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
Responsibility for Vaccinat...
...lists caring for immunocompromised patients sh...
...lists caring for immunocompromised...
Timing of Vaccination
...ing of Vaccinatio...
...nes should be administered prior to planned immuno...
...es should be administered ≥4 weeks prior to...
...avoided within 2 weeks of initiation of immun...
...accines should be administered ≥2 weeks...
Household Members (See Table 1)
...ld Members (See Table 1)
...petent household members of immunoc...
...r for travel. (SR, M)21881...
.... Household members of immunocompromis...
...influenza vaccine (IIV) or (SR, H)218...
...enuated influenza vaccine (LAIV) pro...
...ceptions include household members of an...
..., if administered, contact between the immunocom...
...ocompetent household members of immunocompr...
...us vaccine in infants ages 2-7 months, (SR, L)2188...
...cella vaccine (VAR), (SR, M...
...zoster vaccine (ZOS). (SR,...
...ely receive vaccines for travel: yellow fever vacc...
and oral typhoid vaccine. (SR, L)...
...ovirus vaccine (OPV) should NOT be administere...
...mmunocompromised patients should avoi...
...mmunocompromised patients should avoid conta...
Table 1. Safety of Administration of Live Vaccines to Contacts of Immunocompromised Persons
...le 1. Safety of Administration of Live...
...luenza, live, attenuated nasa...
Administer; (SR,...
...rsons to avoid close contact with persons w...
...Shedding of Agent? (Site) Transmissibilit...
...oral Shedding of Agent? (Site)...
...avirus, oral Shedding of Agent? (Site)...
...Shedding of Agent? (Site...
...cella Shedding of Agent? (Site)...
...ever Shedding of Agent? (Site...
...Shedding of Agent? (Site) Transmi...
International Travel
...national Travel
...ay administer inactivated vaccines...
...ellow fever vaccine generally should NOT be admini...
...HIV-infected adults with CD4 T-cell lymp...
...omatic HIV-infected children age 9 months thr...
...h certain exceptions (eg, yellow fever va...
Specific Vaccinations
...ecific Vaccinati...
...la and Zoster Vaccines...
...iven to immunocompetent patients wi...
...be administered ≥4 weeks before initi...
...2-dose schedule of VAR, separated by...
...ould NOT be administered to highly immunoco...
...R can be considered for patients without evidence...
...should be administered to eligible immun...
...ould be given to patients ≥60 years of...
...ould be considered for varicella-positiv...
...ZOS should be administered to patient...
.... ZOS should NOT be administered t...
Influenz...
...luenza vaccination with IIV is recommended for imm...
...atients who are very unlikely to r...
...ve received anti-B cell antibodies withi...
...should NOT be administered to immunoc...
Special Populations
Special Population...
...nital) Immunodeficiency Disorders...
...rimary Complement Deficiencies...
...with primary complement deficiencie...
...rs old should receive 1 dose of 13-valent...
...old with a classical pathway (C1, C2, C3, C4), alt...
...19 years old with a classical pathway...
...have previously received 23-valent pneumoco...
...s ≥2 years of age with an early classical...
...ildren age 6 weeks through 18 months, administer...
...a 2-dose primary series of quadrivale...
...ons >55 years of age, administer MPSV4 if they...
For patients 9-23 months of age, admi...
...ith a primary complement component deficien...
...tic Cell Deficiencies...
Phagocytic cell deficiencies inclu...
31. Patients with phagocytic cell def...
...ildren 2-5 years of age should recei...
32. Patients ≥6 years of age with ph...
...s ≥2 years of age with phagocytic...
...acterial vaccines, such as bacillus Calmette...
35. Live viral vaccines should be administer...
.... Live viral vaccines should NOT be administ...
...tokine or Cellular Activation Defects...
...ts in the immune system resulting in defe...
...7. Patients with innate immune system defects r...
...tients with innate immune system defect...
...dvice should be sought on individu...
...ial vaccines should NOT be administered to p...
...1. Live viral vaccines should NOT be administere...
...nor Antibody Defic...
...ith immunoglobulin A (IgA) deficiency or specifi...
...3. Children with SPAD or ataxia-telangiectasia...
Those ≥2 years of age should receive PP...
...ng of vaccine responses can be useful for...
...5. OPV should NOT be administered to IgA-...
...Antibody Deficiencies in Patients Receiving Immun...
...d vaccines other than IIV are NOT routin...
