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Biologicals en vaccinatie

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Bijblijven

Samenvatting

Patiënten die immunosuppressiva gebruiken hebben een verhoogd risico op infecties en vaak ook op een ernstiger beloop van ziekte. Vaccinatie kan dat risico verminderen, maar immunosuppressiva verminderen ook de vaccinatierespons. Zowel de kwantitatieve respons – de hoogte van antistofconcentraties en aantallen geactiveerde afweercellen en T‑ en B‑geheugencellen – als de kwalitatieve respons – hoe goed een antistof of afweercel een interactie aangaat met een antigeen van een ziekmakend micro-organisme – kan afnemen. Daardoor ontstaat er na vaccinatie soms slechts suboptimale bescherming of is de duur van de bescherming verkort. De verschillende soorten immunosuppressiva verschillen in hun effect op de vaccinatierespons. In deze bijdrage wordt specifiek ingegaan op de vaccinatierespons tijdens het gebruik van biologicals, zoals die bij auto-immuunaandoeningen worden gebruikt. Effectiviteit en veiligheid van de verschillende soorten vaccins, vooral van het influenza-, pneumokokken- en zostervaccin, worden besproken bij het gebruik van anti-TNF en anti-CD20- (rituximab) medicatie. Er wordt verduidelijkt dat tijdens gebruik van anti-TNF-medicatie de vaccinatierespons minder onderdrukt wordt dan tijdens gebruik van anti-CD20-therapie.

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Authors and Affiliations

  1. RIVM Landelijke Coördinatie Infectieziektebestrijding (LCI), Bilthoven, Nederland

    Albert Vollaard

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  1. Albert Vollaard
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Correspondence to Albert Vollaard.

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Vollaard, A. Biologicals en vaccinatie. Bijblijven 34, 167–178 (2018). https://doi.org/10.1007/s12414-018-0295-5

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