritis. (Abstract).. Arthritis Rheumatol 2015. 67 (Suppl. 10)
    Google Scholar
  • 17 Robert Koch-Institut STIKO: Hinweise zu Impfungen für Patienten mit Immundefizienz. Epidemiologisches Bulletin. 2005. Sonderdruck: 1-12.
    Google Scholar
  • 18 Danza A, Ruiz-Irastorza G. Infection risk in systemic lupus erythematosus patients: susceptibility factors and preventive strategies.. Lupus 2013; 22 (12) 1286-1294.
    CrossrefPubMedGoogle Scholar
  • 19 Rubin LG, Levin MJ, Ljungman P. et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host.. Clin Infect Dis 2014; 58 (03) 309-318.
    CrossrefPubMedGoogle Scholar
  • 20 Speth F, Wellinghausen N, Haas JP. Medikamentöse Prophylaxe während intensivierter Immunsuppression bei Kindern und Jugendlichen. Teil 2.. Z Rheumatol 2013; 72 (09) 896-909.
    CrossrefPubMedGoogle Scholar
  • 21 Robert Koch-Institut. STIKO: Wissenschaftliche Begründung für die Aktualisierung der Empfehlungen zur Indikationsimpfung gegen Pneumokokken für Risikogruppen Epidemiologisches Bulletin. 2016; 37: 386-406.
    PubMedGoogle Scholar
  • 22 Mosca M, Tani C, Aringer M. et al. European League Against Rheumatism recommendations for monitoring patients with systemic lupus erythematosus in clinical practice and in observational studies.. Ann Rheum Dis 2010; 69 (07) 1269-1274.
    CrossrefPubMedGoogle Scholar
  • 23 BAG E. Empfehlungen zur Impfung von Empfängerinnen und Empfängern von Blut-Stammzellen.. BAG 2012; Bulletin 21: 363-370.
    Google Scholar
  • 24 Good R, Zak S. Disturbances in gamma globulin synthesis as „experiments of nature“.. Pediatrics 1956; 18 (01) 109-149.
    PubMedGoogle Scholar
  • 25 Oitani K. Expression of interleukin-2 receptor, CD25, on CD4 lymphocytes in response to varicella-zoster virus antigen among patients with malignancies immunized with live attenuated varicella vaccine.. Pediatr Int 1999; 41 (01) 32-36.
    CrossrefPubMedGoogle Scholar
  • 26 Gershon A A. Varicella -zoster virus: prospects for control.. Advances in Pediatric Infect Dis 1995; 93-124.
    Google Scholar
  • 27 Speth F, Haas J P, Hinze C. Immunological risk factors after rituximab therapy in patients with pediatric rheumatic diseases - a prospective single-center study. (Abstract).. Arthritis Rheumatol 2016. 67: (Suppl. 10)
    Google Scholar
  • 28 Siegrist CA, Aspinall R. B-cell responses to vaccination at the extremes of age.. Nat Rev Immunol 2009; 9 (03) 185-194.
    CrossrefPubMedGoogle Scholar
  • 29 Elkayam O, Paran D, Caspi D. et al. Immunogenicity and safety of pneumococcal vaccination in patients with rheumatoid arthritis or systemic lupus erythematosus.. Clin Infect Dis 2002; 34 (02) 147-153.
    CrossrefPubMedGoogle Scholar
  • 30 Crowe SR, Merrill JT, Vista ES. et al. Influenza vaccination responses in human systemic lupus erythematosus: impact of clinical and demographic features.. Arthritis Rheum 2011; 63 (08) 2396-2406.
    CrossrefPubMedGoogle Scholar
  • 31 Askling J, Fored CM, Brandt L. et al. Time-dependent increase in risk of hospitalisation with infection among Swedish RA patients treated with TNF antagonists.. Ann Rheum Dis 2007; 66 (10) 1339-1344.
    CrossrefPubMedGoogle Scholar
  • 32 Abu-Shakra M. Safety of vaccination of patients with systemic lupus erythematosus.. Lupus 2009; 18 (13) 1205-1258.
