Vaccination of the Immunocompromised Host

Last updated April 8, 2022

Key Points

Key Points

Some recommendations in this guideline have not been addressed by the Advisory Committee on Immunization Practices (ACIP), Centers for Disease Control and Prevention (CDC), or deviate from their recommendations, and are marked by an asterisk (*).
  • 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

...Responsibility for...

...lists caring for immunocompromised patients share...


...caring for immunocompromised patients share...


Timing of Vaccination

...Timing of Vaccination...

...accines should be administered prior to...


...ve vaccines should be administered ≥4 we...

...nd should be avoided within 2 weeks of initiati...


...Inactivated vaccines should be administe...


Household Members (See Table 1)

Hous...

...mmunocompetent household members of immunocompro...

...or travel. (SR, M)218...


...Household members of immunocompromis...

...ivated influenza vaccine (IIV) or (SR, H)21881...

...ve attenuated influenza vaccine (LAIV) provided...

...ude household members of an immunocom...

...f administered, contact between the immunocomp...


...y immunocompetent household members of im...

...otavirus vaccine in infants ages 2-7...

...la vaccine (VAR), (SR, M)21881...

...oster vaccine (ZOS). (SR, M)21881...

...receive vaccines for travel: yellow fever vaccin...

...hoid vaccine. (SR, L)21881...


...oliovirus vaccine (OPV) should NOT...


...ocompromised patients should avoid handling diap...


...unocompromised patients should avoid contac...


Table 1. Safety of Administration of Live Vaccines to Contacts of Immunocompromised Persons

...Table 1. Safety...

...Influenza, live, att...

Administer; (SR, L)218...

...ns to avoid close contact with persons with HS...


...Shedding of Agent? (Site)...


...oliovirus, oral Shedding...


...rus, oral Shedding of Agent...


...oid, oral Shedding of Agen...


...la Shedding of Agent? (Site)...


...Shedding of Agent? (Site)...


...Shedding of Agent? (Site) Tr...


International Travel

...Internati...

...Clinicians may administer inactivated vaccines...


...3. Yellow fever vaccine generally should NOT be a...

...c HIV-infected adults with CD4 T-ce...

...tomatic HIV-infected children age 9 mon...


...exceptions (eg, yellow fever vaccine...


Specific Vaccinations

...Specific Vaccinations...

...Varicell...

...given to immunocompetent patients withou...

...can be administered ≥4 weeks be...

...e schedule of VAR, separated by >4 week...

...R should NOT be administered to highly...

...8. VAR can be considered for patients without ev...

...9. VAR should be administered to eligible i...

...d be given to patients ≥60 years o...

...should be considered for varicella...

.... ZOS should be administered to patients ≥60...

...3. ZOS should NOT be administered to h...


...Infl...

...fluenza vaccination with IIV is re...

...nts who are very unlikely to respond (although...

...ave received anti-B cell antibodies within 6 mont...

...hould NOT be administered to immunocompromis...


Special Populations

...Sp...

...Primary (Congenital) Im...

...Primary Complemen...

...ith primary complement deficiencies sh...

...should receive 1 dose of 13-valent pneumococcal c...

...ld with a classical pathway (C1, C2, C3, C4), al...

...ld with a classical pathway (C1, C2, C3, C4)...

For those who have previously receiv...

...2 years of age with an early classica...

...n age 6 weeks through 18 months, adminis...

...primary series of quadrivalent meningoc...

...>55 years of age, administer MPSV4 if th...

For patients 9-23 months of age, admin...

...th a primary complement component deficiency shou...

...Phagocytic Cell...

...gocytic cell deficiencies include CGD (...

...ith phagocytic cell deficiencies should...

...ren 2-5 years of age should receive PCV13 as in...

...tients ≥6 years of age with phagocyti...

...nts ≥2 years of age with phagocytic cell d...

...acterial vaccines, such as bacillus Ca...

