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
...bility for Vaccinati...
...Specialists caring for immunocompro...
...caring for immunocompromised patients...
Timing of Vaccination
...ming of Vaccinat...
...should be administered prior to pla...
...should be administered ≥4 weeks prior to immu...
...uld be avoided within 2 weeks of initi...
...Inactivated vaccines should be administe...
Household Members (See Table 1)
...d Members (See Table 1)...
...mmunocompetent household members of immunocompromi...
...for travel. (SR, M)21881...
...usehold members of immunocompromised patient...
...tivated influenza vaccine (IIV) or (SR,...
...Live attenuated influenza vaccine...
...include household members of an immunocompr...
...administered, contact between the immuno...
8. Healthy immunocompetent household members of im...
...us vaccine in infants ages 2-7 months, (SR, L)218...
...cella vaccine (VAR), (SR,...
...ster vaccine (ZOS). (SR, M)...
...y can safely receive vaccines for travel: ye...
...al typhoid vaccine. (SR, L)21881...
...l poliovirus vaccine (OPV) should NOT be administ...
.... Highly immunocompromised patients should av...
...munocompromised patients should avoid...
Table 1. Safety of Administration of Live Vaccines to Contacts of Immunocompromised Persons
...ble 1. Safety of Administration of L...
...live, attenuated nasal
...er; (SR, L)21881...
...accinated persons to avoid close contact wi...
...Shedding of Agent? (Site) Transm...
...oral Shedding of Agent? (Site)...
...rus, oral Shedding of Agent? (Site)...
...Shedding of Agent? (Site)...
...Shedding of Agent? (Site) T...
...Shedding of Agent? (Site) Transmis...
...Shedding of Agent? (Site) Transmissibi...
International Travel
...nternational Trave...
...Clinicians may administer inactivate...
...ever vaccine generally should NOT b...
...ic HIV-infected adults with CD4 T-cell lymphocyte...
...symptomatic HIV-infected children age 9 month...
...ith certain exceptions (eg, yellow fever vaccine...
Specific Vaccinations
...ecific Vaccinat...
...and Zoster Vaccines...
VAR should be given to immunocompete...
...be administered ≥4 weeks before init...
...ose schedule of VAR, separated by >4 weeks...
...OT be administered to highly immunocompromised pa...
...be considered for patients without evidence of...
...be administered to eligible immunocomp...
...d be given to patients ≥60 years of age if it...
...should be considered for varicella-positive patie...
...should be administered to patients ≥60 y...
...NOT be administered to highly immunocompromi...
...luenza...
...enza vaccination with IIV is recommended for imm...
...nts who are very unlikely to respond (although...
...those who have received anti-B cell...
...5. LAIV should NOT be administered to...
Special Populations
...ecial Populati...
Primary (Congenital) Immunodeficiency...
...Complement Deficiencies...
...h primary complement deficiencies should receive...
...ld should receive 1 dose of 13-valent pneumoc...
...6-18 years old with a classical pathway (C...
...ears old with a classical pathway...
...ose who have previously received 23-valent pneumo...
...8. Patients ≥2 years of age with...
...r children age 6 weeks through 18 months, admin...
...dose primary series of quadrivalent meningoc...
For persons >55 years of age, administer...
...9-23 months of age, administer the doses 3...
...with a primary complement component deficien...
...ytic Cell Deficiencies...
...ell deficiencies include CGD (chronic granulo...
...Patients with phagocytic cell defic...
...ildren 2-5 years of age should receive PCV1...
...¥6 years of age with phagocytic cell defic...
...3. Patients ≥2 years of age with phagocyti...
...rial vaccines, such as bacillus Calmett...
...e viral vaccines should be administered to pat...
...vaccines should NOT be administered...
...nate Cytokine or Cellular Activation Defe...
...n the immune system resulting in defects of cytok...
...h innate immune system defects resu...
...nts with innate immune system defects resultin...
...ist advice should be sought on individual cond...
