Advances in Rheumatology (Jan 2022)

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,
  • Ana Karla Guedes de Melo,
  • Vítor Alves Cruz,
  • Viviane Angelina de Souza,
  • Joana Starling de Carvalho,
  • Ketty Lysie Libardi Lira Machado,
  • Lilian David de Azevedo Valadares,
  • Edgard Torres dos Reis Neto,
  • Rodrigo Poubel Vieira de Rezende,
  • Maria Fernanda Brandão de Resende Guimarães,
  • Gilda Aparecida Ferreira,
  • Alessandra de Sousa Braz,
  • Rejane Maria Rodrigues de Abreu Vieira,
  • Marcelo de Medeiros Pinheiro,
  • Sandra Lúcia Euzébio Ribeiro,
  • Blanca Elena Gomes Rios Bica,
  • Kátia Lino Baptista,
  • Izaias Pereira da Costa,
  • Claudia Diniz Lopes Marques,
  • Maria Lúcia Lemos Lopes,
  • José Eduardo Martinez,
  • Rina Dalva Neubarth Giorgi,
  • Lícia Maria Henrique da Mota,
  • Marcos Antônio Araújo da Rocha Loures,
  • Eduardo dos Santos Paiva,
  • Odirlei André Monticielo,
  • Ricardo Machado Xavier,
  • Adriana Maria Kakehasi,
  • Gecilmara Cristina Salviato Pileggi

DOI
https://doi.org/10.1186/s42358-022-00234-7
Journal volume & issue
Vol. 62, no. 1
pp. 1 – 11

Abstract

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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.

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