    CrossrefPubMedGoogle Scholar
  • 33 Arnaud G, Huiller L, Posfay-Bare KM. Live viral vaccines in transplanted patients.. Swiss Med Wkly 2014. 144: (w14005)
    Google Scholar
  • 34 Tay L, Leon F, Vratsanos G. et al. Vaccination response to tetanus toxoid and 23-valent pneumococcal vaccines following administration of a single-dose of abatacept: a randomized, open-label, parallel group study in healthy subjects.. Arthritis Res Ther 2007. 9: (R38)
    Google Scholar
  • 35 Frauenärzte im Netz. Mutterschafts-Richtlinien-des-Gemeinsamen-Bundesausschusses über die ärztliche Betreuung während der Schwangerschaft und Stellungnahme der Gesellschaft für Gynäkologie http://www frauenaerzte-im-netz de/de_impfungen-in-der-schwangerschaft_1185 html 2016
  • 36 SGINF, EKIF, BAG Prävention schwerer Infektionen bei anatomischer oder funktioneller Asplenie. Bulletin 2015; 10: 155-162.
    Google Scholar
  • 37 van Assen S, Agmon-Levin N, Elkayam O. et al. EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases.. Ann Rheum Dis 2011; 70 (03) 414-422.
    CrossrefPubMedGoogle Scholar
  • 38 Poolman J, Borrow R. Hyporesponsiveness and its clinical implications after vaccination with polysaccharide or glycoconjugate vaccines.. Expert Rev Vaccines 2011; 10 (03) 307-322.
    CrossrefPubMedGoogle Scholar
  • 39 Liakou CD, Askiti V, Mitsioni A. et al. Safety and immunogenicity of booster immunization with 7-valent pneumococcal conjugate vaccine in children with idiopathic nephrotic syndrome.. Vaccine 2014; 32 (12) 1394-1397.
    CrossrefPubMedGoogle Scholar
  • 40 Figueroa JE, Densen P. Infectious diseases associated with complement deficiencies.. Clin Microbiol Rev 1991; 4 (03) 359-395.
    CrossrefPubMedGoogle Scholar
  • 41 Kroger AT, Atkinson WL, Marcuse EK, Pickering LK. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP).. MMWR Recomm Rep 2006; 55 (RR-15) 1-48.
    PubMedGoogle Scholar
  • 42 Amanna IJ, Carlson NE, Slifka MK. Duration of humoral immunity to common viral and vaccine antigens.. N Engl J Med 2007; 357 (19) 1903-1915.
    CrossrefPubMedGoogle Scholar
  • 43 Plotkin S, Orenstein W, Offit P. Vaccines. 6th ed. Philadelphia: Saunders; 2012
  • 44 Levin MJ. Varicella vaccination of immunocompromised children.. J Infect Dis 2008; 197 (02) S200-S206.
    CrossrefPubMedGoogle Scholar
  • 45 Toplak N, Avcin T. Long-term safety and efficacy of varicella vaccination in children with juvenile idiopathic arthritis treated with biologic therapy.. Vaccine 2015; 33 (33) 4056-4059.
    CrossrefPubMedGoogle Scholar
  • 46 Speth F, Haas JP, Loeber S, Hinze C. Varicella vaccination in patients with pediatric rheumatic diseases receiving immunosuppression. Proposal of a pre-vaccination checklist to ensure safety. (Abstract).. Arthritis Rheumatol 2015. 67: (Suppl. 10)
    Google Scholar
  • 47 Khan S, Erlichman J, Rand EB. Live virus immunization after orthotopic liver transplantation.. Pediatr Transplant 2006; 10 (01) 78-82.
    CrossrefPubMedGoogle Scholar
  • 48 Heijstek MW, Pileggi GC, Zonneveld-Huijssoon E. et al. Safety of measles, mumps and rubella vaccination in juvenile idiopathic arthritis.. Ann Rheum Dis 2007; 66 (10) 1384-1387.