...ral vaccines should be administered to patients w...

...ve viral vaccines should NOT be administered to p...

...Innate C...

...fects in the immune system resulting in defects o...

...atients with innate immune system defects r...

38. For patients with innate immune s...

...t advice should be sought on indiv...

...ive bacterial vaccines should NOT be administered...

.... Live viral vaccines should NOT be admini...

...Minor Antibody Defic...

...tients with immunoglobulin A (IgA) deficiency or s...

...ildren with SPAD or ataxia-telangiectasia sh...

Those ≥2 years of age should receive PPSV23...

44. Monitoring of vaccine responses can b...

...ould NOT be administered to IgA-deficie...

...Major Ant...

...nactivated vaccines other than IIV are NOT routi...

For patients with suspected major antibody de...

47. IIV can be administered to patients with ma...

...Live OPV should NOT be administered to patient...

49. Live vaccines (other than OPV) shou...

...Com...

...ts with suspected combined immunodeficiencie...

...with combined immunodeficiencies who are receiv...

...ts with combined immunodeficiencies an...

...h partial DiGeorge syndrome (pDGS)...

...nts with SCID, DiGeorge syndrome with...


...HIV-Infected Adu...

IIV, (SR, H)21881

...in patients...

H. influenzae type b conjugate vaccine (Hib), (S...

...oxoid, tetanus toxoid, acellular pertussis...

...toxoid, reduced diphtheria toxoid, an...

...nus toxoid, reduced diphtheria toxoid vaccin...

...is B vaccine (HepB), (SR, M)2188...

...vaccine (HepA), (SR, M)21881...

...d poliovirus vaccine (IPV), (SR, M)218...

...ivalent human papillomavirus vaccine (HPV4)* i...

...CV13 should be administered to HIV-infecte...

...ld be administered to HIV-infected children ≥2...

...o HIV-infected adults with CD4 T-lymphocyte co...

...to HIV-infected adults with CD4 T-lymphocyte...

...ld be given ≥8 weeks after the in...

...7. HIV-infected children who are >59...

...mended for HIV-infected adults. (WR...

.... HIV-infected children age 11-18...

...single booster dose (third dose) should be given a...

...ministered to HIV-infected children 2...

...V-infected patients should receive HepB series,...

...onsideration of high-dose HepB (40 μg/dose)...

...scents.* (WR, L)21881...

One to two months after completion, they sh...

...f a postvaccination anti-HBs concentration o...

...stered (alternative: 1 dose of HepB after...

...high-dose HepB (40 μg/dose)* (WR, L)21881

...hildren and high-dose HepB for adole...

...containing 20 μg of HBsAg (hepatitis B surface an...

...ernationally adopted HIV-infected children wh...

...V4 is recommended over bivalent human...

...Live Vaccines...

...sed or -infected infants should receive rota...

...infected patients should NOT receiv...

65. MMR should be administered to clinical...

...nd HIV-infected patients ≥14 years with...

...infected children with a CD4 T-cell percent...

...nts ≥14 years with a CD4 T-cell lymphocyte cou...

...7. HIV-infected patients should NOT receive quadri...

...aricella-nonimmune, clinically stable HIV-inf...

...ith ≥15% CD4 T-lymphocyte percentage,...

...ars with CD4 T-lymphocyte counts of ≥200...

...should be separated by ≥3 months. (SR, M)...


...Table 2. Vaccinat...

...H. influenzae t...

...age...

R: age 5–18 yc (SR, L)2188...

U: ag...

...: age 5–18 yc (SR, L)2...

...Hepatitis...

...r No ImmunosuppressionU: (SR, M)21881...

...mmunosuppressionbU: age 1 y (SR, M)21881...

...Hepatitis Bd...

...Levela or No ImmunosuppressionR: (SR, M)21881

...gh-Level ImmunosuppressionbR: (S...

...ow-Levela or No ImmunosuppressionU: (SR, M...