...ial vaccines should NOT be administered...
...accines should NOT be administered to patients...
...nor Antibody Defici...
...with immunoglobulin A (IgA) deficiency or spec...
...Children with SPAD or ataxia-telangie...
...rs of age should receive PPSV23 ≥8 wee...
44. Monitoring of vaccine responses can be u...
...5. OPV should NOT be administered to I...
...dy Deficiencies in Patients Receivi...
...vaccines other than IIV are NOT routinely...
...or patients with suspected major antibody d...
...be administered to patients with major ant...
...ive OPV should NOT be administered to patients wit...
...e vaccines (other than OPV) should NOT be adminis...
...Immunodeficiencies...
...with suspected combined immunodeficiencies, all...
...with combined immunodeficiencies who...
.... For patients with combined immunodefici...
...n with partial DiGeorge syndrome (pDGS) should un...
...th SCID, DiGeorge syndrome with CD3 T-cell lymphoc...
...dults, Adolescents, and Children (See Table...
...tivated Vaccines...
...(SR, H)21881...
PCV13 in patients
.... influenzae type b conjugate vaccine (Hib), (...
...eria toxoid, tetanus toxoid, acellular...
...oxoid, reduced diphtheria toxoid, and...
...toxoid, reduced diphtheria toxoid va...
...itis B vaccine (HepB), (SR, M)...
...epatitis A vaccine (HepA), (SR, M)2...
...vated poliovirus vaccine (IPV), (SR, M)21...
...nt human papillomavirus vaccine (HPV4)* i...
...ld be administered to HIV-infected pati...
...23 should be administered to HIV-infec...
...IV-infected adults with CD4 T-lymphocyte co...
...ected adults with CD4 T-lymphocyte coun...
...e given ≥8 weeks after the indicated d...
...d children who are >59 months of age and...
...NOT recommended for HIV-infected adults. (...
...children age 11-18 years should receive a 2-dose...
...le booster dose (third dose) should be gi...
...nistered to HIV-infected children...
...HIV-infected patients should receive H...
...eration of high-dose HepB (40 μg/dose) for adu...
...dolescents.* (WR, L)21881
...months after completion, they should be test...
...postvaccination anti-HBs concentration of â...
...ministered (alternative: 1 dose of HepB after...
...HepB (40 μg/dose)* (WR, L)2188...
...or children and high-dose HepB for a...
.... HepB containing 20 μg of HBsAg (hepatit...
...Internationally adopted HIV-infected ch...
...HPV4 is recommended over bivalent human papill...
Live Vaccines
...xposed or -infected infants should...
...infected patients should NOT receive...
...uld be administered to clinically st...
...fected patients ≥14 years without measles im...
...ed children with a CD4 T-cell percent...
...≥14 years with a CD4 T-cell lymphocyte count...
...IV-infected patients should NOT receive quadr...
...cella-nonimmune, clinically stable HIV-infected p...
...years with ≥15% CD4 T-lymphocyte percentage,...
...≥14 years with CD4 T-lymphocyte...
...doses should be separated by ≥3 mo...
...le 2. Vaccination of Persons With...
H. influenzae type b c...
U: age
...age 5–18 yc (SR, L)21...
U: ag...
...ge 5–18 yc (SR, L)...
...patitis A...
...a or No ImmunosuppressionU: (SR, M)2...
...gh-Level ImmunosuppressionbU: age 1 y (SR, M)218...
...titis Bd...
...r No ImmunosuppressionR: (SR, M)21881...
...mmunosuppressionbR: (SR, M)21881...
...TaP
...vela or No ImmunosuppressionU: (S...
...unosuppressionbU: (SR, M)21881...
Tdap
...Levela or No ImmunosuppressionU: (SR, VL)2...
...-Level ImmunosuppressionbU: (SR,...
Td
...o ImmunosuppressionU: (SR, L)21881...
...ImmunosuppressionbU: (SR, L)21881
HPV4e
...w-Levela or No ImmunosuppressionU: age 11-26...
