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Review
. 2021 Jun;10(2):637-661.
doi: 10.1007/s40121-021-00404-y. Epub 2021 Mar 9.

A Review of Vaccinations in Adult Patients with Secondary Immunodeficiency

Elda Righi #  1   2 , Tolinda Gallo #  3 , Anna Maria Azzini  4   5 , Fulvia Mazzaferri  5 , Maddalena Cordioli  4   5 , Mara Merighi  5 , Evelina Tacconelli  4   5
Affiliations
Review

A Review of Vaccinations in Adult Patients with Secondary Immunodeficiency

Elda Righi et al. Infect Dis Ther. 2021 Jun.

Abstract

Vaccine-preventable diseases and their related complications are associated with increased morbidity and mortality in patients with altered immunocompetence. Optimised immunisation in this patient population is challenging because of limited data from vaccine trials, suboptimal vaccine efficacy and safety concerns. Reliable efficacy data are lacking among patients with altered immunocompetence, and existing recommendations are mainly based on expert consensus and may vary geographically. Inactivated vaccines can be generally used without risks in this group, but their efficacy may be reduced, and immunisation schedules vary according to local guidelines, age, and type and stage of the underlying disease. Live vaccines, if indicated, should be administered with care because of the risk of vaccine-associated disease. We have reviewed the current evidence on vaccination principles and recommendations in adult patients with secondary immunodeficiencies, including asplenia, HIV infection, stem cell and solid organ transplant, haematological malignancies, inflammatory bowel disease and other chronic disorders.

Keywords: Altered immunocompetence; Inactivated vaccines; Live vaccines; Vaccination.

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Figures

Fig. 1
Fig. 1
Challenges in the immunisation of patients with altered immunocompetence (AI)
See this image and copyright information in PMC

References

    1. Ljungman P. Vaccination of immunocompromised patients. Clin Microbiol Infect. 2012;18:93–99. - PubMed
    1. Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58:e44–e100. - PubMed
    1. Danziger-Isakov L, Kumar D. Vaccination of solid organ transplant candidates and recipients: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13563. - PubMed
    1. Cordonnier C, Mikulska M, Einarsdottir S, Cesaro S, Ljungman P. 2017 ECIL 7 vaccine guidelines. Lancet Infect Dis. 2019;19:694–695. - PubMed
    1. Mikulska M, Cesaro S, de Lavallade H, et al. Vaccination of patients with haematological malignancies who did not have transplantations: guidelines from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019;19:188–199. - PubMed

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