...l ImmunosuppressionbU: (SR, M)21881...

...Tdap...

...No ImmunosuppressionU: (SR, VL)21881...

...vel ImmunosuppressionbU: (SR, VL)21881...

...ela or No ImmunosuppressionU: (SR, L)218...

...evel ImmunosuppressionbU: (SR, L)2188...

...HPV4e...

...-Levela or No ImmunosuppressionU: age 11-26 y (SR,...

...vel ImmunosuppressionbU: age 11-26 y (SR, V...

...I...

...ow-Levela or No ImmunosuppressionU: (SR, H)21881...

...ImmunosuppressionbU: (SR, H)21881...

...Influenza,...

...or No ImmunosuppressionX:f (WR, VL)218...

...el ImmunosuppressionbX: (WR, VL)21881...

M...

...ow-Levela or No Immunosuppression

...mo to 13 y (SR, M)21881...

...ge ≥14 y (WR, VL)21...

...vel Immunosuppressionb...

...e 12 mo to 13 y (SR, M)21...

...≥14 y (SR, M)21881...

...MMRV,...

...r No ImmunosuppressionX: (SR, VL)2188...

...h-Level ImmunosuppressionbX: (SR, VL)21881...

...Men...

...or No ImmunosuppressionU: age 11-18 y (SR, M)2188...

...ImmunosuppressionbU: age 11-18 y (SR, M)21881...

P...

...a or No Immunosuppression...

...age...

...age 5 yh (SR, M)2188...

...6-18 yh (SR, L)21881...

...≥19 yi (SR, L)2188...

...gh-Level Immunosuppre...

...: age...

R: age 5 y (SR, M)21...

...: age 6-18 y (SR, L...

...e ≥19 yi (SR, VL)218...

...Pneumococcal pol...

...r No ImmunosuppressionR: age ≥2 y (SR, M)2...

...gh-Level Immunosuppr...

R: age 2-18 y (SR, M)...

...: adult (CD4 T-lympho...

...a or No ImmunosuppressionU: (SR, M)21881...

...mmunosuppressionbU: (SR, M)218...

...Rotavi...

...vela or No ImmunosuppressionU: (SR, L)21881...

...unosuppressionbU: (WR, VL)21881...

...Varice...

Low-Levela or No Immunosuppress...

...: age 1-8 y (SR, H)21881...

...≥9 y (SR, VL)21881...

...igh-Level ImmunosuppressionbX: (SR, M)2...

...Zoster, live...

...ela or No Immunosuppression...

X: age

...age ≥60 yk, l (WR, L)218...

...gh-Level ImmunosuppressionbX:...

...—administer if not previously administered or...

...epB (40 µg) should be considered for ad...

...d adolescents (WR,...

...s preferred over HPV2 because of its...

i For patients ≥19 years of age with HIV who...

...PPSV23 should be administered 8 weeks or l...

...can be considered for patients 50 through 59 ye...

...not vaccinated with varicella vacci...


...Cancer (See...

...Patients ≥6 months of age with hematologica...

...umor malignancies (SR, L)21881...

...ept those receiving anti-B cell antibodies* (...

...e chemotherapy, such as for inducti...

...ould be administered to newly diagnosed adul...

...lid malignancies (SR, VL)21881

...n with malignancies (SR, VL)21881...

...ibed in recommendations 27a-c. (,...

...3 should be administered to adults an...

...tivated vaccines (other than IIV) recommended for...

...vaccines administered during cancer...

...ss there is documentation of a protec...

...ive viral vaccines should NOT be a...

...3 months following cancer chemotherapy, patien...

...ive vaccines VAR, (WR, VL)21881

...(SR, L)21881...

...RV (WR, VL)21881...

according to the CDC annual schedule rout...

...mens included anti-B cell antibodies, vacc...


...Table 3. Vac...

...H...

...r During ChemotherapyaU: (WR, L)2...

...3 Months Postchemotherapy and ≥6 Mo...