...gh-Level ImmunosuppressionbU: age 11-2...
...nza, inactivated...
Low-Levela or No ImmunosuppressionU: (SR...
...unosuppressionbU: (SR, H)21881
...za, live attenuated...
...o ImmunosuppressionX:f (WR, VL)21881...
...h-Level ImmunosuppressionbX: (WR, V...
MMR, live
...a or No Immunosuppression
...12 mo to 13 y (SR, M)2...
U: age ≥14 y (WR, VL)2188...
...l Immunosuppressionb...
...mo to 13 y (SR, M)21881...
...≥14 y (SR, M)21881...
...MRV, li...
...o ImmunosuppressionX: (SR, VL)21881...
...l ImmunosuppressionbX: (SR, VL)2188...
...eningococcal conjugat...
Low-Levela or No ImmunosuppressionU: age 11...
...mmunosuppressionbU: age 11-18 y (SR, M)21881...
...al conjugate (PCV13)
...a or No Immunosuppression
U: age...
...: age 5 yh (SR, M)21...
...age 6-18 yh (SR, L)21881...
...≥19 yi (SR, L)2188...
...igh-Level Immunosuppre...
U: ag...
...ge 5 y (SR, M)2188...
...age 6-18 y (SR, L)21...
...ge ≥19 yi (SR, VL)21881...
...neumococcal polysaccharide (PPSV23)...
...ow-Levela or No ImmunosuppressionR: age ≥...
...h-Level Immunosuppressi...
...age 2-18 y (SR, M)21881...
...: adult (CD4 T-lymphocytes
Poliovirus, inactiva...
...ImmunosuppressionU: (SR, M)21881...
...munosuppressionbU: (SR, M)21881...
...otavirus, live...
Low-Levela or No ImmunosuppressionU:...
...igh-Level ImmunosuppressionbU: (WR, VL...
...aricella, live...
...la or No Immunosuppressi...
...1-8 y (SR, H)21881
...: age ≥9 y (SR, V...
...mmunosuppressionbX: (SR, M)21881...
...er, live...
...ow-Levela or No Immunosupp...
X: ag...
...≥60 yk, l (WR, L)2188...
...munosuppressionbX: (SR, M)21881...
...ommended—administer if not previo...
...-dose HepB (40 µg) should be consid...
...d adolescents (WR, L)218...
...referred over HPV2 because of its activity agai...
...or patients ≥19 years of age with HIV who have...
...should be administered 8 weeks or lon...
...ion can be considered for patients 50...
...ents not vaccinated with varicella vaccine....
...ancer (See Table...
...≥6 months of age with hematologic...
...d tumor malignancies (SR, L)21881...
...ept those receiving anti-B cell antibodies* (SR,...
...chemotherapy, such as for induction or consolidat...
...uld be administered to newly diagnosed ad...
...malignancies (SR, VL)218...
...hildren with malignancies (SR, VL)218...
...in recommendations 27a-c. (, )21881...
...be administered to adults and children ≥2 ye...
...ed vaccines (other than IIV) recommended for im...
...ver, vaccines administered during cancer chemothe...
...there is documentation of a protective...
...vaccines should NOT be administered during chem...
...3. Starting 3 months following can...
and the live vaccines VAR, (WR...
...(SR, L)21881
...nd MMRV (WR, VL)2188...
...ccording to the CDC annual schedule r...
...cluded anti-B cell antibodies, vaccinat...
...3. Vaccination of Patients With Cancer
.... influenzae type b conjug...
...uring ChemotherapyaU: (WR, L)21881...
Starting ≥3 Months Postchemotherapy and...
...atitis A...
...r During ChemotherapyaU: (WR, L)21881...
...ing ≥3 Months Postchemotherapy and ≥6 Mon...
...epatitis B
Prior to or During ChemotherapyaU: (WR, L...
...≥3 Months Postchemotherapy and â...
...: (SR, M)2...
...ts (SR, VL)21881...
