Vaccination of the Immunocompromised Host
Key Points
Key Points
- Impaired host defenses predispose patients to an increased rate or severity of vaccine-preventable infection.
- Such patients may also have greater exposure to pathogens due to frequent contact with medical environments.
- Data on safety, immunogenicity, and efficacy/effectiveness of vaccines for immunocompromised populations are limited.
- Immune system defects vary among and within categories of patients with immunodeficiency (eg, degree of immunodeficiency, nutritional status, immunosuppressive regimen), which may limit the generalizability of study findings.
- Inactivated vaccines can be administered to most immunocompromised patients, and live vaccines are contraindicated for most immunocompromised patients, with some important exceptions.
Responsibility for Vaccination
...ponsibility for Vaccination...
...aring for immunocompromised patients share res...
...caring for immunocompromised patients share...
Timing of Vaccination
...g of Vaccination...
...cines should be administered prior to planned immu...
...ive vaccines should be administered â‰...
...avoided within 2 weeks of initiation...
...Inactivated vaccines should be adm...
Household Members (See Table 1)
...ousehold Members (See Table 1)
...nocompetent household members of immunocompromis...
...for travel. (SR, M...
...old members of immunocompromised patients 6...
...d influenza vaccine (IIV) or (SR, H)2188...
...attenuated influenza vaccine (LAIV) pr...
Exceptions include household members o...
...if administered, contact between the immunoco...
...nocompetent household members of immunocomprom...
...vaccine in infants ages 2-7 months, (SR, L...
...vaccine (VAR), (SR, M)21881...
...vaccine (ZOS). (SR, M)21881...
They can safely receive vaccines for travel:...
and oral typhoid vaccine. (SR,...
...ovirus vaccine (OPV) should NOT be administer...
...immunocompromised patients should avoid handlin...
...promised patients should avoid contact with person...
Table 1. Safety of Administration of Live Vaccines to Contacts of Immunocompromised Persons
.... Safety of Administration of Live Vaccines to C...
...nfluenza, live, attenuated na...
...er; (SR, L)21881
...persons to avoid close contact with persons with...
...Shedding of Agent? (Site) Transmissi...
...ovirus, oral Shedding of Agent?...
...Shedding of Agent? (Site) T...
...phoid, oral Shedding of Agent? (Site)...
...la Shedding of Agent? (Site)...
...w fever Shedding of Agent? (Site)...
...Shedding of Agent? (Site) Transmissibility...
International Travel
...ernational Travel...
...ians may administer inactivated vaccine...
...r vaccine generally should NOT be...
...HIV-infected adults with CD4 T-cell lymphoc...
...ic HIV-infected children age 9 mon...
...ertain exceptions (eg, yellow fever vaccine...
Specific Vaccinations
...ecific Vaccinat...
...a and Zoster Vaccines...
...iven to immunocompetent patients without evid...
...dministered ≥4 weeks before initiating...
16. A 2-dose schedule of VAR, sepa...
...VAR should NOT be administered to hi...
...e considered for patients without evidence...
...d be administered to eligible immunocompromised pa...
...should be given to patients ≥60 ye...
...be considered for varicella-positive pat...
...S should be administered to patients ≥60 years o...
...hould NOT be administered to highly immunocompromi...
...nfluenza...
...al influenza vaccination with IIV is recommended...
...t for patients who are very unlikely t...
...ve received anti-B cell antibodies w...
...IV should NOT be administered to immunocompro...
Special Populations
...cial Populations...
...Congenital) Immunodeficiency Disorders
...rimary Complement Defi...
...Patients with primary complement deficiencies sho...
...years old should receive 1 dose of 13-valen...
...d with a classical pathway (C1, C2, C3, C4), al...
...s old with a classical pathway (C1, C2, C3, C...
...ose who have previously received 23-valent...
...tients ≥2 years of age with an early classical...
...dren age 6 weeks through 18 months, administer a 4...
...r a 2-dose primary series of quadrivalen...
...rsons >55 years of age, administer MPSV4 if the...
...patients 9-23 months of age, administer t...
