Journal article
2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases
Arthritis care & research (2010), Vol.75(3), pp.449-464
01/04/2023
DOI: 10.1002/acr.25045
PMCID: PMC10291822
PMID: 36597813
Abstract
To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs).
This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. A core leadership team consisting of adult and pediatric rheumatologists and a guideline methodologist drafted clinical population, intervention, comparator, outcomes (PICO) questions. A review team performed a systematic literature review for the PICO questions, graded the quality of evidence, and produced an evidence report. An expert Voting Panel reviewed the evidence and formulated recommendations. The panel included adult and pediatric rheumatology providers, infectious diseases specialists, and patient representatives. Consensus required ≥70% agreement on both the direction and strength of each recommendation.
This guideline includes expanded indications for some vaccines in patients with RMDs, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy. Safe approaches to the use of live attenuated vaccines in patients taking immunosuppressive medications are also addressed. Most recommendations are conditional and had low quality of supporting evidence.
Application of these recommendations should consider patients' individual risk for vaccine-preventable illness and for disease flares, particularly if immunosuppressive medications are held for vaccination. Shared decision-making with patients is encouraged in clinical settings.
Details
- Title: Subtitle
- 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases
- Creators
- Anne R Bass - Weill Cornell MedicineEliza Chakravarty - Oklahoma Medical Research FoundationElie A Akl - American University of BeirutClifton O Bingham - Johns Hopkins MedicineLeonard Calabrese - Cleveland ClinicLaura C Cappelli - Johns Hopkins MedicineSindhu R Johnson - University of TorontoLisa F Imundo - Columbia UniversityKevin L Winthrop - Oregon Health & Science UniversityReuben J Arasaratnam - The University of Texas Southwestern Medical CenterLindsey R Baden - Brigham and Women's HospitalRoberta Berard - London Health Sciences CentreS Louis Bridges Jr - Weill Cornell MedicineJonathan T L Cheah - University of Massachusetts Chan Medical School, WorcesterJeffrey R Curtis - University of Alabama at BirminghamPolly J Ferguson - University of IowaIda Hakkarinen - Greenbelt, MarylandKaren B Onel - Weill Cornell MedicineGrayson Schultz - Athens, OhioVidya Sivaraman - The Ohio State UniversityBenjamin J Smith - Florida State University College of Medicine, TallahasseeJeffrey A Sparks - Brigham and Women's HospitalTiphanie P Vogel - Baylor College of MedicineEleanor Anderson Williams - The Permanente Medical Group, Union City, CaliforniaCassandra Calabrese - Cleveland ClinicJoanne S Cunha - Brown UniversityJoann Fontanarosa - ECRI InstituteMiriah C Gillispie-Taylor - Baylor College of MedicineElena Gkrouzman - University of Massachusetts Chan Medical School, WorcesterPriyanka Iyer - University of California, Irvine Medical CenterKimberly S Lakin - Weill Cornell MedicineAlexandra Legge - Dalhousie UniversityMindy S Lo - Boston Children's HospitalMegan M Lockwood - Georgetown UniversityRebecca E Sadun - Duke UniversityNamrata Singh - University of WashingtonNancy Sullivan - ECRI InstituteHerman Tam - BC Children's HospitalMarat Turgunbaev - American College of RheumatologyAmy S Turner - American College of RheumatologyJames Reston - ECRI Institute
- Resource Type
- Journal article
- Publication Details
- Arthritis care & research (2010), Vol.75(3), pp.449-464
- DOI
- 10.1002/acr.25045
- PMID
- 36597813
- PMCID
- PMC10291822
- NLM abbreviation
- Arthritis Care Res (Hoboken)
- ISSN
- 2151-464X
- eISSN
- 2151-4658
- Grant note
- American College of Rheumatology
- Language
- English
- Date published
- 01/04/2023
- Academic Unit
- Stead Family Department of Pediatrics; Epidemiology; Rheumatology, Allergy, and Immunology; Internal Medicine
- Record Identifier
- 9984355759302771
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