Vaccination of the Immunocompromised Host

Publication Date: December 4, 2013

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

...nsibility for Vaccination...

...sts caring for immunocompromised patients...


...cialists caring for immunocompromised...


Timing of Vaccination

...of Vaccination...

...ld be administered prior to planned im...


...ccines should be administered ≥4 weeks prior to...

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


...d vaccines should be administered ≥2 weeks prior...


Household Members (See Table 1)

...Members (See Table 1)

...ompetent household members of immunocompr...

...for travel. (SR, M)21...


...members of immunocompromised patients 6 months...

...ivated influenza vaccine (IIV) or (SR, H)2...

...tenuated influenza vaccine (LAIV) prov...

...xceptions include household members of an imm...

...ministered, contact between the imm...


...ealthy immunocompetent household me...

...cine in infants ages 2-7 months, (SR, L)21881...

...aricella vaccine (VAR), (SR, M)...

...nd zoster vaccine (ZOS). (SR, M)21881...

...y can safely receive vaccines for t...

...typhoid vaccine. (SR, L)21...


...al poliovirus vaccine (OPV) should NO...


...munocompromised patients should avoid handling...


11. Immunocompromised patients shou...


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

...of Administration of Live Vaccines to Contact...

...za, live, attenuated nasal...

...minister; (SR, L)...

...cinated persons to avoid close contac...


...hedding of Agent? (Site) Transmis...


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


...tavirus, oral Shedding of Age...


Typhoid, oral Shedding of Agen...


...ella Shedding of Agent? (Site...


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


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


International Travel

...ernational Travel...

...cians may administer inactivated vacci...


13. Yellow fever vaccine generally...

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

.... Asymptomatic HIV-infected children...


...th certain exceptions (eg, yellow fever vaccine a...


Specific Vaccinations

...pecific Vaccinat...

...ricella and Zoster Vaccines

...given to immunocompetent patients w...

...it can be administered ≥4 weeks before initi...

...6. A 2-dose schedule of VAR, separated by...

...should NOT be administered to highly immunocompr...

...be considered for patients without evidenc...

19. VAR should be administered to eligible...

...hould be given to patients ≥60 years of age...

.... ZOS should be considered for varicella-positiv...

...be administered to patients ≥60 years of...

...3. ZOS should NOT be administered to highly imm...


...fluenz...

.... Annual influenza vaccination with IIV...

...patients who are very unlikely to resp...

...have received anti-B cell antibodies within 6...

...V should NOT be administered to immunocompro...


Special Populations

...pecial Populations...

...Congenital) Immunodeficiency Disorders...

...imary Complement Deficiencies...

...ients with primary complement deficienc...

...ears old should receive 1 dose of 13-val...

...8 years old with a classical pathway (C1, C2, C3,...

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

...e who have previously received 23-va...

...Patients ≥2 years of age with an early class...

...age 6 weeks through 18 months, administer...

...ose primary series of quadrivalent meningococcal c...

...5 years of age, administer MPSV4 i...

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

...h a primary complement component defic...

...ytic Cell Deficiencies...

...gocytic cell deficiencies include CGD (chronic gr...

...ents with phagocytic cell deficienci...

...-5 years of age should receive PCV13 as in re...

...6 years of age with phagocytic cell deficiencies...

...ts ≥2 years of age with phagocytic cell def...

...erial vaccines, such as bacillus Calmette-Gué...

...iral vaccines should be administer...

...Live viral vaccines should NOT be adminis...

...e or Cellular Activation Defects...

...cts in the immune system resulting in defects of c...

...ith innate immune system defects resulting...

38. For patients with innate immune system...

...pecialist advice should be sought on individual co...

.... Live bacterial vaccines should NOT be...

...ive viral vaccines should NOT be administere...

Minor Antibody Deficie...

...Patients with immunoglobulin A (IgA) deficien...

...with SPAD or ataxia-telangiectasia should rece...

...≥2 years of age should receive P...

...of vaccine responses can be useful for assessi...

...PV should NOT be administered to IgA-d...

...dy Deficiencies in Patients Receiving Immunogl...

...activated vaccines other than IIV are NOT rou...

...ents with suspected major antibody deficiencies...

...IV can be administered to patients with...

...ould NOT be administered to patients with...

...es (other than OPV) should NOT be admi...

