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DOI: 10.1590/0004-282X-ANP-2021-0162
Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system
Recomendações do Departamento Científico de Neuroimunologia da Academia Brasileira de Neurologia (DCNI/ABN) e do Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla e Doenças Neuroimunológicas (BCTRIMS) sobre vacinação em geral e contra a SARS-CoV-2 para pacientes com doenças desmielinizantes do sistema nervoso central
ABSTRACT
The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.
RESUMO
O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.
Keywords:
Demyelinating Autoimmune Diseases, CNS - Multiple Sclerosis - Neuromyelitis Optica - Vaccination - COVID-19 - SARS-CoV-2Palavras-chave:
Doenças Autoimunes Desmielinizantes do Sistema Nervoso Central - Esclerose Múltipla - Neuromielite Óptica - Vacinação - COVID-19 - SARS-CoV-2Author’s contributions:
JB, LCF, AD, DBB, PC, DG, MALP, NACS, SMA, TA, JSA, TJ, SLAP, ABAGRG, MP, RP: conceptualization, writing of original draft, methodology; JB, FG: project administration and supervision; JB, LCF, AD, DBB, PC, DG, MALP, NACS, SMA, TA, JSA, TJ, SLAP, ABAGRG, MP, RP: writing, review & editing; AKG, ACP, JAA, APGN, ACPO, BSO, CBT, CFV, DKM, DV, DS, EMLO, FRM, FEB, FFAF, FAAG, GRP, GDS, GSO, GACS, HHR, HKS, HRSN, LCC, MVMG, MCAV, MLVP, MCR, MB, MKFP, RBSM, RL, RBT, RK, RMD, SG, SAL, SAL, TF, TAGJR, TCAW, YF, OJMN, MLBF, MFM, DGB, FG: final approval by all participants of the Neuroimmunology Brazilian Study Group.
Publication History
Received: 24 April 2021
Accepted: 30 May 2021
Article published online:
04 July 2023
© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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