...P, Tdap...
...to or During ChemotherapyaU: (WR, L)21881...
...≥3 Months Postchemotherapy and ≥6 Mont...
...ge 0-18 y (SR, M)2...
R: adults with acute lymphoblastic leukem...
...PV...
...uring ChemotherapyaU: age 11-26 y (WR, VL)218...
Starting ≥3 Months Postchemotherapy and ≥6...
...uenza, inactivated...
...uring ChemotherapyaU (SR, L)U (SR-L to M...
...≥3 Months Postchemotherapy and ≥6 Months...
...nza, live attenuated...
...r During ChemotherapyaX: (WR, VL)2...
...Months Postchemotherapy and ≥6 Months After An...
...MR, live
...to or During ChemotherapyaX:c (SR,...
...g ≥3 Months Postchemotherapy and...
...V, live...
...to or During ChemotherapyaX:c (SR, M)...
...3 Months Postchemotherapy and ≥6...
Meningococcal conjugat...
...to or During ChemotherapyaU (WR, L)21881...
...≥3 Months Postchemotherapy and ≥...
...ccal conjugate-13 (PCV13)...
...r to or During Chemotherapy...
...R, L)21881
...ge ≥6 yd (SR, VL)218...
Starting ≥3 Months Postchemotherapy and ≥6 M...
...eumococcal polysaccharide (PPSV...
...or During ChemotherapyaR: age ≥2 y (SR, L)21881...
...≥3 Months Postchemotherapy and ≥6 M...
...rus, inactivated...
...r to or During ChemotherapyaU: (W...
...Months Postchemotherapy and ≥6 Months...
...tavirus, live...
...ng ChemotherapyaX: (SR, VL)21881...
...ng ≥3 Months Postchemotherapy and...
...ricella, live...
...ring ChemotherapyaXc (SR, M)21881...
...ng ≥3 Months Postchemotherapy and ≥6 M...
...er, live...
...or During ChemotherapyaX:c (SR, VL)21881...
...arting ≥3 Months Postchemotherap...
...commended—administer if not previously administe...
...dminister inactivated influenza vaccine (II...
...r malignancies (SR, L)21881...
...xcept those receiving anti–B-cel...
...inistrations of inactivated vaccines other...
...vaccines administered while receiving cancer chemo...
...administered ≤3 months after chemotherap...
...ts ≥19 years of age with HIV who have previous...
...lthough MMR has been given safely...
...atients ≥19 years of age who have previ...
...Stem Cell Transplant (See Table 4)...
...Patients Before Transplantat...
...HSCT donor should be current with rout...
but MMR, MMRV, VAR, and ZOS administration...
...the donor for the benefit of the recipien...
...T, candidates should receive vaccin...
...interval to the start of the conditioni...
...or inactivated vaccines. (SR, M)21881...
...mune HSCT candidates ≥12 months of age should...
...Patients Post-transplanta...
...ister 1 dose of IIV annually. (SR,...
...rsons ≥6 months of age starting 6 months aft...
...ting at 4 months if there is a community outbr...
...onths through 8 years of age who are receiving i...
...Administer 3 doses of PCV13 to adults and childr...
At 12 months after HSCT a dose of...
...nts with chronic GVHD a fourth dose of PCV1...
...ister 3 doses of Hib starting at 6-12 months after...
...minister 2 doses of MCV4 starting 6-12 month...
...3 doses of tetanus/diphtheria-contain...
...children...
For patients 7 years and older, administra...
...vely, administer a dose of Tdap fo...
...2 doses of Td. (WR, L...
...minister 3 doses of HepB starting a...
...ostvaccination anti-HBs concentration of...
...ative: 1 dose of HepB after which an...
...dose (40 μg)* (WR, L)21881...
...dren and high dose for adolescents* and...
83. Administer 3 doses of IPV starting 6-12 mo...
...ider administration of 3 doses of HPV st...
...Do not administer live vaccines to HSCT patients w...
