Page 461 - TBE_Book_V2_2019

Chapter 14: Prevention

Table 4: Post-exposure prophylaxis according to vaccination status
Interval
Vaccination Interval between
between last
history (written immunization tick sting and Recommendation
b
documentation) physicians visit
and tick sting
Wait until ≥4 weeks after sting,
Unvaccinated or
Not applicable <4 weeks then initiate immunization
unknown
series
Wait until ≥4 weeks after sting,
1 dose ≤ 14 days Not relevant
then administer 2nd dose
Administer 2nd dose
15 days - 1 year <48 hours
immediately
Wait until ≥4 weeks after sting,
≥48 h a
then administer 2nd dose
Administer 2nd dose
≥1 year <48 h a
immediately
Wait until ≥4 weeks after sting,
≥ 48 h a
then administer 2nd dose
Additional vaccination
≥2
according to regular schedule
* 79
Austrian Immunization Plan 2017 (http://www.bmgf.gv.at/cms/home/attachments/2/8/1/CH1100/
CMS1452867487477/impfplan.pdf)
a
Testing of antibody response recommended. If not possible, count this vaccination as the first one in basic
immunization schedule
b
If time elapsed is not to be determined, use schedule: >48 h after tick bite

dose, 39% (26/66) of the patients and 79% compared with 81% (17/21) in the control
(44/56) of the healthy controls had group. In addition, this study demonstrated
seroprotective NT levels. The relatively low that in older patients (>60 years of age)
SPR observed in the control group may be immunosenescence apparently added to the
attributed to the fact that 37 and 35 of the treatment effects, leading to seroconversion
patients and controls, respectively, were 60 rates of only around 30% after 4 doses of TBE
years of age and older. Interestingly, the vaccine in patients with combined immuno-
group of patients receiving a combined suppressive treatments.
treatment (TNFi + MTX) had a significantly
lower protection rate compared with healthy The effect of TBE vaccination using an
controls (36% vs 87%), while rates in patients abbreviated immunization schedule was also
treated with only a single medication did not compared in 31 heart transplant recipients,
differ from those seen in healthy controls. The under cyclosporine-based immunosuppres-
82
significant difference in SPR remained even sion, and 29 controls. Immune response
when an additional priming dose was given to (seroconversion rates [SCRs] and GMTs) were
all patients and healthy controls who were markedly reduced in the transplant recipients
≥60 years old: 31% (9/29) in the patient group as compared with the control group. Even

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