Tiêm chủng cho trẻ em và thanh thiếu niên mắc bệnh lý thấp khớp

Zeitschrift für Rheumatologie - Tập 66 - Trang 111-120 - 2007
K. Minden1, M. Niewerth2, M. Borte3, W. Singendonk4, J.-P. Haas5
1Deutsches Rheuma-Forschungszentrum Berlin und Universitätskinderklinik Charité, Campus Virchow-Klinikum, Otto-Heubner-Centrum, SPZ, Berlin, Deutschland
2Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Deutschland
3Klinik für Kinder- und Jugendmedizin, Städtisches Klinikum St. Georg gGmbH, Leipzig, Deutschland
4Kinderarztpraxis Goebenstraße, Berlin, Deutschland
5Zentrum für Kinder- und Jugendmedizin der Universität Greifswald, Greifswald, Deutschland

Tóm tắt

Việc tiêm chủng đối với trẻ em và thanh thiếu niên mắc bệnh lý thấp khớp là một vấn đề đặc biệt. Những tác động và tác dụng phụ của vắc xin đối với nhóm bệnh nhân này đáng tiếc là chưa được nghiên cứu đầy đủ, và thiếu các khuyến nghị tiêm chủng cụ thể. Các phương pháp điều trị ức chế miễn dịch thường được yêu cầu cho những bệnh nhân này tạo ra sự không chắc chắn hơn. Thêm vào đó là những lo ngại liên quan đến sự tái phát bệnh liên quan đến tiêm chủng. Những sự không chắc chắn tồn tại trong việc xử lý tiêm chủng dẫn đến sự biến đổi thực tiễn đáng kể giữa các bác sĩ nhi khoa và sự thiếu hụt tiêm chủng ở những trẻ em và thanh thiếu niên bị ảnh hưởng. Khoảng một phần ba bệnh nhân mắc viêm khớp vô căn ở trẻ em không được tiêm chủng đầy đủ, bao gồm cả những vaccine tiêu chuẩn với vắc xin bất hoạt như uốn ván/ho gà. Theo kiến thức hiện tại, lợi ích của nhiều loại vắc xin đặc biệt cao hơn nhiều so với rủi ro đối với bệnh nhân mắc các bệnh tự miễn. Những bệnh nhân đang điều trị ức chế miễn dịch cần một sự bảo vệ đặc biệt trước các nhiễm trùng. Do đó, trẻ em và thanh thiếu niên mắc bệnh lý thấp khớp nên được tiêm chủng – trong khả năng có thể – theo các khuyến nghị của STIKO. Thời điểm tiêm chủng cần được lựa chọn cẩn thận dựa trên mức độ hoạt động bệnh và phương pháp điều trị.

Từ khóa

#tiêm chủng #bệnh lý thấp khớp #trẻ em #thanh thiếu niên #điều trị ức chế miễn dịch

Tài liệu tham khảo

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