...tients with a primary complement compo...
...ocytic Cell Deficiencie...
...cytic cell deficiencies include CG...
...Patients with phagocytic cell deficiencies sh...
...hildren 2-5 years of age should recei...
...2. Patients ≥6 years of age with phagocy...
33. Patients ≥2 years of age with...
.... Live bacterial vaccines, such as bacillus...
...5. Live viral vaccines should be admi...
...e viral vaccines should NOT be administered to...
...e or Cellular Activation Defects...
...defects in the immune system resulting in de...
...nts with innate immune system defects res...
...or patients with innate immune system defects r...
...alist advice should be sought on indiv...
...terial vaccines should NOT be administered...
...al vaccines should NOT be administered...
...nor Antibody Deficiencies...
...with immunoglobulin A (IgA) deficiency or spe...
...3. Children with SPAD or ataxia-telangiec...
...ars of age should receive PPSV23 â‰...
...ing of vaccine responses can be useful f...
...should NOT be administered to IgA-deficient pati...
...ajor Antibody Deficiencies in Patients Rece...
...ted vaccines other than IIV are NOT routinely...
...with suspected major antibody defici...
...7. IIV can be administered to patients with ma...
...should NOT be administered to patients with major...
...s (other than OPV) should NOT be admi...
...ed Immunodeficiencies
...atients with suspected combined immunodeficien...
...atients with combined immunodeficien...
...For patients with combined immunodeficiencies a...
.... Children with partial DiGeorge syndrome (p...
...tients with SCID, DiGeorge syndrome with CD3 T...
...dults, Adolescents, and Children (Se...
...activated Vaccine...
...(SR, H)21881...
...V13 in patients
...type b conjugate vaccine (Hib), (SR, H)21881...
...eria toxoid, tetanus toxoid, acellu...
...us toxoid, reduced diphtheria toxoid, an...
...d, reduced diphtheria toxoid vaccine...
...B vaccine (HepB), (SR, M)21...
...A vaccine (HepA), (SR, M)21881...
...ctivated poliovirus vaccine (IPV), (SR, M)21881...
...nd quadrivalent human papillomavirus vacci...
.... PCV13 should be administered to HIV-infe...
...6. PPSV23 should be administered to HIV-in...
...ted adults with CD4 T-lymphocyte counts of ≥200...
...ected adults with CD4 T-lymphocyte counts o...
...uld be given ≥8 weeks after the indicated dose(...
...IV-infected children who are >59 months of age an...
...ib is NOT recommended for HIV-infe...
...IV-infected children age 11-18 years sh...
...booster dose (third dose) should be giv...
...MCV4 is administered to HIV-infected ch...
...HIV-infected patients should receive HepB series...
...th consideration of high-dose HepB (40 μg/dose) f...
...d adolescents.* (WR, L)2188...
...to two months after completion, they should be...
...postvaccination anti-HBs concentration of...
...uld be administered (alternative: 1...
...r high-dose HepB (40 μg/dose)* (WR, L)218...
...children and high-dose HepB for adolescents*...
...ontaining 20 μg of HBsAg (hepatitis B...
...nally adopted HIV-infected children wh...
...mmended over bivalent human papillomavirus vaccin...
...ve Vaccin...
63. HIV-exposed or -infected infants s...
...-infected patients should NOT receive LAIV. (WR, V...
65. MMR should be administered to clini...
...HIV-infected patients ≥14 years wi...
...children with a CD4 T-cell percentage of...
...ents ≥14 years with a CD4 T-cell ly...
...ected patients should NOT receive quadriva...
...onimmune, clinically stable HIV-infected patien...
...ars with ≥15% CD4 T-lymphocyte percenta...
...e ≥14 years with CD4 T-lymphocyte counts of...
...should be separated by ≥3 month...
...ccination of Persons With HIV Infection...
H. influenzae type b conj...
...: age...
...age 5–18 yc (SR, L)2188...
...: age...
...5–18 yc (SR, L)21881...
Hepatitis...
...w-Levela or No ImmunosuppressionU: (SR, M)21...
