Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts - PubMed (original) (raw)

Review

doi: 10.1016/j.jaci.2013.11.043. Epub 2014 Feb 28.

William T Shearer 1, Thomas A Fleisher 2, Rebecca H Buckley 3, Zuhair Ballas 4, Mark Ballow 5, R Michael Blaese 6, Francisco A Bonilla 7, Mary Ellen Conley 8, Charlotte Cunningham-Rundles 9, Alexandra H Filipovich 10, Ramsay Fuleihan 11, Erwin W Gelfand 12, Vivian Hernandez-Trujillo 13, Steven M Holland 14, Richard Hong 15, Howard M Lederman 16, Harry L Malech 14, Stephen Miles 17, Luigi D Notarangelo 7, Hans D Ochs 18, Jordan S Orange 19, Jennifer M Puck 20, John M Routes 21, E Richard Stiehm 22, Kathleen Sullivan 23, Troy Torgerson 18, Jerry Winkelstein 16

Affiliations

Review

Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

Medical Advisory Committee of the Immune Deficiency Foundation et al. J Allergy Clin Immunol. 2014 Apr.

Abstract

The present uncertainty of which live viral or bacterial vaccines can be given to immunodeficient patients and the growing neglect of societal adherence to routine immunizations has prompted the Medical Advisory Committee of the Immune Deficiency Foundation to issue recommendations based on published literature and the collective experience of the committee members. These recommendations address the concern for immunodeficient patients acquiring infections from healthy subjects who have not been immunized or who are shedding live vaccine-derived viral or bacterial organisms. Such transmission of infectious agents can occur within the hospital, clinic, or home or at any public gathering. Collectively, we define this type of transmission as close-contact spread of infectious disease that is particularly relevant in patients with impaired immunity who might have an infection when exposed to subjects carrying vaccine-preventable infectious diseases or who have recently received a live vaccine. Immunodeficient patients who have received therapeutic hematopoietic stem transplantation are also at risk during the time when immune reconstitution is incomplete or while they are receiving immunosuppressive agents to prevent or treat graft-versus-host disease. This review recommends the general education of what is known about vaccine-preventable or vaccine-derived diseases being spread to immunodeficient patients at risk for close-contact spread of infection and describes the relative risks for a child with severe immunodeficiency. The review also recommends a balance between the need to protect vulnerable subjects and their social needs to integrate into society, attend school, and benefit from peer education.

Keywords: Live viral and bacterial vaccines; cellular immune reconstitution; primary immunodeficiency disease; severe combined immunodeficiency disease.

Published by Mosby, Inc.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interests:

The authors declare that they have no conflicts of interest with regard to the contents of this policy statement.

Similar articles

Cited by

References

    1. Pickering LK, Baker CJ, Kimberlin DW, Long SS, editors. Red Book: 2012 Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics; 2012. American Academy of Pediatrics: Immunization in special clinical circumstances; pp. 74–90.
    1. Centers for Disease Control and Prevention. Applying public health strategies to primary immunodeficiency diseases: a potential approach to genetic disorders. MMWR Recomm Rep. 2004;53(RR-1):1–29. - PubMed
    1. Wilfert CM, Buckley RH, Mohanakumar T, Griffith JF, Katz SL, Whisnant JK, et al. Persistent and fatal central-nervous-system ECHOvirus infections in patients with agammaglobulinemia. N Engl J Med. 1977;296:1485–9. - PubMed
    1. MacLennan C, Dunn G, Huissoon AP, Kumararatne DS, Martin J, O’Leary P, et al. Failure to clear persistent vaccine-derived neurovirulent poliovirus infection in an immunodeficient man. Lancet. 2004;363:1509–13. - PubMed
    1. Scharenberg AM, Hannibal MC, Torgerson T, Ochs HD, Rawlings DJ. Common variable immune deficiency overview. In: Pagon RA, Adam MP, Bird TD, Dolan CR, Fong CT, Stephens K, editors. GeneReviews™ [Internet] Seattle (WA): University of Washington, Seattle; 1993–2013.

Publication types

MeSH terms

Substances

Supplementary concepts

Grants and funding

LinkOut - more resources