Vaccination during febrile illness, what do we know? A systematic-narrative hybrid review of the literature and international recommendations

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-10-24 DOI:10.1016/j.vaccine.2024.126473

Soumaya Essalim , Chloe Tachet , Sarah Demingo , Sebastien Bruel , Amandine Gagneux-Brunon , Elisabeth Botelho-Nevers

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引用次数: 0

Abstract

Introduction

Vaccination during febrile illness (FI) is often regarded as a contraindication, leading to its postponement in most cases. Considering the doubts about the immunogenicity, efficacy and safety of the procedure among physicians and patients, we sought in this review to assess the data in the literature and international recommendations in terms of vaccination during FI.

Methods

This review was conducted according to the methodological structure for systematic-narrative hybrid reviews, using PubMed and Cochrane library databases until March 2024. Inclusion criteria were studies dealing with vaccination during FI in children or adults, and exclusion criteria were studies related to post-vaccination fever or animal experiments. A review of international recommendations was also carried out. Articles included were fully examined by the authors for eligibility.

Results

Our literature search enabled us to identify six studies about the immunogenicity and safety of vaccination during FI in children. All have shown no significant differences in seroconversion rates, protective antibody levels or adverse events between children vaccinated during FI and controls. Nine articles on physicians and patients' attitudes regarding immunization during FI were also included in this review. Vaccination was frequently postponed in cases of fever, primarily to avoid potential complications. Review of international recommendations allowed us to classify countries into three categories: those recommending vaccination regardless of the body temperature, those recommending vaccination within a temperature limit, and those with unclear recommendations.

Discussion

The immunogenicity and safety studies were only conducted in children, yet results were reassuring. Despite using the same evidence, recommendations differed from country to another. This situation may explain the reluctance of physicians and patients to embrace this practice. Postponing vaccination is however associated with low vaccine coverage and could be considered a missed opportunity to vaccinate. A higher level of evidence seems needed for a firm conclusion.

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发热疾病期间的疫苗接种，我们知道些什么？文献和国际建议的系统叙事混合综述。

导言：发热性疾病（FI）期间接种疫苗通常被视为禁忌症，导致大多数情况下推迟接种疫苗。考虑到医生和患者对疫苗接种的免疫原性、有效性和安全性存在疑虑，我们在本综述中试图评估有关发热疾病期间疫苗接种的文献数据和国际建议：本综述按照系统-叙事混合综述的方法结构进行，使用 PubMed 和 Cochrane 图书馆数据库，截止日期为 2024 年 3 月。纳入标准是有关儿童或成人在 FI 期间接种疫苗的研究，排除标准是与接种后发热或动物实验相关的研究。此外，还对国际建议进行了审查。作者对纳入的文章进行了全面的资格审查：通过文献检索，我们确定了六项有关儿童接种 FI 期间疫苗的免疫原性和安全性的研究。所有研究都表明，在 FI 期间接种疫苗的儿童与对照组在血清转换率、保护性抗体水平或不良反应方面没有明显差异。本综述还收录了九篇关于医生和患者对 FI 期间免疫接种态度的文章。在发烧的情况下，疫苗接种经常被推迟，主要是为了避免潜在的并发症。通过审查国际建议，我们将国家分为三类：建议无论体温高低都接种疫苗的国家、建议在一定体温范围内接种疫苗的国家以及建议不明确的国家：讨论：免疫原性和安全性研究仅在儿童中进行，但结果令人欣慰。尽管采用了相同的证据，但各国的建议却不尽相同。这种情况可能是医生和患者不愿接受这种做法的原因。不过，推迟接种与疫苗接种覆盖率低有关，可被视为错失接种机会。似乎需要更高水平的证据才能得出确定的结论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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