...ImmunosuppressionbU: age 1 y (SR, M)218...
...epatitis Bd
...la or No ImmunosuppressionR: (SR, M)21881
...Level ImmunosuppressionbR: (SR, M)21881...
DTaP
...-Levela or No ImmunosuppressionU: (SR, M...
...l ImmunosuppressionbU: (SR, M)...
Tda...
...vela or No ImmunosuppressionU: (SR,...
...mmunosuppressionbU: (SR, VL)21881...
Td
...w-Levela or No ImmunosuppressionU: (SR, L...
...el ImmunosuppressionbU: (SR, L)21881
...PV4e...
...vela or No ImmunosuppressionU: age 11-26 y (SR, V...
...munosuppressionbU: age 11-26 y (SR, VL)2188...
...za, inactivated...
...-Levela or No ImmunosuppressionU:...
...mmunosuppressionbU: (SR, H)21881...
...a, live attenuated...
...la or No ImmunosuppressionX:f (WR, VL)21881...
...l ImmunosuppressionbX: (WR, VL)21...
MMR, l...
...w-Levela or No Immunosu...
...ge 12 mo to 13 y (SR, M)2188...
...¥14 y (WR, VL)21881...
...evel Immunosuppressionb...
...o to 13 y (SR, M)21881...
...≥14 y (SR, M)21881
...MRV, li...
...evela or No ImmunosuppressionX: (SR...
...Level ImmunosuppressionbX: (SR...
...ningococcal conj...
...w-Levela or No ImmunosuppressionU: age 11-18 y...
...ImmunosuppressionbU: age 11-18 y (SR, M)21881...
...umococcal conjugate (PCV...
...-Levela or No Immunosuppression...
...: age...
...ge 5 yh (SR, M)218...
...ge 6-18 yh (SR, L)...
...ge ≥19 yi (SR, L)21881...
...evel Immunosuppressionb...
U: age...
...5 y (SR, M)21881
...6-18 y (SR, L)21881...
...≥19 yi (SR, VL)21881
...neumococcal polysaccharide (PPSV...
...la or No ImmunosuppressionR: age ≥2 y (SR, M)218...
...gh-Level Immunosuppre...
...2-18 y (SR, M)21881...
...dult (CD4 T-lymphoc...
Poliovirus, inactiv...
...evela or No ImmunosuppressionU: (SR, M...
...-Level ImmunosuppressionbU: (SR, M)21...
...otavirus, live...
...ela or No ImmunosuppressionU: (SR, L)2188...
...unosuppressionbU: (WR, VL)21881...
...icella, liv...
...or No Immunosuppression...
U: age 1-8 y (SR, H)218...
...age ≥9 y (SR, VL)21881
...ImmunosuppressionbX: (SR, M)21...
...oster, live...
...w-Levela or No Immunosupp...
...: age
...age ≥60 yk, l (WR,...
...igh-Level ImmunosuppressionbX: (SR, M)21...
...d—administer if not previously a...
...-dose HepB (40 µg) should be considered for adult...
...dolescents (WR, L)21881...
...preferred over HPV2 because of its activity agai...
...ients ≥19 years of age with HIV who have...
...ould be administered 8 weeks or longer aft...
...accination can be considered for patients...
...ts not vaccinated with varicella vaccine....
...ncer (See Table 3...
69. Patients ≥6 months of age with...
...d tumor malignancies (SR, L...
...cept those receiving anti-B cell a...
...sive chemotherapy, such as for induc...
.... PCV13 should be administered to newly diagnosed...
...id malignancies (SR, VL)21881
...ren with malignancies (SR, VL)21881...
...in recommendations 27a-c. (, )21881...
...V23 should be administered to adults an...
...activated vaccines (other than IIV...
...owever, vaccines administered during cancer c...
...is documentation of a protective antibody leve...
...Live viral vaccines should NOT be administered d...
...3 months following cancer chemother...
...vaccines VAR, (WR, VL)21881...
..., (SR, L)218...
...RV (WR, VL)21881
...cording to the CDC annual schedule routine...