...Hepatitis A...

...or to or During ChemotherapyaU: (WR, L)21881...

...rting ≥3 Months Postchemotherapy and ≥6 Month...

...Hepatiti...

...r to or During ChemotherapyaU: (WR, L)21881...

Starting ≥3 Months Postchemotherapy and...

...SR, M)2188...

...: adults (SR, VL)...

...DTaP, Tdap...

...During ChemotherapyaU: (WR, L)21881...

...ng ≥3 Months Postchemotherapy and ≥...

...age 0-18 y (SR, M...

...dults with acute lymphoblastic leukemia or lymp...

H...

...r to or During ChemotherapyaU: age 11...

...ing ≥3 Months Postchemotherapy and ≥6 Months...

...Influenza, inactiv...

...ring ChemotherapyaU (SR, L)U (SR-L to M)21881...

...g ≥3 Months Postchemotherapy and ≥6 Months Aft...

...Influenza, l...

...to or During ChemotherapyaX: (WR, VL)21...

...≥3 Months Postchemotherapy and ≥6 Months...

...MMR, liv...

...or to or During ChemotherapyaX:c (SR,...

...ng ≥3 Months Postchemotherapy and ≥6 Month...

...MMRV, l...

...or During ChemotherapyaX:c (SR, M)2...

...≥3 Months Postchemotherapy and ≥6 Months Afte...

...Meningococcal conjugate...

...During ChemotherapyaU (WR, L)2...

Starting ≥3 Months Postchemother...

...Pneumococcal con...

Prior to or During Chemothe...

...R, L)21881...

...age ≥6 yd (SR, VL)...

Starting ≥3 Months Postchemotherapy...

...Pneumococcal...

...rior to or During ChemotherapyaR: age ...

...≥3 Months Postchemotherapy and ≥6...

...Poliovirus, inactivated...

...ring ChemotherapyaU: (WR, L)21881...

Starting ≥3 Months Postchemotherapy and ≥...

...Rotavirus, li...

Prior to or During ChemotherapyaX: (SR, VL)218...

...rting ≥3 Months Postchemotherapy and ≥6 Mont...

...Varicell...

...or During ChemotherapyaXc (SR, M)21881...

...≥3 Months Postchemotherapy and ≥6 Mo...

...During ChemotherapyaX:c (SR, VL)21881...

...tarting ≥3 Months Postchemotherapy and ...

...ended—administer if not previously adminis...

...er inactivated influenza vaccine (IIV) annually...

...r solid tumor malignancies (SR,...

...ept those receiving anti–B-cell anti...

Administrations of inactivated vaccines other tha...

...ines administered while receiving c...

...V can be administered ≤3 months after...

...patients ≥19 years of age with HIV who hav...

...h MMR has been given safely 3 months after compl...

...patients ≥19 years of age who have pr...


...Donors and Patients B...

...onor should be current with routinely reco...

...MR, MMRV, VAR, and ZOS administration s...

...he donor for the benefit of the recipient is...

...T, candidates should receive vaccines...

...interval to the start of the conditioning regi...

...for inactivated vaccines. (SR, M)218...

...Nonimmune HSCT candidates ≥12 mo...

77. Administer 1 dose of IIV annually. (SR,...

...ons ≥6 months of age starting 6 months after...

...4 months if there is a community outbreak of infl...

...6 months through 8 years of age who are rece...

...ister 3 doses of PCV13 to adults and ch...

...er HSCT a dose of PPSV23 should be given pro...

...atients with chronic GVHD a fourth dose of P...

.... Administer 3 doses of Hib starting at 6-12 mon...

...ter 2 doses of MCV4 starting 6-12 months...

...dminister 3 doses of tetanus/diphtheria-containin...

...r children...

...7 years and older, administration of 3 doses...

..., administer a dose of Tdap followed by eit...

...doses of Td. (WR, L)21881...

