目的:通过文献综述,就巴西先天性代谢错误(IEM)患者的免疫接种提出建议,评估免疫后对代谢失代偿的可能影响,以及该特定人群对疫苗的免疫反应是否受损。
方法:与术语先天性代谢错误和推荐相关的MeSH术语疫苗接种或疫苗免疫与检索数据库结合使用。只有1990年以后用英语发表的文章,西班牙语,法语或葡萄牙语,包括与人类有关的。
方法:共纳入44篇文章,提出以下建议。使用IEM的个人需要了解最新的免疫接种情况。关于应该提供哪些疫苗,儿童和成人应遵循当地可用的常规免疫计划,包括COVID-19疫苗。唯一的例外是用于遗传性果糖不耐受的轮状病毒疫苗。免疫的益处超过代谢失代偿的非常低的风险。因为不是所有的病人都有足够的免疫反应,建议测量抗体转化率和滴度。结论:所有患者都应在各自的时间表内接受适合年龄的免疫接种,并尽可能延迟.疫苗接种可能是禁忌的唯一情况是在遗传性果糖不耐受中口服轮状病毒疫苗。应监测抗体水平以检测任何免疫功能障碍或增强剂的必要性。个性化的免疫计划是IEM患者的理想选择。参考组织可以改进他们的建议,以解决所有IEM,不仅仅是其中的一些。
Through a literature review, make recommendations regarding immunizations in people living with Inborn Error of Metabolism (IEM) in Brazil, assess the possible impact on metabolic decompensations after immunization, and if this specific population may have an impaired immune response to vaccines.
The MeSH Terms vaccination OR vaccine OR immunization associated with the term inborn error of metabolism AND recommendation were used in combination with search databases. Only articles published after 1990, in the languages English, Spanish, French or Portuguese, human-related were included.
A total of 44 articles were included to make the following recommendations. Individuals with IEMs need to be up to date with their immunizations. Regarding which vaccines should be offered, children and adults should follow the routine immunization schedules locally available, including the COVID-19 vaccines. The only exception is the rotavirus vaccine for hereditary fructose intolerance. The benefit of immunization outweighs the very low risk of metabolic decompensation. Since not all patients will have an adequate immune response, measuring antibody conversion and titers is recommended CONCLUSIONS: All patients should receive age-appropriate immunizations in their respective schedules without delays. The only situation when vaccination may be contraindicated is with oral rotavirus vaccine in hereditary fructose intolerance. Monitoring the levels of antibodies should be done to detect any immune dysfunction or the necessity for boosters. A personalized immunization schedule is ideal for patients with IEMs. The reference organizations could improve their recommendations to address all IEMs, not only some of them.