...ister a 2-dose series of MMR to measles-seronega...
...asles-seronegative children (SR, M)21881...
...er a 2-dose series of VAR starting 24 mo...
...tions Prior to or After Allogeneic or A...
...nzae type b conjugate...
...TU: (SR, M)21881...
...SCTR: 3 doses (SR, M)at 6 mo post-...
...epatitis A...
...TU: (SR, VL)21881...
Post-HSCTR: 2 doses (WR, L)at ≥6 mo pos...
...atitis B...
...CTU: (SR, L)21881...
...CTR: 3 doses (SR, M)at 6–12 mo post-tx218...
..., DT, Td, Tdap...
...re-HSCTU: (SR, L...
...st-HSCT...
...age...
...y: DTaP* 3 doses (WR, VL)at ≥6 mo...
...ose Tdap, followed by either 2 doses DT* or 2 dos...
..., Td (WR, L)2...
...PV
...U: age 11-26 y (SR, VL)2...
...doses at ≥6 mo post-tx (WR, VL)21881...
...nfluenza, inactivated...
...HSCTU: (SR, L)21881...
...t-HSCT
...-tx (SR, VL)if community outbreak;...
...e ≥6 mo post-tx (SR, M)21...
...uenza, live attenuated
...X: (WR, VL)21881...
Post-HSCTX: (WR, VL...
MMR, liv...
...SCTU:a (SR, VL)2188...
...ost-HSCTX:b (SR, L)21881...
...RV, live...
...HSCTU:a (WR, VL)21881
Post-HSCTX: (SR, VL)2188...
...ngococcal conjugat...
...CTU: (SR, VL)218...
...e 11-18 y: 2 doses (SR, L)at 6-12 mo post...
...eumococcal conjugate...
Pre-HSCTR:c (SR, L)21...
...TR: 3 doses (SR, L)at 3-6 mo posttx21881...
...cal polysaccharide (PPSV23)...
...re-HSCTR:c (SR, VL)...
...t-HSCTR: ≥12 mo post-tx if no GVHD (SR, L)...
Poliovirus, inactivate...
Pre-HSCTU: (SR, V...
...: 3 doses (SR, M)at ≥3 mo post-tx21881...
...otavirus, live
Pre-HSCTX: (WR, VL)2188...
...CTX: (WR, VL)2188...
...ella, live
...SCTU:a (SR, L)21881...
...TX:d (SR, L)21881
...ter, live...
Pre-HSCT
...0–59 y* (WR, VL)21881...
...‰¥60 y (SR, L)21881...
...ost-HSC...
...–59 y* (SR, L)21881...
...age ≥60 y (SR, L)21881...
...”administer if not previously administered or...
...notes to Table...
...vaccines should not be administered unless the v...
...nister to adolescents and adults (SR,...
and to children (SR, M)2188...
...f not previously administered....
...ister if varicella-seronegative, the timing is â‰...
...nsider if the patient is not severely immunosuppre...
...Organ Transplant (See Table 5...
...d Patients Before Transplantation...
...donors should be current with vaccines bas...
but MMR, MMRV, VAR, and ZOS administratio...
...of donors solely for the recipient...
...children with chronic or end-stage kidney, liver,...
...he following persons should receive...
91. Adults and children age ≥2 y...
...h end-stage kidney disease should...
...hildren ≥2 years of age with end-...
...oth PCV13 and PPSV23 are indicated, PCV...
...–negative SOT candidates should receive a He...
...on hemodialysis and age ≥20 years they should...
...stvaccination anti-HBs concentration of ≥10...
...tive: 1 dose of HepB after which anti-HBs...
...ose* for children (WR, L)21881...
...e high dose for adolescents* and adults. (S...
...unvaccinated, undervaccinated, or seronega...
...those ≥2 years. (SR, M)should receive a...
...A-HepB vaccine can be used for SOT candidates...
...series should be administered to SOT candidate...
...5. SOT candidates 6-11 months of age can re...
