Infection Screening and Vaccination of Adult and Pediatric Patients with Autoimmune Inflammatory Rheumatic Diseases: An Emirati Delphi Consensus

Introduction: Patients with autoimmune and inflammatory rheumatic diseases (AIIRD) have an increased susceptibility to infections due to their compromised immune systems and the use of immunosuppressive therapies. Infections are a leading cause of morbidity and mortality in these patients, emphasizing the need for strategies such as infection control and vaccination to prevent avoidable harm to both patients and healthcare workers. This study aims to provide expert consensus on infection screening and vaccination guidelines for AIIRD patients. Methods: A task force of experts from the United Arab Emirates developed a set of statements based on available evidence and expert opinion. The consensus was structured into two main categories: infection screening (9 statements with 23 sub-statements) and vaccination (7 statements). Results: The infection screening consensus covered nine key areas: tuberculosis (TB) screening (I.1), methods and periodicity of TB screening (I.2), strategies for managing positive IGRA test results (I.3), and infection control for hepatitis B (I.4), hepatitis C (I.5), HIV (I.6), varicella-zoster virus (I.7), and Pneumocystis jirovecii (I.8). The vaccination consensus included recommendations on general vaccination principles (V.0) and specific vaccinations for influenza (V.1), pneumococcal disease (V.2), human papillomavirus (HPV) (V.3), varicella-zoster virus (V.4), tetanus (V.5), and COVID-19 (V.6). Delphi voting showed strong consensus among the task force experts, validating their relevance and applicability for clinicians managing AIIRD patients. Conclusion: This Emirati consensus provides up-to-date guidance and recommendations for clinicians to enhance the care and safety of AIIRD patients.