title: 2012 Brazilian Society of Rheumatology Consensus on vaccination of patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To elaborate recommendations to the vaccination of patients with rheumatoid arthritis (RA) in Brazil.
  
  
  METHODS
  Literature review and opinion of expert members of the Brazilian Society of Rheumatology Committee of Rheumatoid Arthritis and of an invited pediatric rheumatologist.
  
  
  CONCLUSIONS
  The following 12 recommendations were established: 1) Before starting disease-modifying anti-rheumatic drugs, the vaccine card should be reviewed and updated; 2) Vaccines against seasonal influenza and against H1N1 are indicated annually for patients with RA; 3) The pneumococcal vaccine should be indicated for all patients with RA; 4) The vaccine against varicella should be indicated for patients with RA and a negative or dubious history for that disease; 5) The HPV vaccine should be considered for adolescent and young females with RA; 6) The meningococcal vaccine is indicated for patients with RA only in the presence of asplenia or complement deficiency; 7) Asplenic adults with RA should be immunized against Haemophilus influenzae type B; 8) An additional BCG vaccine is not indicated for patients diagnosed with RA; 9) Hepatitis B vaccine is indicated for patients with RA who are negative for antibodies against HBsAg; the combined hepatitis A and B vaccine should be considered; 10) Patients with RA and at high risk for tetanus, who received rituximab in the preceding 24 weeks, should undergo passive immunization with tetanus immunoglobulin in case of exposure; 11) The YF vaccine is contraindicated to patients with RA on immunosuppressive drugs; 12) The above described recommendations should be reviewed over the course of RA.
authors.affiliation: Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Brazil. cbrenol@hcpa.ufrgs.br
authors.forename: Claiton Viegas
authors.initials: CV
authors.lastname: Brenol
authors.forename: Licia Maria Henrique
authors.initials: LM
authors.lastname: da Mota
authors.forename: Bóris Afonso
authors.initials: BA
authors.lastname: Cruz
authors.forename: Gecilmara Salviato
authors.initials: GS
authors.lastname: Pileggi
authors.forename: Ivânio Alves
authors.initials: IA
authors.lastname: Pereira
authors.forename: Lucila Stange
authors.initials: LS
authors.lastname: Rezende
authors.forename: Manoel Barros
authors.initials: MB
authors.lastname: Bertolo
authors.forename: Max Victor Carioca
authors.initials: MV
authors.lastname: Freitas
authors.forename: Nilzio Antônio da
authors.initials: NA
authors.lastname: Silva
authors.forename: Paulo
authors.initials: P
authors.lastname: Louzada-Junior
authors.forename: Rina Dalva Neubarth
authors.initials: RD
authors.lastname: Giorgi
authors.forename: Rodrigo Aires Corrêa
authors.initials: RA
authors.lastname: Lima
authors.forename: Geraldo da Rocha Castelar
authors.initials: Gda R
authors.lastname: Pinheiro
mesh_terms: D001172:Arthritis, Rheumatoid; D006801:Humans; D014611:Vaccination