...regimens included anti-B cell antibodies, vaccina...
...accination of Patients With Cancer...
.... influenzae type b co...
...or During ChemotherapyaU: (WR, L)...
...Months Postchemotherapy and ≥6 Months After...
...patitis A...
Prior to or During ChemotherapyaU: (WR, L)2...
...ing ≥3 Months Postchemotherapy and ≥6 Months...
...patitis B
...or During ChemotherapyaU: (WR, L)21881...
...Months Postchemotherapy and ≥6 Months After...
U: (SR, M)21...
...adults (SR, VL)2188...
...TaP, Tda...
...During ChemotherapyaU: (WR, L)21881...
...‰¥3 Months Postchemotherapy and ≥6 Months Afte...
U: age 0-18 y (SR, M)218...
...dults with acute lymphoblastic leukemia or...
HP...
...ng ChemotherapyaU: age 11-26 y (WR, VL)...
...¥3 Months Postchemotherapy and ≥6 Months Afte...
...luenza, inactivated...
...During ChemotherapyaU (SR, L)U (SR-...
...nths Postchemotherapy and ≥6 Months...
...nfluenza, live attenuated
...or During ChemotherapyaX: (WR, VL)21881...
...onths Postchemotherapy and ≥6 Month...
...R, live...
...uring ChemotherapyaX:c (SR, M)21881...
...ng ≥3 Months Postchemotherapy and ≥6 Months...
...MRV, live...
...o or During ChemotherapyaX:c (SR, M)218...
...rting ≥3 Months Postchemotherapy...
...coccal conjugate...
...rior to or During ChemotherapyaU (WR,...
...arting ≥3 Months Postchemotherapy an...
...al conjugate-13 (PCV13)...
...o or During Chemotherap...
...(SR, L)21881...
...≥6 yd (SR, VL)21881...
...Months Postchemotherapy and ≥6 Months After...
...polysaccharide (PPSV23)...
...ring ChemotherapyaR: age ≥2 y (SR, L)2...
...≥3 Months Postchemotherapy and ≥6 Months A...
Poliovirus, inact...
...ior to or During ChemotherapyaU: (WR, L)21881...
...arting ≥3 Months Postchemotherapy and ≥6 Mont...
...tavirus, li...
...o or During ChemotherapyaX: (SR, VL)218...
...ng ≥3 Months Postchemotherapy and ≥6...
...cella, live...
...rior to or During ChemotherapyaXc (SR, M...
...‰¥3 Months Postchemotherapy and ≥6 Months...
...er, live...
...or During ChemotherapyaX:c (SR, VL)21881...
...ting ≥3 Months Postchemotherapy...
...ecommended—administer if not prev...
...inactivated influenza vaccine (IIV) annua...
...r malignancies (SR, L)21881...
...ose receiving anti–B-cell antibod...
...ons of inactivated vaccines other than IIV rou...
...ever, vaccines administered while receiv...
...V can be administered ≤3 months after ch...
...ents ≥19 years of age with HIV who have prev...
...ough MMR has been given safely 3 months after...
...For patients ≥19 years of age who ha...
...tem Cell Transplant (See Table 4...
...ients Before Transplantation...
...onor should be current with routinely recommend...
...MR, MMRV, VAR, and ZOS administration should be...
...ccination of the donor for the benefit of...
...r to HSCT, candidates should receive vaccines indi...
...nterval to the start of the conditioning regi...
...eeks for inactivated vaccines. (SR, M)21881...
...6. Nonimmune HSCT candidates ≥12 month...
...SCT Patients Post-transplan...
...7. Administer 1 dose of IIV annually. (SR, M...
...≥6 months of age starting 6 mon...
...rting at 4 months if there is a communi...
...children 6 months through 8 years of age who...
.... Administer 3 doses of PCV13 to adults and ch...
...2 months after HSCT a dose of PPSV23 should be...
...patients with chronic GVHD a fourth dose...
...inister 3 doses of Hib starting at 6-12 month...
...ter 2 doses of MCV4 starting 6-12 months after...