...2. Administer 3 doses of HepB starting at 6-12 mon...

...a postvaccination anti-HBs concentration of ...

...ternative: 1 dose of HepB after which ant...

...dose (40 μg)* (WR, L)218...

...hildren and high dose for adolescents* and adult...

...Administer 3 doses of IPV starting 6-12 months...

...onsider administration of 3 doses of...

...Do not administer live vaccines to HSCT patien...

...er a 2-dose series of MMR to measles-se...

...les-seronegative children (SR, M)2188...

...Administer a 2-dose series of VAR starting 24 mon...


...Table 4. Vaccination...

...H. influenzae type b conju...

...e-HSCTU: (SR, M)...

...-HSCTR: 3 doses (SR, M)at 6 mo p...

...Hepatitis A...

...CTU: (SR, VL)21881...

Post-HSCTR: 2 doses (WR, L)at ≥6 mo post-tx2188...

...Hepatitis B...

...-HSCTU: (SR, L)21881...

...: 3 doses (SR, M)at 6–12 mo post-tx2188...

...DTaP, DT, Td, T...

Pre-HSCTU: (SR, L)2188...

...t-HSCT...

R: age

...7 y: DTaP* 3 doses (WR, VL)at ≥6 mo po...

...se Tdap, followed by either 2 doses DT* or...

DT, Td (WR, L)21881

...HPV...

...-HSCTU: age 11-26 y (SR, VL)2...

Post-HSCTU: 3 doses at ≥6 mo post-tx...

...Influenz...

...TU: (SR, L)21881...

...st-HSCT...

...≥4 mo post-tx (SR, VL)if communi...

...erwise ≥6 mo post-tx (SR, M)2188...

...Influenza, live attenuated...

Pre-HSCTX: (WR, VL)21881

...-HSCTX: (WR, VL)21881...

Pre-HSCTU:a (SR, VL...

Post-HSCTX:b (SR, L)218...

...MMRV, live...

...HSCTU:a (WR, VL)2188...

...t-HSCTX: (SR, VL)218...

...Meningococcal conj...

...TU: (SR, VL)21881...

...t-HSCTR: age 11-18 y: 2 doses (SR, L...

...Pneumoc...

...SCTR:c (SR, L)21881...

...HSCTR: 3 doses (SR, L)at 3-6 mo posttx21881

...P...

...re-HSCTR:c (SR, VL)...

...TR: ≥12 mo post-tx if no GVHD (SR, L)218...

...Poliovirus, inact...

...U: (SR, VL)21881...

...st-HSCTR: 3 doses (SR, M)at ≥3 mo pos...

...-HSCTX: (WR, VL)2188...

...-HSCTX: (WR, VL)218...

...Varicella, l...

Pre-HSCTU:a (SR, L)2188...

...-HSCTX:d (SR, L)21881...

...Zo...

...e-HSCT

...a,e age 50–59 y* (WR, VL...

...:a age ≥60 y (SR, L...

...st-HSC...

...–59 y* (SR, L)21881...

...e ≥60 y (SR, L)2...

...mmended—administer if not previously adm...

...tnotes to Table 4...

...ve vaccines should not be administered un...

...r to adolescents and adults (SR, L)21881...

...ildren (SR, M)21881...

...t previously administered...

...minister if varicella-seronegative, the timing...

...ider if the patient is not severely immunosuppres...


...Solid Organ T...

...Donors an...

...onors should be current with vaccines based on...

...MMRV, VAR, and ZOS administration should be avoi...

...ation of donors solely for the recipient’s b...

...and children with chronic or end-stage kidney,...

...g persons should receive PCV13 as in recommend...

...ts and children age ≥2 years old wh...

...ients with end-stage kidney disease should...

...dren ≥2 years of age with end-stage hea...

...CV13 and PPSV23 are indicated, PCV13 s...

...2. anti-HBs–negative SOT candidate...

...if on hemodialysis and age ≥20 years they shou...