    CrossrefPubMedGoogle Scholar
  • 49 Shinjoh M, Miyairi I, Hoshino K. et al. Effective and safe immunizations with live-attenuated vaccines for children after living donor liver transplantation.. Vaccine 2008; 26 (52) 6859-6863.
    CrossrefPubMedGoogle Scholar
  • 50 Robert Koch-Institut. STIKO: Änderung der Empfehlung zur Impfung gegen Masern Epidemiologisches Bulletin. 2010; 32: 315-330.
    PubMedGoogle Scholar
  • 51 Ha K, Baba K, Ikeda T. et al. Application of live varicella vaccine to children with acute leukemia or other malignancies without suspension of anticancer therapy.. Pediatrics 1980; 65 (02) 346-350.
    PubMedGoogle Scholar
  • 52 Paul-Ehrlich-Institut. Fachinformation für Variltix https://portal dimdi de/amispb/doc/pei/Web/2604228-spcde-20100401 pdf 2010
  • 53 GSK. Fachinformation für Varilrix https://www gsk-med de/pdfurl?action=getfi&id=06955421 2014
  • 54 Hardy I, Gershon AA, Steinberg SP, LaRussa P. The incidence of zoster after immunization with live attenuated varicella vaccine. A study in children with leukemia. Varicella Vaccine Collaborative Study Group.. N Engl J Med 1991; 325 (22) 1545-1550.
    CrossrefPubMedGoogle Scholar
  • 55 ECDC. Varicella vaccination in the European Union Control ECfDPa Varicella vaccination in the European Union 2015.. 2015
    PubMedGoogle Scholar
  • 56 Robert Koch-Institut KV-Impfsurveillance: Auswertung von Abrechnungsdaten der Kassenärztlichen Vereinigungen.. 2016
    PubMedGoogle Scholar
  • 57 Seth A, Deepa S, Dutta R, Chandra J. Evaluation of Immune Response to Measles Component of MMR Vaccine in Children with HIV Infection Receiving Antiretroviral Therapy.. Pediatr Infect Dis J 2016; 35 (01) e8-e11.
    PubMedGoogle Scholar
  • 58 Levin MJ, Gershon AA, Weinberg A. et al. Administration of live varicella vaccine to HIV-infected children with current or past significant depression of CD4(+) T cells.. J Infect Dis 2006; 194 (02) 247-255.
    CrossrefPubMedGoogle Scholar
  • 59 Lacki JK, Mackiewicz SH, Leszczynski P, Muller W. The effect of intravenous cyclophosphamide pulse on peripheral blood lymphocytes in lupus erythematosus patients.. Rheumatol Int 1997; 17 (02) 55-60.
    CrossrefPubMedGoogle Scholar
  • 60 Hofstetter AM, Jakob K, Klein NP. et al. Live vaccine use and safety in DiGeorge syndrome.. Pediatrics 2014; 133 (04) e946-e954.
    CrossrefPubMedGoogle Scholar
  • 61 McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013; summary recommendations of the Advisory Committee on Immunization Practices (ACIP).. MMWR Recomm Rep 2013; 62 (RR-04) 1-34.
    PubMedGoogle Scholar
  • 62 Borte S, Liebert UG, Borte M, Sack U. Efficacy of measles, mumps and rubella revaccination in children with juvenile idiopathic arthritis treated with methotrexate and etanercept.. Rheumatology (Oxford) 2009; 4 8 (02) 144-148.
    Google Scholar
  • 63 Singh JA, Saag KG, Bridges Jr SL. et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.. Arthritis Rheumatol 2016; 68 (01) 1-26.
    CrossrefPubMedGoogle Scholar
  • 64 Yun H, Yang S, Chen L. et al. Risk of Herpes Zoster in Autoimmune and Inflammatory Diseases: Implications for Vaccination.. Arthritis Rheumatol 2016; 68 (09) 2328-2337.
    CrossrefPubMedGoogle Scholar
  • 65 Wasan SK, Zullow S, Berg A. et al. Herpes Zoster Vaccine Response in Inflammatory Bowel Disease Patients on Low-dose Immunosuppression.. Inflamm Bowel Dis 2016; 22 (06) 1391-1396.