...transplantation is delayed (and the child is no...
...should be administered to SOT candidates witho...
...an be administered to varicella-naive S...
..., 2 doses should be administered ≥3 months apar...
...didates age ≥60 years (SR, M)21881...
...cella-positive (as defined in recommendation...
...Recipients...
...cination should be withheld from S...
...t that IIV can be administered ≥1...
...rd age-appropriate inactivated vaccine se...
...luding IIV. (SR, M)(Table 5)21881...
...13 should be administered starting 2-6...
...ients ≥2 years of age, 1 dose of PPSV23 sh...
...should be considered for chronic h...
...R and VAR should generally not be adminis...
...t for VAR in children without evidence of immuni...
104. Vaccination should not be withheld b...
...le 5. Vaccinations Prior to or After...
...influenzae type b conjugate...
...splantU: (SR, M)21881...
...2–6 Months PosttransplantU: (SR, M)21881...
...patitis A...
...etransplant
...age 12-23 mo (SR, M)...
...ge ≥2 y (SR, M)21881...
...ng 2–6 Months PosttransplantR: if not com...
...patitis...
...ransplant...
...1-18 y (SR, M)21881...
...age ≥18 y (SR, M)21881
...tarting 2–6 Months PosttransplantR: if not...
DTaP, Td...
...nsplantU: (SR, M)21881...
...ting 2–6 Months PosttransplantU: if...
HP...
...etransplantU: females age 11-26 y (SR,...
...rting 2–6 Months Posttran...
...females age 11-26 y (SR,...
...age 11-26 y (SR, L)21881...
...nza, inactivated...
...nsplantU: (SR, M)21881...
...ing 2–6 Months PosttransplantU:b (SR, M)2188...
...luenza, live attenuated
...ransplantX: (WR, L)2...
...onths PosttransplantX: (WR, L)21881...
..., live
...etransplan...
...age 6-11 mo (WR, VL)21881...
...ge ≥12 mo (SR, M)21881...
...tarting 2–6 Months PosttransplantX: (SR, L)218...
...RV, live
...ansplantU:d (SR, M)21881...
...6 Months PosttransplantX: (SR, L)21881...
...eningococcal conj...
...etransplantU: (SR, M)21881
...arting 2–6 Months PosttransplantU: (SR, M)21...
...umococcal conjugate (PC...
...ransplant...
...age
R: age ≥6 ye (SR, V...
...g 2–6 Months Posttranspl...
...ge 2-5 y (SR, M)21881...
...y, if not administered pretransplante (SR, V...
...polysaccharide (PPSV23)...
...antR: age ≥2 y (SR, M)21881...
...“6 Months PosttransplantR: age ≥2 y, if no...
...iovirus, inactivated...
...transplantU: (SR, M)21881...
...ing 2–6 Months PosttransplantU: (SR, M)218...
...irus, live...
...transplantU:c (SR, M...
...€“6 Months PosttransplantX: (SR, L)2188...
...aricella, li...
...etranspla...
...age 6-11 mo (WR, VL)21881
U:d (SR, L)...
...€“6 Months PosttransplantX:g (SR, L)21881...
...er, live...
...retransplant
...:h age 50-59 y (WR, L)218...
U:i age ≥60 y (SR, M)2...
...ing 2–6 Months PosttransplantX: (SR, L)21881...
..., recommended—administer if not previously...
...hepatitis B vaccine for hepatitis B-infe...
...IV may be administered to SOT recipients d...
...nister only if patient is not immunosupp...
...nts ≥19 years who have previously received P...
f Administer only if patient is not immunosuppre...
...flammatory Disease Patients Taking Immunosu...
...5. Inactivated vaccines, including IIV...
...out to be treated with immunosuppressive agents. (...
...ould be administered to adults and children w...
...V23 should be administered to patients ≥2 yea...
...ow-level immunosuppression, (SR, L)...
...evel immunosuppression. (SR, VL)...
...ients should receive PPSV23 ≥8 weeks...