...ned Immunodeficiencies...

...For patients with suspected combined...

...h combined immunodeficiencies who are receiving i...

...s with combined immunodeficiencies...

...en with partial DiGeorge syndrome (pDGS) shoul...

...with SCID, DiGeorge syndrome with CD3 T-cell l...


...ults, Adolescents, and Children (See Table...

...activated Vaccines...

...V, (SR, H)21...

...CV13 in patients...

...nfluenzae type b conjugate vaccine (Hib), (SR,...

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

...xoid, reduced diphtheria toxoid, and reduced...

...anus toxoid, reduced diphtheria toxoid...

...s B vaccine (HepB), (SR, M)21881...

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

...ctivated poliovirus vaccine (IPV), (SR,...

...lent human papillomavirus vaccine (HPV4)...

...should be administered to HIV-infe...

...23 should be administered to HIV-infected childre...

...nfected adults with CD4 T-lymphocyte co...

...nfected adults with CD4 T-lymphocyte count...

...be given ≥8 weeks after the indicated dose(s)...

...-infected children who are >59 mon...

...recommended for HIV-infected adults....

...fected children age 11-18 years should receive...

...er dose (third dose) should be given at age...

...CV4 is administered to HIV-infected children 2-10...

...ected patients should receive HepB series, (S...

...sideration of high-dose HepB (40 μg/dose) for a...

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

...months after completion, they should be...

...postvaccination anti-HBs concentration of ≥...

...ministered (alternative: 1 dose of...

...se HepB (40 μg/dose)* (WR, L)2...

...en and high-dose HepB for adolescents* and adults....

...epB containing 20 μg of HBsAg (hepatitis B su...

...Internationally adopted HIV-infected childre...

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

...ve Vaccines

...V-exposed or -infected infants shou...

...cted patients should NOT receive LAIV....

...uld be administered to clinically stable HI...

...ected patients ≥14 years without measles immu...

...ed children with a CD4 T-cell percentage of...

or patients ≥14 years with a CD4 T-cell lymphocy...

...ected patients should NOT receive quadrivalent...

...nonimmune, clinically stable HIV-infe...

...ears with ≥15% CD4 T-lymphocyte percentag...

...d age ≥14 years with CD4 T-lymph...

...should be separated by ≥3 months. (SR, M)21881...


...nation of Persons With HIV Infectio...

...nfluenzae type b conj...

U: age

...e 5–18 yc (SR, L)21881...

...: age

...e 5–18 yc (SR, L)21881...

...patitis A...

...la or No ImmunosuppressionU: (SR,...

...igh-Level ImmunosuppressionbU: age 1 y (SR, M)2188...

...patitis Bd

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

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

DTaP

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

...unosuppressionbU: (SR, M)21881

...dap

...or No ImmunosuppressionU: (SR, VL)2...

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

Td

...w-Levela or No ImmunosuppressionU: (SR, L)2188...

...igh-Level ImmunosuppressionbU:...

HPV4e

...ela or No ImmunosuppressionU: age 11-26 y (SR, VL)...

High-Level ImmunosuppressionbU: age 11-...

Influenza, inactivat...

...ela or No ImmunosuppressionU: (SR, H...

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

...a, live attenuated...

...a or No ImmunosuppressionX:f (WR, VL)21881...

...h-Level ImmunosuppressionbX: (...

MMR, li...

...a or No Immunosuppression...

U: age 12 mo to 13 y (SR...

...14 y (WR, VL)21881...

...vel Immunosuppressionb...

...: age 12 mo to 13 y (SR,...

X: age ≥14 y (SR, M...

MMRV, liv...

...-Levela or No ImmunosuppressionX: (S...

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

...coccal conjugateg...

...w-Levela or No ImmunosuppressionU: age 11...

...igh-Level ImmunosuppressionbU: age 11-1...

...occal conjugate (PCV13)...

Low-Levela or No Immunosuppression

U: ag...

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

...: age 6-18 yh (SR,...

...age ≥19 yi (SR, L)21881

High-Level Immunosuppr...

U: ag...

...ge 5 y (SR, M)21881

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

R: age ≥19 yi (SR, VL)21...

...cal polysaccharide (PPSV23)j...

...ow-Levela or No ImmunosuppressionR: age ...