...patients with suspected major antibo...
...dministered to patients with major...
...ould NOT be administered to patien...
...accines (other than OPV) should NOT be administ...
...bined Immunodeficiencie...
...s with suspected combined immunodeficiencie...
...th combined immunodeficiencies who are receiving...
...r patients with combined immunodefi...
...dren with partial DiGeorge syndrome (p...
...ents with SCID, DiGeorge syndrome with CD3...
...Adults, Adolescents, and Children (See...
...nactivated Vac...
...V, (SR, H)21881
...13 in patients...
...ae type b conjugate vaccine (Hib), (...
...id, tetanus toxoid, acellular pertu...
...nus toxoid, reduced diphtheria toxoid,...
...etanus toxoid, reduced diphtheria toxoid vacci...
hepatitis B vaccine (HepB), (SR...
...A vaccine (HepA), (SR, M)21881...
...tivated poliovirus vaccine (IPV), (SR, M)218...
...nt human papillomavirus vaccine (HPV4)* in femal...
...ould be administered to HIV-infected patients â‰...
...PSV23 should be administered to HIV-infected chi...
...ted adults with CD4 T-lymphocyte counts of ≥200...
...nd to HIV-infected adults with CD4 T-lymphocyte c...
...PSV23 should be given ≥8 weeks after the indi...
57. HIV-infected children who are >59 months of...
...recommended for HIV-infected adults. (W...
...ed children age 11-18 years should receive a 2-do...
...ngle booster dose (third dose) should be given a...
...dministered to HIV-infected children 2...
...9. HIV-infected patients should receive HepB...
...sideration of high-dose HepB (40 μg/dose) for a...
...nd adolescents.* (WR, L)2...
...o months after completion, they should b...
...ation anti-HBs concentration of ≥10 mIU/mL i...
...ld be administered (alternative: 1 dose of...
...dose HepB (40 μg/dose)* (WR, L...
...hildren and high-dose HepB for adolescents* and ad...
...epB containing 20 μg of HBsAg (hepatitis B surf...
...onally adopted HIV-infected children wh...
...4 is recommended over bivalent human papillom...
...Vaccines...
...posed or -infected infants should rece...
...HIV-infected patients should NOT receive LAIV. (...
...hould be administered to clinically stable HI...
...-infected patients ≥14 years without measles...
.... HIV-infected children with a CD4 T-cel...
...‰¥14 years with a CD4 T-cell lymphocyte...
...ted patients should NOT receive quadrival...
...-nonimmune, clinically stable HIV-infected pati...
...13 years with ≥15% CD4 T-lymphocyte p...
and age ≥14 years with CD4 T-lymphocyte...
...he 2 doses should be separated by ≥3 mo...
...nation of Persons With HIV Infection...
...nzae type b conjugat...
...age...
R: age 5–18 yc (SR, L)2188...
...: age
...ge 5–18 yc (SR, L)21...
Hepatiti...
...or No ImmunosuppressionU: (SR, M)21881...
...igh-Level ImmunosuppressionbU: age 1 y (SR,...
Hepatitis...
...la or No ImmunosuppressionR: (SR, M)2188...
...gh-Level ImmunosuppressionbR: (S...
DTaP
...r No ImmunosuppressionU: (SR, M)21881...
...Level ImmunosuppressionbU: (SR, M)...
Tda...
...a or No ImmunosuppressionU: (SR, VL)...
...unosuppressionbU: (SR, VL)21881...
Td
...o ImmunosuppressionU: (SR, L)21881...
...munosuppressionbU: (SR, L)21881...
HPV4e
...ow-Levela or No ImmunosuppressionU: age 1...
High-Level ImmunosuppressionbU: age 11-26 y (SR,...
...za, inactivated...
...vela or No ImmunosuppressionU: (SR,...
...ImmunosuppressionbU: (SR, H)21881...
...fluenza, live attenuated...
...w-Levela or No ImmunosuppressionX:f (WR,...
...nosuppressionbX: (WR, VL)21881...
...R, live...
...evela or No Immunosuppres...
...2 mo to 13 y (SR, M)218...
...age ≥14 y (WR, VL)...
...l Immunosuppressionb...
...12 mo to 13 y (SR, M)2188...
...age ≥14 y (SR,...
...V, live...
...evela or No ImmunosuppressionX: (SR...
...munosuppressionbX: (SR, VL)21881...