    CrossrefPubMedGoogle Scholar
  • 66 Zhang J, Xie F, Delzell E. et al. Association between vaccination for herpes zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases.. JAMA 2012; 308 (01) 43-49.
    CrossrefPubMedGoogle Scholar
  • 67 Maves RC, Tripp MS, Dell TG. et al. Disseminated vaccine-strain varicella as initial presentation of the acquired immunodeficiency syndrome: a case report and review of the literature.. J Clin Virol 2014; 59 (01) 63-66.
    CrossrefPubMedGoogle Scholar
  • 68 Kramer JM, LaRussa P, Tsai WC. et al. Disseminated vaccine strain varicella as the acquired immunodeficiency syndrome-defining illness in a previously undiagnosed child.. Pediatrics 2001; 108 (02) E39.
    CrossrefPubMedGoogle Scholar
  • 69 Bergen RE, Diaz PS, Arvin AM. The immunogenicity of the Oka/Merck varicella vaccine in relation to infectious varicella-zoster virus and relative viral antigen content.. J Infect Dis 1990; 162 (05) 1049-1054.
    CrossrefPubMedGoogle Scholar
  • 70 Pileggi GS, de Souza CB, Ferriani VP. Safety and immunogenicity of varicella vaccine in patients with juvenile rheumatic diseases receiving methotrexate and corticosteroids.. Arthritis Care Res (Hoboken ) 2010; 62 (07) 1034-1039.
    CrossrefPubMedGoogle Scholar
  • 71 Speth F, Minden K. Impfungen bei Kindern und Jugendlichen mit rheumatischen und muskuloskelettalen Erkrankungen. Hinweise für das Vorgehen im Alltag.. arthritis + rheuma 2015; 35 (01) 44-55.
    Google Scholar
  • 72 Rice P, Young Y, Cohen B, Ramsay M. MMR immunisation after contact with measles virus.. Lancet 2004; 363 9408 569-570.
    PubMedGoogle Scholar
  • 73 enters for Disease Control and Prevention. Mumps Epidemiology and Prevention of Vaccine-Preventable Diseases 2015; https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/mumps.pdf (13th Edition): 247-60
  • 74 Erdman DD, Heath JL, Watson JC. et al. Immunoglobulin M antibody response to measles virus following primary and secondary vaccination and natural virus infection.. J Med Virol 1993; 41 (01) 44-48.
    CrossrefPubMedGoogle Scholar
  • 75 Lo MS, Zurakowski D, Son MB, Sundel RP. Hypergammaglobulinemia in the pediatric population as a marker for underlying autoimmune disease: a retrospective cohort study.. Pediatr Rheumatol Online J 2013; 11 (01) 42.
    CrossrefPubMedGoogle Scholar
  • 76 Kumagai T, Chiba Y, Fujiwara M. et al. Humoral and cellular immune response to varicella-zoster virus in children inoculated with live attenuated varicella vaccine.. Biken J 1980; 23 (03) 135-141.
    PubMedGoogle Scholar
  • 77 Perez EE, Bokszczanin A, McDonald-McGinn D. et al. Safety of live viral vaccines in patients with chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome).. Pediatrics 2003; 112 (04) e325.
    CrossrefPubMedGoogle Scholar
  • 78 Goldstein MF, Goldstein AL, Dunsky EH. et al. Pediatric selective IgM immunodeficiency.. Clin Dev Immunol 2008 2008; 624850.
    Google Scholar
  • 79 Furst DE. Serum immunoglobulins and risk of infection: how low can you go?. Semin Arthritis Rheum 2009; 39 (01) 18-29.
    CrossrefPubMedGoogle Scholar
  • 80 Ameratunga R, Brewerton M, Slade C. et al. Comparison of diagnostic criteria for common variable immunodeficiency disorder.. Front Immunol 2014; 5: 415.
    PubMedGoogle Scholar
  • 81 Centers for Disease Control and Prevention. Prevention of herpes zoster Recommendations of the advisory committee on immunization practices (ACIP). MMWR 2008; 57 (RR-5) 1-30.