...accination anti-HBs concentration of ...

(Alternative: 1 dose of HepB after which anti...

or high dose* for children (WR...

...he high dose for adolescents* and adults. (SR,...

Hepatitis A–unvaccinated, undervaccin...

...years. (SR, M)should receive a HepA...

...ned HepA-HepB vaccine can be used for SOT cand...

...ies should be administered to SOT candi...

...es 6-11 months of age can receive MMR if...

...nsplantation is delayed (and the child is...

...VAR should be administered to SOT candidates w...

...istered to varicella-naive SOT candid...

...es should be administered ≥3 months...

...SOT candidates age ≥60 years (SR, M)21881...

...varicella-positive (as defined in re...

...SOT Recipients...

...should be withheld from SOT recipient...

...can be administered ≥1 month after...

...e-appropriate inactivated vaccine serie...

...IIV. (SR, M)(Table 5)21...

...0. PCV13 should be administered startin...

...SOT patients ≥2 years of age, 1 d...

...HepB should be considered for chronic he...

...d VAR should generally not be administ...

...R in children without evidence of immunity (as de...

...ation should not be withheld because...


...Table 5. Vaccinati...

...H. influen...

...ansplantU: (SR, M)21881

...6 Months PosttransplantU: (SR, M)21881...

...Hepatitis A...

Pretransplan...

...age 12-23 mo (SR, M)21881...

...≥2 y (SR, M)21881

...6 Months PosttransplantR: if not co...

...Hepatitis B

Pretransplan...

...: age 1-18 y (SR, M)21881...

...age ≥18 y (SR, M)21881

...Months PosttransplantR: if not co...

...lantU: (SR, M)21881

...Months PosttransplantU: if not completed...

...ansplantU: females age 11-26 y (SR, M)2...

...tarting 2–6 Months Posttran...

...ales age 11-26 y (SR, M)21881

...ales age 11-26 y (SR, L)21881...

...Influenza, ina...

...nsplantU: (SR, M)21881

...tarting 2–6 Months PosttransplantU:b (S...

I...

...ransplantX: (WR, L)21881...

...tarting 2–6 Months PosttransplantX: (...

...MMR, live

...etransplant...

...e 6-11 mo (WR, VL)21881...

...ge ≥12 mo (SR, M)21881...

Starting 2–6 Months PosttransplantX: (SR, L...

...MMRV, live...

...nsplantU:d (SR, M)21881

...ng 2–6 Months PosttransplantX: (SR...

...Menin...

...retransplantU: (SR, M...

...ng 2–6 Months PosttransplantU: (SR, M)...

...Pneumococca...

...transplant...

U: age...

...≥6 ye (SR, VL)21881...

...6 Months Posttransplant...

...e 2-5 y (SR, M)21...

...if not administered pretransplante (SR, VL)21...

...Pneumoc...

...R: age ≥2 y (SR, M)21881...

...rting 2–6 Months PosttransplantR: age...

PretransplantU: (SR, M...

...ting 2–6 Months PosttransplantU:...

...Rotavirus, live...

...plantU:c (SR, M)21881...

...2–6 Months PosttransplantX: (SR,...

...Varicella, live...

...retranspla...

...f age 6-11 mo (WR, VL)21881...

U:d (SR, L)2...

...Months PosttransplantX:g (SR, L)21881...

...Zoster, live...

...transplant...

...0-59 y (WR, L)21881...

...60 y (SR, M)21881...

...–6 Months PosttransplantX: (SR, L)21881...

...mended—administer if not previously...

...Consider hepatitis B vaccine for hepatitis...

...V may be administered to SOT recipients despite i...

...minister only if patient is not immun...

...≥19 years who have previously received PPSV23, P...

...minister only if patient is not immu...


...Chronic...

...Inactivated vaccines, including I...

...to be treated with immunosuppressive a...

...PCV13 should be administered to adults...

