Recomendações para a Vacinação contra o Herpes Zoster: Documento de Consenso da Sociedade Portuguesa de Medicina Interna e da Associação Portuguesa de Medicina Geral e Familiar

Autores

  • Sofia Duque Assistente Convidada de Geriatria, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal https://orcid.org/0000-0001-9273-5650
  • António Marinho Unidade de Imunologia Clínica, Centro Hospitalar e Universitário de Santo António - Porto. UMIB - Unidade Multidisciplinar de Investigação Biomédica do Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto. NEDAI - Núcleo de Estudos de Doenças Autoimunes da Sociedade Portuguesa de Medicina Interna https://orcid.org/0000-0002-3295-6723
  • Paulo Almeida Assistente Hospitalar de Medicina Interna com Competência em Geriatria, Serviço de Medicina Interna, Centro Hospitalar Universitário São João, Porto, Portugal. Membro do Secretariado do Núcleo de Estudos de Geriatria da Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal. Assistente Convidado, Faculdade de Medicina da Universidade do Porto, Porto, Portugal https://orcid.org/0000-0002-4879-559X
  • Raul Marques Pereira Assistente Graduado em Medicina Geral e Familiar, ULSAM - Unidade Local de Saúde do Alto Minho. Assistente Convidado, Escola de Medicina, Universidade do Minho. Diretor Executivo, Centro de Medicina Digital P5, Universidade do Minho. Coordenador, Grupo de Estudos de Dor, Associação Portuguesa de Medicina Geral e Familiar https://orcid.org/0000-0001-8678-4325
  • Rui Buzaco Assistente em Medicina Geral e Familiar com Competência em Geriatria pela Ordem dos Médicos, Clínica CUF Alvalade. Membro da Coordenação do Grupo de Estudos de Saúde do Idoso. https://orcid.org/0000-0003-0181-3081

DOI:

https://doi.org/10.24950/rspmi.1886

Palavras-chave:

Herpes Zoster, Idoso, Nevralgia Pós-Herpética, Vacina contra Herpes Zoster, Vacinação

Resumo

O herpes zoster (HZ), ou zona, é causado pela reativação do vírus varicela zoster latente. Trata-se de uma doença com elevada incidência, associada a grande morbilidade, que pode originar ou agravar uma situação de fragilidade do doente, o que realça a importância da vacinação. Entre os fatores de risco para HZ e nevralgia pós-herpética (NPH), a sua principal complicação, encontram-se a idade, a imunossupressão e a presença de doenças crónicas. A vacinação é uma estratégia eficaz na prevenção do HZ e da NPH. Em Portugal, estão disponíveis duas vacinas contra o HZ: a vacina viva atenuada e a vacina recombinante, a qual apresenta elevada eficácia contra o HZ e suas complicações, especialmente nas populações de maior risco, imunodeprimidas e com imunossenescência que têm contraindicação para a formulação viva atenuada. Contudo, a vacina contra o HZ não consta do Programa Nacional de Vacinação nem existem recomendações nacionais específicas para a imunização. Assim, a Sociedade Portuguesa de Medicina Interna e a Associação Portuguesa de Medicina Geral e Familiar elaboraram um documento de consenso que estabelece orientações para a vacinação contra o HZ.

Recomenda-se a vacinação contra o HZ em todos os adultos com idade igual ou superior a 50 anos, assim como em adultos com idade entre 18 e 49 anos com risco elevado de zona, nomeadamente doentes com comorbilidades médicas ou imunossupressão. Os adultos imunocompetentes devem ser preferencialmente imunizados com a vacina recombinante, podendo receber a vacina viva atenuada em situações pontuais; os adultos imunocomprometidos só podem ser imunizados com a vacina recombinante.

Recomenda-se a vacinação de indivíduos com antecedentes de zona e a imunização com a vacina recombinante de indivíduos previamente vacinados com a vacina viva atenuada. Salienta-se ainda a relevância da promoção da literacia do doente aquando do ato de prescrição da vacina contra o HZ, bem como o papel ativo do médico na sensibilização para a importância da vacinação contra esta patologia

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31-08-2023 — Atualizado em 27-09-2023

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Duque S, Marinho A, Almeida P, Marques Pereira R, Buzaco R. Recomendações para a Vacinação contra o Herpes Zoster: Documento de Consenso da Sociedade Portuguesa de Medicina Interna e da Associação Portuguesa de Medicina Geral e Familiar. RPMI [Internet]. 27 de Setembro de 2023 [citado 30 de Maio de 2024];30(3):180-91. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/1886

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