    PubMedGoogle Scholar
  • 82 Orenstein WA, Perry R T, Halsey NA. The clinical significance of measles: a review.. J Infect Dis 2004; 189 (Suppl. 01) S4-S16.
    CrossrefPubMedGoogle Scholar
  • 83 Robert-Koch-Institut Mitteilung der Ständigen Impfkommission am RKI Neuerungen in den aktuellen Empfehlungen der Ständigen Impfkommission (STIKO) am RKI vom Juli 2012.. Epidemiologisches Bulletin 2012; 31: 311-321.
    Google Scholar
  • 84 Sartori AM. A review of the varicella vaccine in immunocompromised individuals.. Int J Infect Dis 2004; 8 (05) 259-270.
    CrossrefPubMedGoogle Scholar
  • 85 Robert Koch-Institut STIKO: Fragen und Antworten zu verschiedenen Impfungen. (Zur Hib-Impfung für Patienten mit Asplenie). Epidemiologisches Bulletin 2002; 10 (41) 345.
    PubMedGoogle Scholar
  • 86 National Foundation for Infectious Diseases, Adolescent Vaccination.org. Hepatitis B. Adolescent vaccination recommendation http://www adolescentvaccination org/vpd/hbv 2016
  • 87 Robert Koch-Institut Emfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut. Epidemiologisches Bulletin 2015; 34: 327-362.
    Google Scholar
  • 88 Nath R, Mant C, Luxton J. et al. High risk of human papillomavirus type 16 infections and of development of cervical squamous intraepithelial lesions in systemic lupus erythematosus patients.. Arthritis Rheum 2007; 57 (04) 619-625.
    CrossrefPubMedGoogle Scholar
  • 89 Adam D. Grippeimpfung bei Kindern. Adjuvan tierte Vakzine ist hochwirksam und sicher.. Dtsch Ärztebl 2011; 108 (48) DOI: A-2607/B-2178/C-2150.
    CrossrefGoogle Scholar
  • 90 Sengler C, Niewerth M, Kallinich T. et al. Survey about tolerance of the AS03-adjuvanted H1N1 influenza vaccine in children with rheumatic diseases.. Clin Rheumatol 2014; 33 (01) 137-139.
    CrossrefPubMedGoogle Scholar
  • 91 Robert Koch-Institut Aktualisierung der Meningokokken-Impfempfehlung: Anwendung des Meningokokken-B-Impfstoffs bei Personen mit erhöhtem Risiko für Meningokokken-Erkrankungen. Epidemiologisches Bulletin 2015; 37: 393-410.
    Google Scholar
  • 92 Robert Koch-Institut Hinweis zur Impfung mit Meningokokken-ACWY-Konjugatimpfstoff. Änderung der Empfehlungen zur Indikationsimpfung gegen Meningokokken. Epidemiologisches Bulletin. 2012; 32: 323-334.
    PubMedGoogle Scholar
  • 93 Rosado MM, Gesualdo F, Marcellini V. et al. Preserved antibody levels and loss of memory B cells against pneumococcus and tetanus after splenectomy: tailoring better vaccination strategies.. Eur J Immunol 2013; 43 (10) 2659-2670.
    CrossrefPubMedGoogle Scholar
  • 94 Dengler TJ, Strnad N, Buhring I. et al. Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation.. Transplantation 1998; 66 (10) 1340-1347.
    CrossrefPubMedGoogle Scholar
  • 95 Smets F, Bourgois A, Vermylen C. et al. Randomised revaccination with pneumococcal polysaccharide or conjugate vaccine in asplenic children previously vaccinated with polysaccharide vaccine.. Vaccine 2007; 25 (29) 5278-5282.
    CrossrefPubMedGoogle Scholar
  • 96 Musher DM, Manoff SB, McFetridge RD. et al. Antibody persistence ten years after first and second doses of 23-valent pneumococcal polysaccharide vaccine, and immunogenicity and safety of second and third doses in older adults.. Hum Vaccin 2011; 7 (09) 919-928.
    CrossrefPubMedGoogle Scholar