...7. PPSV23 should be administered to patients ...

...-level immunosuppression, (SR, L)21881...

...high-level immunosuppression. (SR, VL)...

...receive PPSV23 ≥8 weeks after PCV13 an...

...should be administered to patients with c...

...eeks prior to initiation of immunosuppression,...

...AR should be considered for patients without evi...

110. ZOS should be administered to patients...

...r while being treated with low-dose immunosuppr...

...hose who are 50-59 years of age and varic...

...ile being treated with low-dose immu...

...er live vaccines should NOT be adminis...

...ents receiving low-level (WR, VL)21881...

...h-level immunosuppression, (WR, VL)21881...

...d MMRV in patients receiving low-leve...

...el immunosuppression. (SR, VL)21881...

112. Otherwise recommended vaccines, including IIV...


...Table 6....

...H. influenz...

...munosuppressionU: (SR, M)21881

...ow-Level ImmunosuppressionaU: (SR, L)21...

...ImmunosuppressionaU: (SR, L)21881...

...Hepatitis A...

...ImmunosuppressionU: (SR, M)21881...

...mmunosuppressionaU: (SR, L)21881...

...ImmunosuppressionaU: (SR, L)21881

...Hepatitis B...

...ed ImmunosuppressionU: (SR, M)218...

...munosuppressionaU: (SR, L)21881...

...ImmunosuppressionaU: (SR, L)21881...

...DTaP, Td,...

...nosuppressionU: (SR, M)21881...

...mmunosuppressionaU: (SR, L)2188...

...ImmunosuppressionaU: (SR, L)21...

...HPV...

...nosuppressionU: age 11-26 y (SR, M)21881...

...vel ImmunosuppressionaU: age 11-26 y (SR...

...munosuppressionaU: age 11-26 y (SR, VL)21881...

...In...

...lanned ImmunosuppressionU: (SR, M)21881...

...munosuppressionaU: (SR, M)21881...

...ImmunosuppressionaU: (SR, M)21881...

...Influenza, l...

...nosuppressionX: (WR, VL)21881...

...nosuppressionaX: (WR, VL)21881...

...ImmunosuppressionaX: (WR, VL)21881...

...MMR, live...

...unosuppressionU:b (SR, M)21881...

...Level ImmunosuppressionaX: (WR, VL)...

...Level ImmunosuppressionaX: (WR, VL)21881...

...MMRV, live...

...ned ImmunosuppressionU:b (SR, L)2188...

...mmunosuppressionaX: (WR, VL)21881...

...l ImmunosuppressionaX: (SR, VL)21881...

...Meni...

Planned ImmunosuppressionU: (...

...ImmunosuppressionaU: (SR, M)21881...

...ImmunosuppressionaU: (SR, L)21881...

...Pneumococcal...

...unosuppressionR:c (SR, M)21881

...w-Level Immunosuppressi...

...age

...≥6 yc (SR, VL)218...

...vel Immunosuppressiona...

...age...

...6 yc (SR, VL)21881...

...Pneumococcal po...

...lanned ImmunosuppressionR: age ≥2 y (S...

...munosuppressionaR: age ≥2 y (SR, L)218...

...ImmunosuppressionaR: age ≥2 y (SR...

Planned ImmunosuppressionU: (SR,...

...vel ImmunosuppressionaU: (SR, M)21881...

...evel ImmunosuppressionaU: (SR,...

...Rot...

...ned ImmunosuppressionU: (SR, M)21881...

...-Level ImmunosuppressionaX: (WR, VL)21881...

...h-Level ImmunosuppressionaX: (WR, VL...

...Varicella, live...

Planned ImmunosuppressionU:d (SR...

...el ImmunosuppressionaX:d (WR, VL)21881...

...h-Level ImmunosuppressionaX: (...

...Zoster, live...

...ed Immunosuppression...

...e 50-59 y* (WR, L)21881...

...: age ≥60 y (SR, L)2188...