...nister 3 doses of tetanus/diphtheria-containi...
...children...
...s 7 years and older, administration...
...administer a dose of Tdap followed...
...2 doses of Td. (WR, L...
...er 3 doses of HepB starting at 6-12 months after...
...tion anti-HBs concentration of ≥10 mIU...
...ernative: 1 dose of HepB after which...
...gh dose (40 μg)* (WR, L)21...
...dren and high dose for adolescents* an...
...3. Administer 3 doses of IPV starting 6-1...
84. Consider administration of 3 doses of H...
...minister live vaccines to HSCT patients with activ...
.... Administer a 2-dose series of MMR to me...
...easles-seronegative children (SR, M)21881...
...a 2-dose series of VAR starting 24 months after...
...tions Prior to or After Allogeneic or...
.... influenzae type b conjugate...
...CTU: (SR, M)21881
...CTR: 3 doses (SR, M)at 6 mo post-tx218...
...patitis...
...U: (SR, VL)21881
...t-HSCTR: 2 doses (WR, L)at ≥6 mo post-tx...
Hepatitis...
...TU: (SR, L)21881...
Post-HSCTR: 3 doses (SR, M)at 6–...
...TaP, DT, Td,Â...
...CTU: (SR, L)21881...
...t-HSCT...
R: age...
R: age ≥7 y: DTaP* 3 doses (WR, VL)at â...
...ap, followed by either 2 doses DT* or 2 d...
...Td (WR, L)21881
HP...
Pre-HSCTU: age 11-26 y (SR, VL)218...
...3 doses at ≥6 mo post-tx (WR, VL)21881...
Influenza, inactiv...
...TU: (SR, L)21881...
...st-HSCT...
...≥4 mo post-tx (SR, VL)if community...
...erwise ≥6 mo post-tx (SR, M)21881
...fluenza, live attenu...
Pre-HSCTX: (WR, VL)21881
...TX: (WR, VL)21881...
..., live...
...U:a (SR, VL)21881
...CTX:b (SR, L)2188...
...V, live...
...SCTU:a (WR, VL)21881...
...HSCTX: (SR, VL)21881...
...eningococcal conju...
...e-HSCTU: (SR, VL)2188...
...e 11-18 y: 2 doses (SR, L)at 6-12 mo post-tx2...
...neumococcal conjugate (PC...
...CTR:c (SR, L)21881...
...R: 3 doses (SR, L)at 3-6 mo posttx2188...
...al polysaccharide (PPSV23)...
...-HSCTR:c (SR, VL)2188...
...12 mo post-tx if no GVHD (SR, L)21881...
...iovirus, inactivate...
...CTU: (SR, VL)2188...
...doses (SR, M)at ≥3 mo post-tx21881...
...otavirus, live
...re-HSCTX: (WR, VL)...
...HSCTX: (WR, VL)21881...
...ella, live...
...U:a (SR, L)21881...
...ost-HSCTX:d (SR,...
...er, live...
...re-HSCT...
...age 50–59 y* (WR, VL)2...
...ge ≥60 y (SR, L)21881...
Post-HS...
X: age 50–59 y* (SR, L)2188...
...age ≥60 y (SR, L...
...ded—administer if not previously administer...
...ootnotes to Table 4...
...vaccines should not be administered unles...
...inister to adolescents and adults (S...
...nd to children (SR, M)218...
...previously administere...
...nister if varicella-seronegative, the tim...
...the patient is not severely immunosuppressed...
...Organ Transplant (See Ta...
...ients Before Transplantation...
...ving donors should be current with vaccines b...
...VAR, and ZOS administration should be avoid...
...f donors solely for the recipient’s benefit is g...
...ults and children with chronic or end-stage...
...owing persons should receive PCV13 as...
...ults and children age ≥2 years old who a...
...tients with end-stage kidney disease should re...
...dren ≥2 years of age with end-stage heart o...
...CV13 and PPSV23 are indicated, PCV13 should b...
...i-HBs–negative SOT candidates should...
