COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States
Abstract Introduction The United States Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (CDC) recommend COVID-19 vaccines for all immunocompromised individuals. Certain disease groups are at increased risk of comorbidity and death for which disease-specific re...
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Adis, Springer Healthcare
2024-10-01
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| Series: | Infectious Diseases and Therapy |
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| Online Access: | https://doi.org/10.1007/s40121-024-01052-8 |
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| author | Kira Zhi Hua Lai Stuart Greenstein Rajesh Govindasamy Jaya Paranilam Joseph Brown Samantha Kimball-Carroll |
| author_facet | Kira Zhi Hua Lai Stuart Greenstein Rajesh Govindasamy Jaya Paranilam Joseph Brown Samantha Kimball-Carroll |
| author_sort | Kira Zhi Hua Lai |
| collection | DOAJ |
| description | Abstract Introduction The United States Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (CDC) recommend COVID-19 vaccines for all immunocompromised individuals. Certain disease groups are at increased risk of comorbidity and death for which disease-specific recommendations should be considered. The objective of the Delphi panel of experts was to summarize expert consensus on COVID-19 vaccinations for patients with rheumatologic disease, renal disease, hematologic malignancy and solid organ transplant (SOT) in the US. Methods A two-stage Delphi panel method was employed, starting with qualitative interviews with key opinion leaders (KOLs) in the four disease areas (n = 4 KOLs, n = 16 total) followed by three rounds of iterative revision of disease-specific COVID-19 vaccine recommendations. Final consensus was rated after the third round. Statements addressed primary and booster dosing (e.g., number and frequency) and other considerations such as vaccine type or heterologous messenger ribonucleic acid (mRNA) vaccination. Following the Delphi Panel, an online survey was conducted to assess physician agreement within the disease areas (n = 50 each, n = 200 total) with the consensus statements. Results Moderate to strong consensus was achieved for all primary series vaccination statements across disease groups, except one in hematology. Similarly, moderate to strong consensus was achieved for all booster series statements in all disease areas. However, statements on antibody titer measurements for re-vaccination considerations and higher dosages for immunocompromised patients did not reach agreement. Overall, approximately 62%–96% of physicians strongly agreed with the primary and booster vaccine recommendations. However, low agreement (29%–69%) was found among physicians for time interval between disease-specific treatment and vaccination, recommendations for mRNA vaccines, heterologous mRNA vaccination, antibody titer measurement and higher vaccine dosage for immunocompromised groups. Conclusion Consensus was achieved for disease-specific COVID-19 vaccine recommendations concerning primary and booster series vaccines and was generally well accepted by practicing physicians. |
| format | Article |
| id | doaj-art-ac16767a940a44e889cd8f109dd51549 |
| institution | OA Journals |
| issn | 2193-8229 2193-6382 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Infectious Diseases and Therapy |
| spelling | doaj-art-ac16767a940a44e889cd8f109dd515492025-08-20T02:11:22ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822024-10-0113112255228310.1007/s40121-024-01052-8COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United StatesKira Zhi Hua Lai0Stuart Greenstein1Rajesh Govindasamy2Jaya Paranilam3Joseph Brown4Samantha Kimball-Carroll5ICON Clinical ResearchWestchester Medical Center, Transplant SurgeryUPMC Hamot Medical CenterICON Clinical ResearchICON Clinical ResearchICON Clinical ResearchAbstract Introduction The United States Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (CDC) recommend COVID-19 vaccines for all immunocompromised individuals. Certain disease groups are at increased risk of comorbidity and death for which disease-specific recommendations should be considered. The objective of the Delphi panel of experts was to summarize expert consensus on COVID-19 vaccinations for patients with rheumatologic disease, renal disease, hematologic malignancy and solid organ transplant (SOT) in the US. Methods A two-stage Delphi panel method was employed, starting with qualitative interviews with key opinion leaders (KOLs) in the four disease areas (n = 4 KOLs, n = 16 total) followed by three rounds of iterative revision of disease-specific COVID-19 vaccine recommendations. Final consensus was rated after the third round. Statements addressed primary and booster dosing (e.g., number and frequency) and other considerations such as vaccine type or heterologous messenger ribonucleic acid (mRNA) vaccination. Following the Delphi Panel, an online survey was conducted to assess physician agreement within the disease areas (n = 50 each, n = 200 total) with the consensus statements. Results Moderate to strong consensus was achieved for all primary series vaccination statements across disease groups, except one in hematology. Similarly, moderate to strong consensus was achieved for all booster series statements in all disease areas. However, statements on antibody titer measurements for re-vaccination considerations and higher dosages for immunocompromised patients did not reach agreement. Overall, approximately 62%–96% of physicians strongly agreed with the primary and booster vaccine recommendations. However, low agreement (29%–69%) was found among physicians for time interval between disease-specific treatment and vaccination, recommendations for mRNA vaccines, heterologous mRNA vaccination, antibody titer measurement and higher vaccine dosage for immunocompromised groups. Conclusion Consensus was achieved for disease-specific COVID-19 vaccine recommendations concerning primary and booster series vaccines and was generally well accepted by practicing physicians.https://doi.org/10.1007/s40121-024-01052-8VaccinesSevere acute respiratory syndrome coronavirus 2SARS-CoV-2Coronavirus disease 2019COVID-19Rheumatologic disease |
| spellingShingle | Kira Zhi Hua Lai Stuart Greenstein Rajesh Govindasamy Jaya Paranilam Joseph Brown Samantha Kimball-Carroll COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States Infectious Diseases and Therapy Vaccines Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 Coronavirus disease 2019 COVID-19 Rheumatologic disease |
| title | COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States |
| title_full | COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States |
| title_fullStr | COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States |
| title_full_unstemmed | COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States |
| title_short | COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States |
| title_sort | covid 19 vaccination recommendations for immunocompromised patient populations delphi panel and consensus statement generation in the united states |
| topic | Vaccines Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 Coronavirus disease 2019 COVID-19 Rheumatologic disease |
| url | https://doi.org/10.1007/s40121-024-01052-8 |
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