...h-Level Immunosuppressionb...

...e 2-18 y (SR, M)218...

...ult (CD4 T-lymphocytes...

...rus, inactivated

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

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

...otavirus, liv...

...vela or No ImmunosuppressionU: (SR, L)21...

...igh-Level ImmunosuppressionbU: (...

...ella, live

...la or No Immunosuppression...

...: age 1-8 y (SR, H)2188...

...: age ≥9 y (SR, VL)2188...

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

Zoster,...

...w-Levela or No Immunosuppressio...

X: ag...

...≥60 yk, l (WR, L)2...

...-Level ImmunosuppressionbX: (SR, M)21...

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

d High-dose HepB (40 µg) should b...

...olescents (WR, L)21...

...is preferred over HPV2 because of its...

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

...be administered 8 weeks or longer...

...Vaccination can be considered for...

...r patients not vaccinated with varicella vaccine....


...(See Table 3)...

...tients ≥6 months of age with hematological ma...

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

...xcept those receiving anti-B cell antibodies* (SR,...

...ive chemotherapy, such as for induction o...

...be administered to newly diagnosed adults with h...

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

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

...described in recommendations 27a-c. (, )2188...

PPSV23 should be administered to adults and chil...

...d vaccines (other than IIV) recommended for immuno...

...owever, vaccines administered during cancer ch...

...s documentation of a protective an...

...accines should NOT be administered during chemo...

...ng 3 months following cancer chemot...

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

...MR, (SR, L)21...

...MMRV (WR, VL)21881...

...to the CDC annual schedule routinely in...

...imens included anti-B cell antibod...


...3. Vaccination of Patients With...

...influenzae type b conj...

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

...Months Postchemotherapy and ≥6 Months After Anti...

...patitis A...

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

...arting ≥3 Months Postchemotherapy and...

...epatitis...

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

...g ≥3 Months Postchemotherapy and...

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

...ults (SR, VL)2188...

DTaP, Tdap

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

...ting ≥3 Months Postchemotherapy a...

...e 0-18 y (SR, M)21881...

...adults with acute lymphoblastic leukemia...

HPV

Prior to or During ChemotherapyaU: age 11-26 y...

...Months Postchemotherapy and ≥6 Months Af...

...nfluenza, inactivat...

...ring ChemotherapyaU (SR, L)U (SR-L to M)2188...

...nths Postchemotherapy and ≥6 Months...

...luenza, live attenuate...

...or During ChemotherapyaX: (WR,...

Starting ≥3 Months Postchemotherapy an...

MMR, live

...r During ChemotherapyaX:c (SR, M)21881...

...Months Postchemotherapy and ≥6 Months After...

...RV, live

...uring ChemotherapyaX:c (SR, M)2188...

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

...coccal conjugate...

...r to or During ChemotherapyaU (WR...

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

...coccal conjugate-13 (PCV13)

...or to or During Chemotherapy...

...R, L)21881...

...e ≥6 yd (SR, VL)21881...

...Months Postchemotherapy and ≥6 Months After A...

...coccal polysaccharide (PPSV23)...

...ng ChemotherapyaR: age ≥2 y (SR, L)21881...

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

...liovirus, inacti...

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

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

...irus, live...

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

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

...icella, live...

Prior to or During ChemotherapyaXc (SR, M...

...Months Postchemotherapy and ≥6 Months After Anti...

...ster, live

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

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

...d—administer if not previously administere...

...minister inactivated influenza vaccine (I...

...solid tumor malignancies (SR, L)21881...

...hose receiving anti–B-cell antibodies s...

...ons of inactivated vaccines other than IIV...

...vaccines administered while receiving cance...

...e administered ≤3 months after chemotherapy, bu...

d For patients ≥19 years of age with HIV who h...

...h MMR has been given safely 3 mont...

f For patients ≥19 years of age who...


Hematopoietic Stem Cell Transplant...

...ients Before Transplantation

...nor should be current with routinely recomme...

...MMR, MMRV, VAR, and ZOS administrati...

...nation of the donor for the benefit of...

...or to HSCT, candidates should receive vaccines...

...en the interval to the start of the cond...

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

...Nonimmune HSCT candidates ≥12 months of...

...SCT Patients Post-transplantati...

77. Administer 1 dose of IIV annually...

to persons ≥6 months of age starti...

