Vaccination against Infectious Diseases in Immunocompromised Individuals: A Review of Russian Recommendations

Relevance. Group of immunocompromised patients is large and diverse and has high risk of infection and severe outcomes. Despite evidence that vaccination is effective and safe for this group, official Russian clinical guidelines remain limited in their recommendations. This circumstance poses a risk to the lives and health of immunocompromised individuals. Aim. To analyze whether Russian clinical guidelines and other official documents include recommendations for the vaccination of immunocompromised patients and to assess how detailed they are. Materials and methods. We analyzed Russian clinical guidelines for specific infectious diseases and conditions that may potentially be accompanied by immunosuppression available on the online platform «Rubricator of Clinical Guidelines of Russian Federation» and other official documents. We assessed whether they include recommendations on vaccination for immunocompromised individuals and evaluated the level of detail of these recommendations. Results. Recommendations for the vaccination of immunocompromised individuals are not included in 11 of the 19 (57,9 %) reviewed clinical guidelines for the management of patients with conditions that may potentially be accompanied by immunosuppression (including «Breast cancer», «Chronic kidney disease» and «Living kidney donation»), and in 3 of the 13 (23,1 %) reviewed clinical guidelines for specific infectious diseases (including «Viral Pneumonia», «Community-acquired pneumonia in children» and «Acute bronchiolitis»). There are also no specific guidelines on the vaccination of immunocompromised patients in the Russian National Immunization Schedule. Many of the clinical guidelines that recommend vaccination provide only general recommendations and do not specify the vaccination schedules or vaccine types. Conclusion. The reviewed clinical guidelines contain gaps in recommendations for the vaccination of immunocompromised patients. When vaccination is mentioned, the recommendations are usually incomplete and lack details regarding vaccine types and immunization schedules. Incorporating evidence-based vaccine recommendations into clinical guidelines may help raise awareness among healthcare professionals about the importance of vaccinating immunocompromised individuals, increase vaccination coverage, and reduce the risk of infectious diseases and their consequences in this vulnerable population.

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