...w-Level Immunosuppres...

...age 50-59 y* (WR, VL...

...≥60 y (SR, VL)21881...

...l ImmunosuppressionaX: (WR, VL)21881...

...recommended—administer if not previously adm...

...19 years who have previously received...

...Administration of VAR can be considered fo...

...recommendations deviate from CDC ACIP recomm...


...Asplenia o...

...splenic patients or those with sickle cel...

...n patients with sickle cell diseas...

...CV13 should be administered to asplenic patient...

...PPSV23 should be administered to asple...

...al of ≥8 weeks after PCV13, and a second...

...V23--naive patients ≥2 years of age for who...

...≥2 weeks following surgery.* (WR, L)2...

...of Hib should be administered to unvaccinat...

118. Meningococcal vaccine should be admini...

...tion 29 except that MCV4--D should not be...

...cinate with MCV4 (or MPSV4 for those >55 ye...


...Anatom...

...d children with profound deafness scheduled to re...

...ith a cochlear implant, with profound deafness w...

...s ≥24 months of age with a cochlear implant,...

...PPSV23 should be administered ≥2 w...


...Table 7. Vaccin...

...H. influenzae type b...

...or a Sickle Cell Disease...

...age...

...5 y (WR, L)21881...

...Implantsa or CSF LeakU: (SR, M...

...Hepati...

...or a Sickle Cell DiseaseU: (SR,...

...antsa or CSF LeakU: (SR, M)21881

...Hep...

...r a Sickle Cell DiseaseU: (SR, M)21...

...lantsa or CSF LeakU: (SR, M)21881...

...DTaP, Td, ...

...ckle Cell DiseaseU: (SR, M)21881...

...tsa or CSF LeakU: (SR, M)21881...

...HPV...

...Sickle Cell DiseaseU: (SR, M)2188...

Cochlear Implantsa or CSF LeakU: (SR, M)21881

...Influenza, inactivated...

...plenia or a Sickle Cell DiseaseU:...

Cochlear Implantsa or CSF LeakU: (SR...

...Influen...

...or a Sickle Cell DiseaseX: (WR, VL)...

...hlear Implantsa or CSF LeakU: (SR, M)21881...

...MMR, li...

...a or a Sickle Cell DiseaseU: (SR, M)21881...

...Implantsa or CSF LeakU: (SR, M)21881...

...MMRV, li...

...ckle Cell DiseaseU: (SR, M)21881...

...lantsa or CSF LeakU: (SR, M)21881...

...Meningococcal conjugate...

...ia or a Sickle Cell DiseaseR: age 2-55 yb (S...

...r Implantsa or CSF LeakU: (SR, M)21881...

...Me...

...a or a Sickle Cell DiseaseR: age >55 yb (SR...

...mplantsa or CSF LeakU: (SR, M)21881...

...Pneumococcal co...

...or a Sickle Cell Disease...

...age...

...6 yd (SR, VL)2188...

...Implantsa or CSF Leak...

...: age...

...e ≥6 yd (SR, L)2...

...Pneumococca...

...or a Sickle Cell DiseaseR: age ≥2 ye (SR, L)218...

...chlear Implantsa or CSF LeakR: age ≥2 y...

...Poliovirus,...

...a Sickle Cell DiseaseU: (SR, M)2...

...ntsa or CSF LeakU: (SR, M)21881...

...Rotavirus,...

...ckle Cell DiseaseU: (SR, M)21881

...r Implantsa or CSF LeakU: (SR, M)...

...Var...

...ia or a Sickle Cell DiseaseU: (SR, M)21881...

...ochlear Implantsa or CSF LeakU: (SR, M)...

...Zoster...

...plenia or a Sickle Cell DiseaseU: (SR...

...Implantsa or CSF LeakU: (SR, M)2...

...administer if not previously admi...

...If PCV13 has not previously been administered....

...ster 8 or more weeks after indicated dose(s)...