Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

被引：103

作者：

Shearer, William T. ^{[1
,2
]}

Fleisher, Thomas A. ^{[3
]}

Buckley, Rebecca H. ^{[4
]}

Ballas, Zuhair ^{[5
,6
]}

Ballow, Mark ^{[7
]}

Blaese, R. Michael ^{[8
]}

Bonilla, Francisco A. ^{[9
]}

Conley, Mary Ellen ^{[10
,11
]}

Cunningham-Rundles, Charlotte ^{[12
]}

Filipovich, Alexandra H. ^{[13
]}

Fuleihan, Ramsay ^{[14
]}

Gelfand, Erwin W. ^{[15
]}

Hernandez-Trujillo, Vivian ^{[16
]}

Holland, Steven M. ^{[17
]}

Hong, Richard

Lederman, Howard M. ^{[18
]}

Malech, Harry L. ^{[17
]}

Miles, Stephen

Notarangelo, Luigi D. ^{[9
]}

Ochs, Hans D. ^{[19
]}

Orange, Jordan S. ^{[1
,2
]}

Puck, Jennifer M. ^{[20
]}

Routes, John M. ^{[21
]}

Stiehm, E. Richard ^{[22
]}

Sullivan, Kathleen ^{[23
]}

Torgerson, Troy ^{[19
]}

Winkelstein, Jerry ^{[18
]}

机构：

[1] Baylor Coll Med, Houston, TX 77030 USA

[2] Texas Childrens Hosp, Houston, TX 77030 USA

[3] NIH, Ctr Clin, Bethesda, MD 20892 USA

[4] Duke Univ, Sch Med, Durham, NC 27706 USA

[5] Univ Iowa, Iowa City, IA USA

[6] Iowa City Vet Affairs Med Ctr, Iowa City, IA USA

[7] SUNY Buffalo, Childrens Hosp Buffalo, Buffalo, NY USA

[8] Immune Deficiency Fdn, Columbia, SC USA

[9] Boston Childrens Hosp, Boston, MA USA

[10] Univ Tennessee, Hlth Sci Ctr, Memphis, TN 38163 USA

[11] St Jude Childrens Res Ctr, Memphis, TN USA

[12] Mt Sinai Med Ctr, New York, NY 10029 USA

[13] Cincinnati Childrens Hosp, Cincinnati, OH USA

[14] Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL USA

[15] Natl Jewish Hlth, Denver, CO USA

[16] Miami Childrens Hosp, Miami, FL USA

[17] Natl Inst Allergy & Infect Dis, Bethesda, MD USA

[18] Johns Hopkins Univ, Sch Med, Baltimore, MD USA

[19] Seattle Childrens Hosp, Seattle, WA USA

[20] Univ Calif San Francisco, San Francisco, CA 94143 USA

[21] Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA

[22] Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA

[23] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY | 2014年 / 133卷 / 04期

基金：

美国国家卫生研究院;

关键词：

Live viral and bacterial vaccines; primary immunodeficiency disease; severe combined immunodeficiency disease; cellular immune reconstitution; STEM-CELL TRANSPLANTATION; POLIOVIRUS; VACCINATION; PERSISTENT; CHILDREN;

D O I：

10.1016/j.jaci.2013.11.043

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

The present uncertainty of which live viral or bacterial vaccines can be given to immunodeficient patients and the growing neglect of societal adherence to routine immunizations has prompted the Medical Advisory Committee of the Immune Deficiency Foundation to issue recommendations based on published literature and the collective experience of the committee members. These recommendations address the concern for immunodeficient patients acquiring infections from healthy subjects who have not been immunized or who are shedding live vaccine-derived viral or bacterial organisms. Such transmission of infectious agents can occur within the hospital, clinic, or home or at any public gathering. Collectively, we define this type of transmission as close-contact spread of infectious disease that is particularly relevant in patients with impaired immunity who might have an infection when exposed to subjects carrying vaccine-preventable infectious diseases or who have recently received a live vaccine. Immunodeficient patients who have received therapeutic hematopoietic stem transplantation are also at risk during the time when immune reconstitution is incomplete or while they are receiving immunosuppressive agents to prevent or treat graft-versus-host disease. This review recommends the general education of what is known about vaccine-preventable or vaccine-derived diseases being spread to immunodeficient patients at risk for close-contact spread of infection and describes the relative risks for a child with severe immunodeficiency. The review also recommends a balance between the need to protect vulnerable subjects and their social needs to integrate into society, attend school, and benefit from peer education.

引用

页码：961 / 966

页数：6

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