Vaccination Practice In Children With Rheumatic Disease

Evaluate clinical practice through assessment of vaccination card and recommendation of specific vaccines in pediatric patients with rheumatic diseases in use of different drugs and reveal the possible association between vaccination frequency and time of the clinical practice of pediatric rheumatologists in the state of São Paulo. Material and Methods: A questionnaire was sent to pediatric rheumatologists of the Departamento de Reumatologia da Sociedade de Pediatria de São Paulo. This instrument included questions about practice time on Pediatric Rheumatology, vaccination of patients with juvenile systemic lupus erythematosus (JSLE), juvenile idiopathic arthritis (JIA), juvenile dermatomyositis (JDM), and immunization according to the treatments used. Results: Vaccination card was seen by 100% of the professionals at the first visit and by 36% annually. Vaccines of live agents were not recommended for patients with JSLE, JIA, and JDM in 44%, 64%, and 48%, respectively. The professionals were divided into two groups: Group A (≤ 15 years of practice, n = 12) and B (≥ 16 years, n = 13). No statistical difference was observed in the use of live agent vaccine and vaccines with inactivated agents or protein components in the two treatment groups (P > 0.05). Moreover, the groups had similar opinion regarding severity of immunosuppression in patients with JSLE, JIA, and JDM (with or without activity) and treatment used (P > 0.05). Conclusions: The frequency of immunization by pediatric rheumatologists in São Paulo is low, especially after the first visit, and not influenced by time of professional practice.504356361Len, C.A., Terreri, M.T., Hilário, M.O., Lúpus eritematoso sistêmico juvenil e infecção (2002) Rev Bras Reumatol, 42 (4), pp. 218-222Facó, M.M., Leone, C., Campos, L.M., Febrônio, M.V., Marques, H.H., Silva, C.A., Risk factors associated with the death of patients hospitalized for juvenile systemic lupus erythematosus (2007) Braz J Med Biol Res, 40 (7), pp. 993-1002Facó, M.M., Nukumizu, L.A., Pantoja, A.J., Barros, P.C., Troster, E.J., Silva, C.A., Avaliação dos óbitos e necropsias em pacientes internados em um Serviço de Reumatologia Pediátrica por um período de dez anos (2005) Rev Bras Reumatol, 45 (2), pp. 55-63O'neill, S.G., Isenberg, D.A., Immunizing patients with systemic lupus erythematosus: A review of effectiveness and safety (2006) Lupus, 15 (11), pp. 778-783Gluck, T., Muller-Ladner, U., Vaccination in patients with chronic rheumatic or autoimmune diseases (2008) Clin Infect Dis, 46 (9), pp. 1459-1465Conti, F., Rezai, S., Valesini, G., Vaccination and autoimmune rheumatic diseases (2008) Autoimmunity Reviews, 8 (2), pp. 124-128Maillefert, J.F., Sibilia, J., Toussirot, E., Vignon, E., Eschard, J.P., Lorcerie, B., Rheumatic disorders developed after hepatitis B vaccination (1999) Rheumatology, 38 (10), pp. 978-983. , OxfordSilva, C.A., Terreri, M.T., Barbosa, C.M., Hilário, M.O., Pillegi, G.S., Ferriani, V.P., Consenso de imunização para crianças e adolescentes com doenças reumáticas (2009) Rev Bras Reumatol, 49 (5), pp. 562-589Davies, K., Woo, P., Immunization in rheumatic diseases of childhood: An audit of the clinical practice of British Paediatric Rheumatology Group members and a review of the evidence (2002) Rheumatology (Oxford), 41, pp. 937-941Hochberg, M.C., Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus (1997) Arthritis Rheum, 40 (9), p. 1725Petty, R.E., Southwood, T., Manners, P., Baum, J., Glass, D.N., Goldenberg, J., International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: Second revision, Edmonton, 2001 (2004) J Rheumatol, 31 (2), pp. 390-392Bohan, A., Peter, J.B., Polymyositis and dermatomyositis (1975) N Engl J Med, 292 (7), p. 344Delbecq, A.L., van de Ven, A.H., Gustafson, D.H., (1975) Group Technique For Program Planning - a Guide to Nominal Group and Delphi Processes, , Glenview, Illinois. 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