...ould be administered to patients with chronic infl...
...prior to initiation of immunosuppression, (S...
...be considered for patients without evidence of...
...uld be administered to patients with a...
...reated with low-dose immunosuppression, (SR, VL)21...
...those who are 50-59 years of age and varicell...
...while being treated with low-dose immunosup...
111. Other live vaccines should NOT be administer...
...in patients receiving low-level (WR,...
...vel immunosuppression, (WR, VL)21881...
...patients receiving low-level (WR, VL)21881...
...immunosuppression. (SR, VL)21881...
...wise recommended vaccines, includi...
Table 6. Vaccination of Persons With Chronic Infl...
...nzae type b conjugat...
...lanned ImmunosuppressionU: (SR, M)21881
...ImmunosuppressionaU: (SR, L)21881...
...h-Level ImmunosuppressionaU: (SR, L)2188...
...epatitis A
...osuppressionU: (SR, M)21881...
...munosuppressionaU: (SR, L)21881...
...ImmunosuppressionaU: (SR, L)21...
...atitis B...
...nned ImmunosuppressionU: (SR, M...
...munosuppressionaU: (SR, L)21881...
High-Level ImmunosuppressionaU...
...aP, Td, Tdap...
Planned ImmunosuppressionU: (SR, M)2188...
Low-Level ImmunosuppressionaU: (SR...
...munosuppressionaU: (SR, L)21881...
...PV
...ImmunosuppressionU: age 11-26 y (SR, M)2188...
...-Level ImmunosuppressionaU: age 11-2...
...-Level ImmunosuppressionaU: age 11-...
...za, inactivated
...unosuppressionU: (SR, M)21881...
...Level ImmunosuppressionaU: (SR, M...
...ImmunosuppressionaU: (SR, M)21881...
Influenza, live atten...
...d ImmunosuppressionX: (WR, VL)2188...
Low-Level ImmunosuppressionaX: (WR, VL...
...Level ImmunosuppressionaX: (WR, VL)21881...
...MR, live
...munosuppressionU:b (SR, M)218...
...nosuppressionaX: (WR, VL)21881...
...Level ImmunosuppressionaX: (WR,...
MMRV, li...
Planned ImmunosuppressionU:b (SR, L)218...
...ImmunosuppressionaX: (WR, VL)21881...
...nosuppressionaX: (SR, VL)21881...
...eningococcal conjug...
Planned ImmunosuppressionU: (SR, M)21...
...ImmunosuppressionaU: (SR, M)21881...
...Level ImmunosuppressionaU: (SR, L)21881...
...ococcal conjugate (PCV13...
...lanned ImmunosuppressionR:c (SR...
...l Immunosuppressiona...
...: age
...ge ≥6 yc (SR, VL)2188...
High-Level Immunosuppre...
U: ag...
R: age ≥6 yc (SR, VL...
...l polysaccharide (PPSV23)...
...ned ImmunosuppressionR: age ≥2 y (SR, L)2...
...munosuppressionaR: age ≥2 y (SR, L)...
...ImmunosuppressionaR: age ≥2 y (SR, VL)2188...
...irus, inactivate...
...ImmunosuppressionU: (SR, M)21881...
...l ImmunosuppressionaU: (SR, M)21881...
...unosuppressionaU: (SR, L)21881...
...virus, liv...
Planned ImmunosuppressionU: (SR,...
...munosuppressionaX: (WR, VL)21881...
...ImmunosuppressionaX: (WR, VL)21881...
...aricella, live
...ImmunosuppressionU:d (SR, M)21881...
...evel ImmunosuppressionaX:d (WR, VL)21...
...ImmunosuppressionaX: (SR, M)218...
Zoster, li...
...d Immunosuppression...
...0-59 y* (WR, L)21881...
U: age ≥60 y (SR,...
Low-Level Immunosup...
R: age 50-59 y* (WR, VL)21881
U: age ≥60 y (SR, VL)2188...