...starting at 4 months if there is a c...

...ren 6 months through 8 years of age...

...ter 3 doses of PCV13 to adults and chil...

...ter HSCT a dose of PPSV23 should be given...

...patients with chronic GVHD a fourth dose of PCV13...

...dminister 3 doses of Hib starting at 6-1...

...ister 2 doses of MCV4 starting 6-12...

...nister 3 doses of tetanus/diphtheria-containing v...

For childre...

...s 7 years and older, administration...

...ernatively, administer a dose of Tdap f...

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

...2. Administer 3 doses of HepB start...

...postvaccination anti-HBs concentration of ≥...

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

...h dose (40 μg)* (WR, L)21881

...ldren and high dose for adolescents* and a...

...3 doses of IPV starting 6-12 month...

...dministration of 3 doses of HPV starting at 6-12...

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

...dminister a 2-dose series of MMR to meas...

...measles-seronegative children (SR, M)21881...

...minister a 2-dose series of VAR starting 24 mo...


...inations Prior to or After Allogeneic or Autolog...

...influenzae type b conj...

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

...CTR: 3 doses (SR, M)at 6 mo post-tx21881...

...epatitis...

...re-HSCTU: (SR, V...

...: 2 doses (WR, L)at ≥6 mo post-tx21881...

Hepatitis...

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

...R: 3 doses (SR, M)at 6–12 mo post-tx2...

...TaP, DT, Td, Td...

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

...t-HSCT...

...: age

...7 y: DTaP* 3 doses (WR, VL)at ≥6 mo post-tx218...

...dose Tdap, followed by either 2 doses DT...

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

...PV...

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

...CTU: 3 doses at ≥6 mo post-tx (WR, VL)21881...

...luenza, inactivated...

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

Post-HSCT

...4 mo post-tx (SR, VL)if community outbreak;21...

...≥6 mo post-tx (SR, M)21881...

...fluenza, live attenuate...

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

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

...R, live...

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

...CTX:b (SR, L)21881...

...V, live...

...HSCTU:a (WR, VL)21881...

...st-HSCTX: (SR, VL)21881...

...coccal conjugate

...U: (SR, VL)21881

...R: age 11-18 y: 2 doses (SR, L)at 6-12 mo...

...occal conjugate (PCV13)...

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

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

...l polysaccharide (PPSV23)...

Pre-HSCTR:c (SR, V...

...HSCTR: ≥12 mo post-tx if no GVHD (SR, L)2...

...virus, inactivated...

...-HSCTU: (SR, VL)...

...CTR: 3 doses (SR, M)at ≥3 mo post-tx21881...

...avirus, li...

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

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

...ricella, live...

...U:a (SR, L)21881...

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

...ster, li...

Pre-HS...

...,e age 50–59 y* (WR, VL...

...a age ≥60 y (SR, L)21...

...ost-HSCT

...ge 50–59 y* (SR, L)218...

...≥60 y (SR, L)21881...

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

...otes to Table...

...e vaccines should not be administe...

...ter to adolescents and adults (SR, L)2188...

...o children (SR, M)21881...

...reviously administered....

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

...if the patient is not severely immuno...


...an Transplant (See Table 5)

...nd Patients Before Transplant...

...8. Living donors should be current with vaccines...

...R, MMRV, VAR, and ZOS administration should b...

...of donors solely for the recipient’s ben...

...9. Adults and children with chronic or end-stage k...

...0. The following persons should receive...

...1. Adults and children age ≥2 years o...

...th end-stage kidney disease should receive 2 lifet...

...and children ≥2 years of age with end-...

...13 and PPSV23 are indicated, PCV13 should be co...

...s–negative SOT candidates should...

...emodialysis and age ≥20 years they shoul...

...tvaccination anti-HBs concentration of ...

...ternative: 1 dose of HepB after which anti-...

...se* for children (WR, L)21881...

...the high dose for adolescents* and ad...

...atitis A–unvaccinated, undervaccinated, or sero...

...hose ≥2 years. (SR, M)should receive a He...

...A-HepB vaccine can be used for SOT candidat...

...should be administered to SOT candidates ages 11-...

...ndidates 6-11 months of age can re...

If transplantation is delayed (and the child...

...AR should be administered to SOT candi...

