FA16 Immunization Module’s Updates
Vaccinating Immunosuppressed Persons
While there are various types of conditions that affect immunosupression, there are some key acts that should be considered when vaccinating immunosupressed individuals. Key features include:
*Avoid the use of live-virus or live-bacterial vaccines (e.g. MMR),
*Aim for killed or inactivated viruses, or use a polysaccharide vaccine if available,
*Increase booster frequency or dosage to increase chances of immunity.
Immunodeficiency caused by steroid therapy should not interfere with the process of vaccination if the steroid is short term, low to moderate dosage, alternate-day treatment, replacement therapy, or applied topically or by aerosol. The key numbers to consider is below 2 mg/kg body weight or below 20 mg/day of prednisone. If the patient is above those values, then the patient should wait at least 3 months before being administered a live vaccine.
For condition-specific details, visit the Center for Disease Contol's website on vaccinating immunosupressed persons at: http://www.cdc.gov/Mmwr/Preview/Mmwrhtml/00023141.htm
AJ, interesting points here. Avoiding the use of live-virus or live-bacterial vaccines and increasing booster frequencies make total sense. I'm wondering how efficacious a polysaccharide vaccine would be seeing as how we spoke about their better cousin, the conjugate vaccine. I suppose it could all depend on the type of immunosuppression. I also wonder what kind of response vaccines would elicit in elderly populations and those who are status post-thymectomy.