VACCINE EFFICACY IN IMMUNOCOMPROMISED POPULATIONS: AN INTEGRATIVE REVIEW

Abstract

Introduction: Immunocompromised populations, such as patients with autoimmune diseases, cancer, HIV, or those undergoing transplantation, are more vulnerable to infections due to immune suppression. The use of vaccines in these populations is a crucial strategy for the prevention of serious infectious diseases. However, the efficacy of vaccines can be compromised, and the risks and benefits must be carefully evaluated. Objective: The objective of this integrative review is to evaluate the available evidence on the efficacy of vaccines in immunocompromised populations, considering factors such as type of vaccine, level of immunosuppression, and immune response. Methodology: A systematic search was performed in the PubMed, Scopus, Cochrane, and Lilacs databases to identify studies published between 2010 and 2023 that investigated the efficacy of vaccines in immunocompromised individuals. Clinical trials, cohort studies, and systematic reviews that addressed the immune response and protection conferred by vaccines such as influenza, pneumococcal, hepatitis B, and COVID-19 in these populations were included. The analysis was conducted through narrative synthesis. Results and Discussion: The review included 32 studies, which showed that, although immune responses are generally reduced in immunocompromised individuals, vaccines such as influenza and COVID-19 still demonstrate significant benefits in reducing hospitalizations and disease severity. Patients with HIV and those undergoing cancer treatments responded better to inactivated vaccines, while individuals undergoing transplantation or with prolonged use of immunosuppressants presented more limited vaccine responses. Co-administration of adjuvants or booster doses has been shown to be effective in increasing immunogenicity in some cases, highlighting the need for personalized vaccination schedules for these patients. Conclusion: Vaccines play a vital role in protecting immunocompromised populations, although their efficacy may be reduced. The adoption of adapted strategies, such as booster doses or the use of adjuvanted vaccines, is recommended to improve immune responses. Further studies are needed to determine optimal vaccination schedules in different immunocompromised groups, ensuring greater protection against serious infections.