...ministered to varicella-naive SOT candidates 6-...

...doses should be administered ≥3 mont...

...idates age ≥60 years (SR, M)21881...

...positive (as defined in recommendation 22)...

SOT Recipient...

...nation should be withheld from SOT r...

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

...9. Standard age-appropriate inactiva...

...ncluding IIV. (SR, M)(Table 5)2188...

...CV13 should be administered starti...

...01. For SOT patients ≥2 years of age,...

...HepB should be considered for chronic hepati...

...VAR should generally not be adminis...

...VAR in children without evidence...

.... Vaccination should not be withheld b...


...accinations Prior to or After Solid Organ Transp...

...zae type b conjugate...

PretransplantU: (SR, M...

...2–6 Months PosttransplantU: (SR, M)21881...

...patitis A...

...transplant

...age 12-23 mo (SR, M)2...

R: age ≥2 y (SR, M...

...arting 2–6 Months PosttransplantR: if not c...

...atitis B...

...etransplant...

...e 1-18 y (SR, M)21...

...ge ≥18 y (SR, M)21881

...ing 2–6 Months PosttransplantR: if...

DTaP, Td...

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

...tarting 2–6 Months PosttransplantU: if not...

...PV...

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

...6 Months Posttransplant...

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

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

...uenza, inactivated...

PretransplantU: (SR,...

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

...nza, live attenuate...

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

Starting 2–6 Months PosttransplantX: (WR, L)...

..., live...

...etransplant

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

...12 mo (SR, M)21881...

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

...RV, live

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

...ng 2–6 Months PosttransplantX: (SR, L)2...

...eningococcal conjugate...

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

...2–6 Months PosttransplantU: (SR, M)21...

...mococcal conjugate (...

...etransplan...

...age

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

...ing 2–6 Months Posttransplan...

...: age 2-5 y (SR, M)21...

...f not administered pretransplante (S...

...occal polysaccharide (PPSV23)...

...ansplantR: age ≥2 y (SR, M...

...Months PosttransplantR: age ≥2...

...irus, inactivated...

...ransplantU: (SR, M)2...

...ting 2–6 Months PosttransplantU: (SR, M)21881...

...tavirus, li...

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

...2–6 Months PosttransplantX: (SR, L)21881...

Varicella,...

Pretranspl...

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

...SR, L)21881...

...arting 2–6 Months PosttransplantX:g (SR, L)2...

...ster, live...

Pretranspla...

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

...ge ≥60 y (SR, M)218...

...onths PosttransplantX: (SR, L)21881...

...commended—administer if not previously admi...

...er hepatitis B vaccine for hepatitis B-infected li...

...may be administered to SOT recipien...

...inister only if patient is not immun...

...nts ≥19 years who have previousl...

...ter only if patient is not immunosuppressed and th...


...lammatory Disease Patients Taking Immunosuppore...

...vaccines, including IIV, should be admin...

...treated with immunosuppressive ag...

...should be administered to adults and ch...

...uld be administered to patients ≥2 year...

...ow-level immunosuppression, (SR, L)218...

...h-level immunosuppression. (SR, VL)2188...

...tients should receive PPSV23 ≥8 weeks...

...should be administered to patient...

...to initiation of immunosuppression, (SR,...

...VAR should be considered for patients w...

...ZOS should be administered to patients with...

...while being treated with low-dose immuno...

...o those who are 50-59 years of age and varicella-p...

...being treated with low-dose immunosuppression.*...

...ive vaccines should NOT be administered to pati...

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

...high-level immunosuppression, (WR,...

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

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

...therwise recommended vaccines, includin...


...ination of Persons With Chronic Inflammatory Di...

...zae type b conjugate...

...ed ImmunosuppressionU: (SR, M)21...

...-Level ImmunosuppressionaU: (SR, L)2188...

...gh-Level ImmunosuppressionaU: (...

...patitis...

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

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

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

Hepatitis...

...ImmunosuppressionU: (SR, M)2188...

...w-Level ImmunosuppressionaU: (SR, L)2...

...Level ImmunosuppressionaU: (SR, L)2188...

..., Td, Tda...

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

...-Level ImmunosuppressionaU: (SR, L)2188...

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

...PV...

...anned ImmunosuppressionU: age 11-26 y (SR,...