...gococcal conjugateg...
...la or No ImmunosuppressionU: age 11-18...
...Level ImmunosuppressionbU: age 11-18...
...ococcal conjugate (P...
Low-Levela or No Immunos...
...: age...
...ge 5 yh (SR, M)2188...
R: age 6-18 yh (SR, L)21...
...age ≥19 yi (SR, L)21881
...evel Immunosuppressionb...
...: age...
...ge 5 y (SR, M)218...
...ge 6-18 y (SR, L)2...
...age ≥19 yi (SR, VL...
...occal polysaccharide (PPS...
...r No ImmunosuppressionR: age ≥2...
...evel Immunosuppression...
R: age 2-18 y (SR, M)21...
...adult (CD4 T-lymphocytes...
...oliovirus, inactivate...
...No ImmunosuppressionU: (SR, M)21881...
...unosuppressionbU: (SR, M)21881...
...tavirus, live...
...Levela or No ImmunosuppressionU: (SR, L)21881
...munosuppressionbU: (WR, VL)21881
...ella, live...
...ow-Levela or No Immunosupp...
...-8 y (SR, H)21881...
...‰¥9 y (SR, VL)21881...
...l ImmunosuppressionbX: (SR, M)21881...
...ter, live...
...a or No Immunosuppressio...
X: age
...‰¥60 yk, l (WR, L)21881...
...evel ImmunosuppressionbX: (SR, M)21881
...recommended—administer if not previously a...
...HepB (40 µg) should be considered for adu...
...lescents (WR, L)218...
...4 is preferred over HPV2 because of its acti...
i For patients ≥19 years of age with H...
...be administered 8 weeks or longer after...
...can be considered for patients 50...
l For patients not vaccinated with varicel...
...(See Table 3)...
...¥6 months of age with hematological malignanc...
...tumor malignancies (SR, L)21881...
...eiving anti-B cell antibodies* (SR, M)21881...
...ive chemotherapy, such as for inductio...
...ld be administered to newly diagnosed adults w...
...malignancies (SR, VL)21881...
...children with malignancies (SR,...
...bed in recommendations 27a-c. (, )...
...hould be administered to adults and child...
...1. Inactivated vaccines (other than IIV)...
...vaccines administered during cancer...
...less there is documentation of a protective ant...
...ral vaccines should NOT be administere...
73. Starting 3 months following cancer chemot...
...live vaccines VAR, (WR, VL)21881...
...R, (SR, L)218...
...V (WR, VL)21881...
...ing to the CDC annual schedule routinely ind...
If regimens included anti-B cell antibodies, vac...
...accination of Patients With Cancer
H. influenzae type b c...
...ring ChemotherapyaU: (WR, L)21881...
...≥3 Months Postchemotherapy and â...
...atitis A...
...or During ChemotherapyaU: (WR, L)21...
...ting ≥3 Months Postchemotherapy and ≥6 Months...
...patitis...
...ring ChemotherapyaU: (WR, L)21881...
...onths Postchemotherapy and ≥6 Months After Antiâ...
...(SR, M)218...
...ults (SR, VL)21881...
...aP, Tdap...
...o or During ChemotherapyaU: (WR, L)2...
...Months Postchemotherapy and ≥6 Months Afte...
...0-18 y (SR, M)218...
...acute lymphoblastic leukemia or lymphoma (...
HP...
...or During ChemotherapyaU: age 11-26 y (WR, VL)2188...
Starting ≥3 Months Postchemothera...
...luenza, inactivated...
...uring ChemotherapyaU (SR, L)U (SR-L to M)2188...
...≥3 Months Postchemotherapy and â...
Influenza, live attenuated
...or During ChemotherapyaX: (WR, VL)21881...
...¥3 Months Postchemotherapy and ≥6...
MMR, l...
...During ChemotherapyaX:c (SR, M)21881...
...3 Months Postchemotherapy and ≥6 Months After...
MMRV, liv...
...ng ChemotherapyaX:c (SR, M)21881...
...ng ≥3 Months Postchemotherapy an...
...coccal conjugate
...to or During ChemotherapyaU (WR...
...¥3 Months Postchemotherapy and ≥6 Mont...
...occal conjugate-13 (PCV13...
...r During Chemotherapya...
...(SR, L)21881...
...‰¥6 yd (SR, VL)21881...
...Months Postchemotherapy and ≥6 Months After A...
...eumococcal polysaccharide...