...munosuppressionaX: (WR, VL)21881...
...recommended—administer if not previously...
...‰¥19 years who have previously received PPSV23...
...stration of VAR can be considered for non–vari...
...dations deviate from CDC ACIP reco...
...enia or Sickle Cell Diseases (See Table 7)...
...Asplenic patients or those with sickle cell di...
...ept LAIV in patients with sickle cell disease. (WR...
...14. PCV13 should be administered to asplenic pat...
...PSV23 should be administered to asplenic pa...
...th an interval of ≥8 weeks after...
For PPSV23--naive patients ≥2 yea...
...r ≥2 weeks following surgery.* (WR...
...of Hib should be administered to unvaccinate...
...coccal vaccine should be administered to...
...ndation 29 except that MCV4--D should no...
...ccinate with MCV4 (or MPSV4 for those >55 ye...
...omic Barrier Defects (See...
...Adults and children with profound deafness sched...
...with a cochlear implant, with profound deafness...
...‰¥24 months of age with a cochlear im...
...and PPSV23 should be administered ≥2...
.... Vaccination of Persons With Asplenia or a Si...
...influenzae type b conjuga...
...a Sickle Cell Disease...
...age
...‰¥5 y (WR, L)21881...
...ntsa or CSF LeakU: (SR, M)21881...
...patitis A...
...a Sickle Cell DiseaseU: (SR, M)21881...
...tsa or CSF LeakU: (SR, M)21881...
...patitis B
...r a Sickle Cell DiseaseU: (SR, M)21881...
...ntsa or CSF LeakU: (SR, M)21881...
...TaP, Td, ...
...a or a Sickle Cell DiseaseU: (SR...
...lear Implantsa or CSF LeakU: (SR, M...
...PV
...nia or a Sickle Cell DiseaseU: (SR, M)21881...
Cochlear Implantsa or CSF LeakU: (S...
...za, inactivated...
...a Sickle Cell DiseaseU: (SR, M)2...
...hlear Implantsa or CSF LeakU:...
...nfluenza, live attenua...
...Sickle Cell DiseaseX: (WR, VL)21881...
...ntsa or CSF LeakU: (SR, M)21881...
...MR, li...
...plenia or a Sickle Cell DiseaseU: (SR, M)21881...
...ear Implantsa or CSF LeakU: (SR...
...MRV, li...
...splenia or a Sickle Cell DiseaseU: (SR, M)2188...
...hlear Implantsa or CSF LeakU: (SR, M...
...ngococcal conjugate...
...ia or a Sickle Cell DiseaseR: age...
...chlear Implantsa or CSF LeakU: (SR, M)...
...ccal polysaccharide...
...ckle Cell DiseaseR: age >55 yb (SR, L)21881...
...ear Implantsa or CSF LeakU: (SR...
...occal conjugate (PCV1...
...lenia or a Sickle Cell D...
...age...
R: age ≥6 yd (SR, VL)21...
...ochlear Implantsa or CS...
U: age...
...e ≥6 yd (SR, L)21881...
...neumococcal polysaccharide (PPSV23...
...splenia or a Sickle Cell DiseaseR: age â...
...ear Implantsa or CSF LeakR: age ≥2 ye (SR, M)21...
Poliovirus, inact...
...Sickle Cell DiseaseU: (SR, M)21881...
...ntsa or CSF LeakU: (SR, M)2188...
...irus, live...
...splenia or a Sickle Cell DiseaseU: (SR, M)2188...
Cochlear Implantsa or CSF LeakU: (SR, M)21...
...icella, live
...a or a Sickle Cell DiseaseU: (SR, M)21881...
...Implantsa or CSF LeakU: (SR, M)21881...
...oster, l...
...splenia or a Sickle Cell DiseaseU: (SR, M)2188...
...ar Implantsa or CSF LeakU: (SR, M)2...
...ecommended—administer if not previ...
...If PCV13 has not previously been administere...
...Administer 8 or more weeks after indicated...