...alysis and age ≥20 years they should rece...
...postvaccination anti-HBs concentration o...
...rnative: 1 dose of HepB after which anti-...
...h dose* for children (WR, L)21881...
...the high dose for adolescents* and adults. (SR, L)...
...epatitis A–unvaccinated, undervaccinated, or...
...ears. (SR, M)should receive a HepA s...
...Combined HepA-HepB vaccine can be used for SOT c...
...series should be administered to SOT candidates...
...T candidates 6-11 months of age ca...
If transplantation is delayed (and t...
.... VAR should be administered to SOT candidate...
...an be administered to varicella-na...
...2 doses should be administered ≥3 months...
...tes age ≥60 years (SR, M)21881...
...varicella-positive (as defined in recomm...
...Recipient...
...nation should be withheld from SOT rec...
...at IIV can be administered ≥1 month afte...
...rd age-appropriate inactivated vac...
...V. (SR, M)(Table 5)21881...
...d be administered starting 2-6 months afte...
...patients ≥2 years of age, 1 dose of PPSV23 shou...
...should be considered for chronic hepatitis B-infe...
...VAR should generally not be admini...
...n children without evidence of immunity...
...Vaccination should not be withheld because of c...
...le 5. Vaccinations Prior to or After...
.... influenzae type b conjugate
...splantU: (SR, M)21881...
...Months PosttransplantU: (SR, M)21881...
...epatitis...
...ransplant...
...: age 12-23 mo (SR, M)...
...age ≥2 y (SR, M)21881...
...6 Months PosttransplantR: if not completed pretr...
...epatitis...
...etransplan...
...: age 1-18 y (SR, M...
...age ≥18 y (SR, M)21881
...tarting 2–6 Months PosttransplantR:...
DTaP, Tda...
...etransplantU: (SR, M)...
...€“6 Months PosttransplantU: if not completed...
HP...
...tU: females age 11-26 y (SR, M)21881...
...tarting 2–6 Months Posttransplan...
...emales age 11-26 y (SR, M...
...ge 11-26 y (SR, L)21881...
...nza, inactivated...
...lantU: (SR, M)21881...
...Months PosttransplantU:b (SR, M)21881...
...nfluenza, live att...
...splantX: (WR, L)21881
...Months PosttransplantX: (WR, L)21881...
...R, live...
...ransplant
...e 6-11 mo (WR, VL)218...
...‰¥12 mo (SR, M)21881...
...“6 Months PosttransplantX: (SR, L)21881...
MMRV, live
PretransplantU:d (SR...
...2–6 Months PosttransplantX: (SR, L)21881...
...ingococcal conjugate...
PretransplantU: (SR,...
...–6 Months PosttransplantU: (SR, M)21881...
...ococcal conjugate (PCV13)
...retransplant...
U: age...
...ge ≥6 ye (SR, VL)21881...
...ng 2–6 Months Posttran...
...age 2-5 y (SR, M)...
...age ≥6 y, if not administered pretrans...
...al polysaccharide (PPSV23)...
...splantR: age ≥2 y (SR, M)21881...
...onths PosttransplantR: age ≥2 y, if not adminis...
...irus, inactivated...
...lantU: (SR, M)21881...
...ing 2–6 Months PosttransplantU: (SR, M)2...
...avirus, live...
...ransplantU:c (SR, M)21881...
...2–6 Months PosttransplantX: (SR,...
...ricella, live
...etransplan...
...age 6-11 mo (WR, VL)21881
...SR, L)21881...
...ing 2–6 Months PosttransplantX:g (SR,...
...ter, liv...
...ransplant
...50-59 y (WR, L)21881...
...≥60 y (SR, M)21881...
...ng 2–6 Months PosttransplantX: (SR, L)2...
...recommended—administer if not previo...
...sider hepatitis B vaccine for hepatitis B-...
...dministered to SOT recipients despite intensive i...
c Administer only if patient is not immunosup...
...≥19 years who have previously receiv...
...nister only if patient is not immunosuppressed a...
...lammatory Disease Patients Taking Immunosuppor...
