Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2022 Jan 17;62(1):3.
doi: 10.1186/s42358-022-00234-7.

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force

Anna Carolina Faria Moreira Gomes Tavares  1 , Ana Karla Guedes de Melo  2 , Vítor Alves Cruz  3 , Viviane Angelina de Souza  4 , Joana Starling de Carvalho  1 , Ketty Lysie Libardi Lira Machado  5 , Lilian David de Azevedo Valadares  6 , Edgard Torres Dos Reis Neto  7 , Rodrigo Poubel Vieira de Rezende  8 , Maria Fernanda Brandão de Resende Guimarães  1 , Gilda Aparecida Ferreira  1 , Alessandra de Sousa Braz  9 , Rejane Maria Rodrigues de Abreu Vieira  10 , Marcelo de Medeiros Pinheiro  7 , Sandra Lúcia Euzébio Ribeiro  11 , Blanca Elena Gomes Rios Bica  12 , Kátia Lino Baptista  8 , Izaias Pereira da Costa  13 , Claudia Diniz Lopes Marques  14 , Maria Lúcia Lemos Lopes  15 , José Eduardo Martinez  16 , Rina Dalva Neubarth Giorgi  17 , Lícia Maria Henrique da Mota  18 , Marcos Antônio Araújo da Rocha Loures  19 , Eduardo Dos Santos Paiva  20 , Odirlei André Monticielo  21 , Ricardo Machado Xavier  21 , Adriana Maria Kakehasi  1 , Gecilmara Cristina Salviato Pileggi  7
Affiliations
Practice Guideline

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force

Anna Carolina Faria Moreira Gomes Tavares et al. Adv Rheumatol. .

Abstract

Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process.

Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle-Ottawa Scale to assess the quality of nonrandomized studies.

Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4-agree-and 5-strongly agree-, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response.

Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.

Keywords: Covid-19 vaccination; Guidelines; Immune-mediated rheumatic diseases; Immunosuppression; Task force.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram
See this image and copyright information in PMC

References

    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan. China Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed
    1. Retrieved from: https://covid.saude.gov.br [cited 09/14/2021]
    1. Retrieved from: https://www.paho.org/pt/covid19 [cited 09/14/2021]
    1. Monti S, Balduzzi S, Delvino P, Bellis E, Quadrelli VS, Montecucco C. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis. 2020;79(5):667–668. doi: 10.1136/annrheumdis-2020-217424. - DOI - PMC - PubMed
    1. Pablos JL, Galindo M, Carmona L, Lledó A, Retuerto M, Blanco R, et al. Clinical outcomes of hospitalized patients with COVID-19 and chronic inflammatory and immune-mediated rheumatic diseases: a multicentric matched cohort study. Ann Rheum Dis. 2020;79(12):1544–1549. doi: 10.1136/annrheumdis-2020-218296. - DOI - PubMed

Publication types

Substances

LinkOut - more resources