FA16 Immunization Module’s Updates
Vaccinating Immunosuppressed persons
People who are immunosuppressed have very limited options when it comes to vaccinations. Live vaccinations are not recommended since adverse effects can develop due to their immune systems not being able to suppress the virus or bacterium leading to uncontrolled replication. A relatively functional immune system is necessary for an appropriate immune response for a vaccine. However, the immunosuppressed are able to receive certain inactivated vaccines, but the immunity that is developed is reduced in magnitude and duration.
The link below shows the CDC guideline for the type of immune deficiencies and which diseases can the patient be immunized against with limited effectiveness:
https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/a/immuno-table.pdf
A physician needs to weigh the risks and benefits of the inactivated vaccine for the individual depending on the type of immunodeficiency and degree of immunosuppression that they have. The immunosuppressed are especially vulnerable to diseases, so they ultimately depend on herd immunity for protection. Immunocompetent people surrounding those who are immunosuppressed, such as family, should be fully vaccinated.
Sources:
http://healthycanadians.gc.ca/publications/healthy-living-vie-saine/3-canadian-immunization-guide-canadien-immunisation/index-eng.php?page=8
http://www.idsociety.org/2013_Immunocompromised_Guideline/
http://www.aafp.org/afp/2014/1101/p664.html
@Jessica Luo, a great illustration of the reason to promote herd immunity. It protects those who simply cannot be vaccinated. For example, a young cancer patient undergoing chemotherapy. What is interesting about the table are the risk-specific recommended vaccines for certain immunosuppressed patients because they are safe for those patients and protect them against diseases for which they are especially susceptible.