...tivated vaccines, including IIV, should be admini...
...be treated with immunosuppressive age...
...CV13 should be administered to adul...
...V23 should be administered to patients ≥2 year...
...-level immunosuppression, (SR, L)21...
and high-level immunosuppression. (SR, VL...
...nts should receive PPSV23 ≥8 weeks aft...
...ould be administered to patients with chronic...
...weeks prior to initiation of immunosuppres...
...VAR should be considered for pati...
110. ZOS should be administered to patients...
...hile being treated with low-dose immunosuppress...
...to those who are 50-59 years of age and varice...
...le being treated with low-dose immunosuppressi...
...e vaccines should NOT be administered...
...in patients receiving low-level (WR,...
...vel immunosuppression, (WR, VL)...
...ients receiving low-level (WR, VL)21881...
...mmunosuppression. (SR, VL)21881
...Otherwise recommended vaccines, including IIV a...
...Vaccination of Persons With Chronic Infla...
...influenzae type b conj...
...mmunosuppressionU: (SR, M)2...
Low-Level ImmunosuppressionaU: (SR,...
...l ImmunosuppressionaU: (SR, L)21881...
...epatitis...
...ImmunosuppressionU: (SR, M)218...
...ImmunosuppressionaU: (SR, L)...
...l ImmunosuppressionaU: (SR, L)218...
...patitis...
...ImmunosuppressionU: (SR, M)21881...
...el ImmunosuppressionaU: (SR, L)21881...
...Level ImmunosuppressionaU: (SR, L)21881...
...TaP, Td, Tdap
...nosuppressionU: (SR, M)21881...
Low-Level ImmunosuppressionaU: (SR, L)...
...vel ImmunosuppressionaU: (SR,...
...PV...
...osuppressionU: age 11-26 y (SR, M)2188...
...osuppressionaU: age 11-26 y (SR, L)21881...
...h-Level ImmunosuppressionaU: age 11-26 y (SR, V...
...za, inactivated
...ImmunosuppressionU: (SR, M)218...
...nosuppressionaU: (SR, M)21881...
...-Level ImmunosuppressionaU: (SR, M)21881...
Influenza, live at...
...unosuppressionX: (WR, VL)21881...
...ImmunosuppressionaX: (WR, VL)21881...
...igh-Level ImmunosuppressionaX: (W...
..., live...
...osuppressionU:b (SR, M)21881...
...ImmunosuppressionaX: (WR, VL)21881...
...unosuppressionaX: (WR, VL)21881...
MMRV, li...
...d ImmunosuppressionU:b (SR, L)...
...Level ImmunosuppressionaX: (WR, VL)2188...
...-Level ImmunosuppressionaX: (SR, VL)21881...
...coccal conjugate...
...ned ImmunosuppressionU: (SR, M)218...
...munosuppressionaU: (SR, M)21881...
...l ImmunosuppressionaU: (SR, L)21881
Pneumococcal conjugate (P...
Planned ImmunosuppressionR:c (SR...
...el Immunosuppressiona...
...: age...
R: age ≥6 yc (SR, V...
...Level Immunosuppressiona...
U: age
...age ≥6 yc (SR, VL)21881...
...polysaccharide (PPSV23)...
Planned ImmunosuppressionR: age ≥2 y (SR, L)...
...-Level ImmunosuppressionaR: age â‰...
...osuppressionaR: age ≥2 y (SR, VL)21881...
Poliovirus, inactivate...
...ImmunosuppressionU: (SR, M)21881...
...l ImmunosuppressionaU: (SR, M)21...
...el ImmunosuppressionaU: (SR, L)21881...
...tavirus, l...
...ImmunosuppressionU: (SR, M)21881
...mmunosuppressionaX: (WR, VL)21881
High-Level ImmunosuppressionaX: (WR, VL)21881
Varicella, li...
...nned ImmunosuppressionU:d (SR, M)21881...
...munosuppressionaX:d (WR, VL)21881...
...igh-Level ImmunosuppressionaX: (SR, M)2...
...ter, live...
