Vaccine | Combined immunodeficiency syndromes | Antibody deficiency | Patients receiving IgG | Diseases of immune dysregulation | Phagocytic cell disorders | Diseases of innate immunity | Autoinflammatory disorders | Complement deficiency | Phenocopies | Immuno suppression¶ | ||||||
Severe | Mild* | Severe | Mild | Replacement | Immuno modulatory | CGD and neutropenia | LAD and cytotoxic granule defects | Invasive bacterial infections | Invasive viral infections | Mycobacterial infections | ||||||
Inactivated/subunit | ||||||||||||||||
DTaP | B | A | B | A | B | B | A | A | A | A | A | A | A | A | A | B |
HAV | B | A | B | A | B | A | A | A | A | A | A | A | A | A | A | B |
HBV | B | A | B | A | B | B | A | A | A | A | A | A | A | A | A | B |
HIB | B | A | B | A | B | A | A | A | A | E | A | A | A | E | AΔ | B |
HPV | B | A | A | A | A | A | A | A | A | A | A | A | A | A | A | B |
Influenza (IM/SC) | B | A | A | A | A | A | A | E | A | A | A | A | A | A | A | A |
Meningococcal | B | A | B | A | A | A | A | A | A | E | A | A | A | E | AΔ | B |
Serogroup B meningococcal vaccine | B | A | B | A | A | A | A | A | A | E | A | A | A | E | AΔ | B |
Pneumococcal conjugate vaccine | B | A | B | A | B | A | A | A | A | E | A | A | A | E | AΔ | B |
Pneumococcal polysaccharide | B | A | B | A | B | A | A | A | A | E | A | A | A | E | AΔ | B |
Polio (IM) | B | A | B | A | B | B | A | A | A | A | A | A | A | A | A | B |
Anthrax | B | A | A | A | A | A | A | A | A | A | A | A | A | A | A | A |
JE | B | A | B | A | B | A | A | A | A | A | A | A | A | A | A | B |
Typhoid (IM) | B | A | B | A | B | A | A | A | A | A | A | A | A | A | A | B |
Rabies◊ | B | A | A | A | A | A | A | A | A | A | A | A | A | A | A | A |
Zoster (recombinant)§ | B | A | B | A | B | B | A | A | A | A | A | A | A | A | A | B |
Live-attenuated | ||||||||||||||||
Influenza | C | C | C | C | C | A | C | C | C | C | C | C | C | C | C¥ | C |
MMR | C | D | C | D | C | B | A | A | C | A | C | A | A | A | D¥ | C |
Polio (oral) | C | C | C | C | C | A | A | A | C | A | C | A | A | A | D¥ | C |
Rotavirus | C | C | C | D | C | A | A | A | C | A | C | A | A | A | D¥ | C |
Varicella | C | D | C | D | C | B | A | A | C | A | C | A | A | A | D¥ | C |
Herpes zoster | C | D | C | D | C | B | A | A | C | A | C | A | A | A | D¥ | C |
Adenovirus | C | C | C | C | C | D | C | C | C | C | C | C | C | C | C¥ | C |
Smallpox‡ | C | C | C | D | C | A | A | A | C | A | C | A | A | A | D¥ | C |
Typhoid | C | C | C | C | C | C | C | C | C | C | C | C | C | C | C¥ | C |
Yellow fever | C | C | C | C | C | D | D | A | C | A | C | A | A | A | D¥ | C |
BCG | C | C | D | D | D | D | D | C | C | D | D | C | A | A | D¥ | C |
A: No possibility of harm; benefit possible; administration recommended; use according to routine schedule.
B: No possibility of harm; benefit unlikely; administration not recommended.
C: Possibility of harm (significant); benefit unlikely; administration not recommended.
D: Possibility of harm (small); benefit likely; administration recommended.
E: Administration recommended for therapeutic benefit.IgG: immunoglobulin G; CGD: chronic granulomatous disease; LAD: leukocyte-adhesion deficiency; DTaP: diphtheria, tetanus toxoids, and acellular pertussis vaccine; HAV: hepatitis A virus; HBV: hepatitis B virus; HIB: Haemophilus influenzae type B; HPV: human papilloma virus; IM: intramuscular; SC: subcutaneous; JE: Japanese encephalitis; MMR: measles-mumps-rubella; BCG: Bacille Calmette-Guérin; MMRV: measles-mumps-rubella-varicella.
* Patients with partial defects (eg, most patients with DiGeorge syndrome, hyperimmunoglobulin M syndrome, Wiskott-Aldrich syndrome, and others). Patients with ≥500 CD3+ T lymphocytes/mm3 ≥200 CD8+ T lymphocytes/mm3, and normal mitogen response should receive MMR and varicella vaccine (but not MMRV).
¶ High-level immunosuppression.
Δ Patients with atypical hemolytic uremic syndrome who receive eculizumab should receive the same schedule of pneumococcal, HIB, and meningococcal vaccines as patients with primary complement deficiency and asplenia.
◊ All patients should receive postexposure regimen of rabies vaccine, and patients with severe immunosuppression should be assessed for antibody response.
§ Live zoster vaccine is no longer available in the United States.
¥ Patients with Mendelian susceptibility to mycobacterial disease due to autoantibodies to interferon gamma should not receive live bacterial vaccines. Patients with autoantibodies to type 1 interferon should not receive live viral vaccines.
‡ These recommendations are for preexposure, if indicated; however, no absolute contraindication for smallpox vaccine in postexposure settings.Do you want to add Medilib to your home screen?