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Impfen bei Immunsuppression

Vaccination during immunosuppression

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Aufgrund des erhöhten Infektionsrisikos bei immundefizienten und immunsupprimierten Patienten sollten Impfungen zur Vermeidung von Infektionskrankheiten konsequent eingesetzt werden. Je nach Ausprägung der Immundefizienz oder Immunsuppression ändern sich die Indikationen und Kontraindikationen zu Impfungen. Gemäß den aktuellen Empfehlungen der Ständigen Impfkommission am Robert Koch-Institut (STIKO) besteht für diese Patienten keine Kontraindikation für Totimpfstoffe. Je nach Ausprägung der Immundefizienz kann die Impfantwort jedoch reduziert sein oder ganz ausbleiben, daher ist eine Kontrolle des Impftiters zu empfehlen. Lebendimpfungen galten bei immungeschwächten Patienten wegen lebensbedrohlicher Komplikationen lange als absolut kontraindiziert. Heute kann im Einzelfall eine Indikation für bestimmte Lebendimpfungen gestellt werden.

Abstract

Patients with immunodeficiency and patients under immunosuppressive therapy have an increased risk of infectious diseases. Vaccination strategies are needed to protect them from preventable diseases. The underlying disease and severity of immune impairment may have an influence on the indications and contraindications of vaccines. Inactivated vaccines can be safely administered according to the current recommendations of the Standing Commission on Vaccinations of the Robert Koch Institute in Berlin, Germany (STIKO). Depending on the severity of the immune dysfunction, the antibody response to vaccinations varies. When possible the antibody response following vaccinations should be tested. Previously, attenuated live vaccines were considered to be strictly contraindicated in immunocompromised patients but nowadays the administration of attenuated live vaccines is considered possible, depending on the individual degree and type of immunodeficiency or immunosuppression.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Löbermann: Klinische Studien mit Novartis Vaccines, Roche, Glaxo Smith Kline, Intercell. E.C. Reisinger: Klinische Studien mit Novartis Vaccines, Roche, Glaxo Smith Kline, Intercell C. Fritzsche: Klinische Studien mit Novartis Vaccines, Roche, Glaxo Smith Kline, Intercell. H. Geerdes-Fenge: Klinische Studien mit Novartis Vaccines. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Zentrum für Innere Medizin, Klinik und Poliklinik für Innere Medizin II, Abteilung für Tropenmedizin, Infektionskrankheiten und Sektion Nephrologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland

    M. Löbermann, H. Geerdes-Fenge, C. Fritzsche & E.C. Reisinger

Authors
  1. M. Löbermann
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  2. H. Geerdes-Fenge
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  3. C. Fritzsche
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  4. E.C. Reisinger
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Corresponding author

Correspondence to M. Löbermann.

Additional information

Abdruck der gekürzten und aktualisierten Version mit freundlicher Genehmigung des Thieme-Verlags: D. Boršo, M. Löbermann, C. Fritzsche, et al (2013) Impfen bei Immundefekten oder medikamentöser Immunsuppression. DMW – Deutsche Medizinische Wochenschrift 138:145–50

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Löbermann, M., Geerdes-Fenge, H., Fritzsche, C. et al. Impfen bei Immunsuppression. Pneumologe 11, 486–492 (2014). https://doi.org/10.1007/s10405-014-0787-7

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  • DOI: https://doi.org/10.1007/s10405-014-0787-7

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