...Immunosuppression...
R: age 50-59 y* (WR, L)218...
U: age ≥60 y (SR, L)218...
...l Immunosuppressiona...
...-59 y* (WR, VL)21881...
...age ≥60 y (SR, VL)21881...
...el ImmunosuppressionaX: (WR, V...
...nded—administer if not previously administer...
...s ≥19 years who have previously received PPSV23...
...inistration of VAR can be considered for nonâ...
...endations deviate from CDC ACIP recommendations...
Asplenia or Sickle Cell Diseases...
...ic patients or those with sickle cell diseases s...
except LAIV in patients with sickle...
...CV13 should be administered to asplenic...
...PPSV23 should be administered to asplenic...
...interval of ≥8 weeks after PCV13, and a secon...
...SV23--naive patients ≥2 years of ag...
...following surgery.* (WR, L)21881...
...17. One dose of Hib should be administered...
...cal vaccine should be administered to patients...
...ation 29 except that MCV4--D should not be adm...
...cinate with MCV4 (or MPSV4 for those >55 years o...
...arrier Defects (See Table 7)
...children with profound deafness sch...
...with a cochlear implant, with profound...
...1. Patients ≥24 months of age with a cochlear im...
122. PCV13 and PPSV23 should be ad...
...ination of Persons With Asplenia or a...
...uenzae type b conjugate
...or a Sickle Cell Disease...
...: age...
...e ≥5 y (WR, L)21881...
...lantsa or CSF LeakU: (SR, M)21881
...atitis A
...lenia or a Sickle Cell DiseaseU: (SR,...
...r Implantsa or CSF LeakU: (SR, M)21881...
Hepatiti...
...ckle Cell DiseaseU: (SR, M)21881...
...ear Implantsa or CSF LeakU: (SR, M)...
... Td, Tdap...
...a Sickle Cell DiseaseU: (SR, M)21881...
...ochlear Implantsa or CSF LeakU: (S...
HP...
...Sickle Cell DiseaseU: (SR, M)21881...
...Implantsa or CSF LeakU: (SR, M...
...fluenza, inactivated...
...plenia or a Sickle Cell DiseaseU...
...tsa or CSF LeakU: (SR, M)21881...
...za, live attenuated...
...enia or a Sickle Cell DiseaseX: (W...
...lantsa or CSF LeakU: (SR, M)21881...
..., live...
...ia or a Sickle Cell DiseaseU: (SR, M)21881...
...Implantsa or CSF LeakU: (SR, M)21881...
...RV, live
...enia or a Sickle Cell DiseaseU: (S...
...Implantsa or CSF LeakU: (SR, M)...
...ngococcal conjugat...
...ia or a Sickle Cell DiseaseR: age 2-...
...ar Implantsa or CSF LeakU: (SR, M)21881...
...ningococcal polysaccharide...
...lenia or a Sickle Cell DiseaseR: age >55 y...
...lear Implantsa or CSF LeakU: (SR, M)2...
...ococcal conjugate (PCV13)
...r a Sickle Cell Diseas...
U: age
...≥6 yd (SR, VL)21881...
...mplantsa or CSF Leak...
...: age...
...: age ≥6 yd (SR,...
...eumococcal polysaccharide (P...
...a or a Sickle Cell DiseaseR: age ≥2 y...
...r Implantsa or CSF LeakR: age ≥2...
...liovirus, inactivated
...plenia or a Sickle Cell DiseaseU: (SR,...
...Implantsa or CSF LeakU: (SR, M)21881...
...avirus, live...
Asplenia or a Sickle Cell DiseaseU...
...Implantsa or CSF LeakU: (SR, M)21881...
...aricella, live
...splenia or a Sickle Cell DiseaseU: (SR, M...
...lear Implantsa or CSF LeakU: (SR, M)21881...
...ter, live...
...or a Sickle Cell DiseaseU: (SR, M)21881...
...chlear Implantsa or CSF LeakU:...
...ecommended—administer if not previously adm...
...V13 has not previously been administ...
...Administer 8 or more weeks after indicate...