...ImmunosuppressionaU: age 11-26 y (SR, L)...

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

...nza, inactivated...

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

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

...ImmunosuppressionaU: (SR, M)2188...

Influenza, live at...

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

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

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

..., live...

...ed ImmunosuppressionU:b (SR, M)2188...

...Level ImmunosuppressionaX: (WR,...

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

MMRV, live

...ImmunosuppressionU:b (SR, L)21...

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

...igh-Level ImmunosuppressionaX: (S...

Meningococcal con...

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

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

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

...occal conjugate (PCV13)...

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

...vel Immunosuppressiona

...: age...

...age ≥6 yc (SR, VL...

...el Immunosuppression...

...age

R: age ≥6 yc (SR, V...

...al polysaccharide (PPSV23)

Planned ImmunosuppressionR: age ≥2 y (SR, L)21...

...vel ImmunosuppressionaR: age ≥2 y (SR, L...

...nosuppressionaR: age ≥2 y (SR, VL)21881...

...oliovirus, inactivated

...lanned ImmunosuppressionU: (SR, M)2188...

...-Level ImmunosuppressionaU: (SR, M)21...

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

...irus, live...

...ed ImmunosuppressionU: (SR, M)2...

...ow-Level ImmunosuppressionaX: (...

...gh-Level ImmunosuppressionaX: (WR, VL)218...

...cella, live

...anned ImmunosuppressionU:d (SR,...

...l ImmunosuppressionaX:d (WR, VL...

...igh-Level ImmunosuppressionaX: (SR...

...ter, live...

...anned Immunosuppres...

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

...age ≥60 y (SR, L)218...

...Immunosuppressiona...

...age 50-59 y* (WR, VL)218...

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

...evel ImmunosuppressionaX: (WR, V...

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

...s ≥19 years who have previously received PPSV2...

...ation of VAR can be considered for no...

...e recommendations deviate from CDC ACIP recommenda...


...ckle Cell Diseases (See Table 7)...

...Asplenic patients or those with sick...

...atients with sickle cell disease....

...ld be administered to asplenic patients or pa...

...uld be administered to asplenic patients or patie...

...erval of ≥8 weeks after PCV13, a...

For PPSV23--naive patients ≥2 yea...

...following surgery.* (WR, L)21881...

117. One dose of Hib should be administered to...

...al vaccine should be administered to pa...

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

...vaccinate with MCV4 (or MPSV4 for those >55 year...


...ic Barrier Defects (See Tabl...

...children with profound deafness scheduled...

...atients with a cochlear implant, with p...

...≥24 months of age with a cochlear impla...

...PCV13 and PPSV23 should be administ...


...accination of Persons With Asplenia or a...

...influenzae type b c...

...plenia or a Sickle Cell Diseas...

...age...

...age ≥5 y (WR, L)21881

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

...atitis A...

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

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

...patitis...

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

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

DTaP, Td,...

...lenia or a Sickle Cell DiseaseU: (SR, M)218...

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

...PV...

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

...ntsa or CSF LeakU: (SR, M)21881...

...fluenza, inactivat...

...Sickle Cell DiseaseU: (SR, M)218...

...tsa or CSF LeakU: (SR, M)21881...

...fluenza, live attenuate...

...or a Sickle Cell DiseaseX: (WR, VL)21881

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

..., live...

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

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

...V, live...

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

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

...gococcal conjugate

...plenia or a Sickle Cell DiseaseR: age 2-...

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

...ingococcal polysacchari...

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

...ar Implantsa or CSF LeakU: (SR,...

...umococcal conjugate...

...or a Sickle Cell Disease...

...age...

...age ≥6 yd (SR, VL)218...

...ochlear Implantsa or...

...: age...

R: age ≥6 yd (SR,...

...cal polysaccharide (PPSV2...

...ckle Cell DiseaseR: age ≥2 ye (SR, L)2188...

...plantsa or CSF LeakR: age ≥2 ye (SR, M...

...liovirus, inactivated...

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

...ochlear Implantsa or CSF LeakU: (S...

...virus, liv...

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

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

Varicella,...

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

...r Implantsa or CSF LeakU: (SR,...

...ster, live...

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

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

...ended—administer if not previously admi...

...f PCV13 has not previously been admini...

...inister 8 or more weeks after indicated d...