...ng ChemotherapyaR: age ≥2 y (SR,...
...g ≥3 Months Postchemotherapy and ≥6 Month...
Poliovirus, inactiva...
Prior to or During ChemotherapyaU: (WR, L)218...
Starting ≥3 Months Postchemotherapy and ≥6 Mon...
...avirus, live...
...or During ChemotherapyaX: (SR, VL)21881...
...Months Postchemotherapy and ≥6 Months After...
...ricella, liv...
...or During ChemotherapyaXc (SR, M)218...
...≥3 Months Postchemotherapy and ≥6 Months Aft...
Zoster,...
...r During ChemotherapyaX:c (SR, VL)21881...
...ting ≥3 Months Postchemotherapy a...
..., recommended—administer if not previously ad...
...ster inactivated influenza vaccine (IIV) annua...
...olid tumor malignancies (SR, L)21881...
...cept those receiving anti–B-cell antibodie...
...dministrations of inactivated vaccines o...
...wever, vaccines administered while receiving...
...IIV can be administered ≤3 mont...
...atients ≥19 years of age with HI...
...MMR has been given safely 3 months after co...
...tients ≥19 years of age who have previously...
...opoietic Stem Cell Transplant (See Table 4)...
...ors and Patients Before Transplantation...
.... The HSCT donor should be current with routin...
but MMR, MMRV, VAR, and ZOS administrati...
...ccination of the donor for the benefit of th...
...or to HSCT, candidates should receiv...
...en the interval to the start of the conditio...
...ks for inactivated vaccines. (SR, M)218...
.... Nonimmune HSCT candidates ≥12 months o...
...tients Post-transplantation
...1 dose of IIV annually. (SR, M)21881...
...‰¥6 months of age starting 6 months...
...tarting at 4 months if there is a community outbr...
...ildren 6 months through 8 years of age...
...3 doses of PCV13 to adults and children starting...
...months after HSCT a dose of PPSV23 should be giv...
...nts with chronic GVHD a fourth dose...
79. Administer 3 doses of Hib starting at...
...er 2 doses of MCV4 starting 6-12 months afte...
...doses of tetanus/diphtheria-containing vaccine s...
...children
...patients 7 years and older, administrati...
..., administer a dose of Tdap followed by either 2...
...doses of Td. (WR, L)2188...
...nister 3 doses of HepB starting at 6-12 months aft...
...cination anti-HBs concentration of ≥10 m...
...dose of HepB after which anti-HBs i...
...igh dose (40 μg)* (WR, L)2188...
...high dose for adolescents* and adults...
...er 3 doses of IPV starting 6-12 months...
...sider administration of 3 doses of...
...not administer live vaccines to HSCT pa...
...dminister a 2-dose series of MMR to...
...s-seronegative children (SR, M)21881
...Administer a 2-dose series of VAR starting 24...
...4. Vaccinations Prior to or After Allogenei...
...nfluenzae type b conj...
...CTU: (SR, M)21881...
...oses (SR, M)at 6 mo post-tx21881...
...epatitis A...
...SCTU: (SR, VL)21881...
...2 doses (WR, L)at ≥6 mo post-tx21881...
Hepatitis...
...e-HSCTU: (SR, L)21881...
...oses (SR, M)at 6–12 mo post-tx21881...
... DT, Td, Tdap
...e-HSCTU: (SR, L)21881
Post-H...
...age
...‰¥7 y: DTaP* 3 doses (WR, VL)at ≥6 mo pos...
...dose Tdap, followed by either 2 doses DT...
...d (WR, L)21881...
HP...
...age 11-26 y (SR, VL)21881...
...ses at ≥6 mo post-tx (WR, VL)21881...
...nfluenza, inactiva...
...HSCTU: (SR, L)21881...
...ost-HSCT
...t-tx (SR, VL)if community outbreak;...
...therwise ≥6 mo post-tx (S...
...enza, live attenuated...
...e-HSCTX: (WR, VL)21...
...-HSCTX: (WR, VL)21881
MMR, li...
...U:a (SR, VL)21881...
...CTX:b (SR, L)21881...
MMRV, liv...
...TU:a (WR, VL)21881
...CTX: (SR, VL)21881...
...coccal conjugate...
...HSCTU: (SR, VL)218...
...HSCTR: age 11-18 y: 2 doses (SR, L)a...
...al conjugate (PCV13)
...re-HSCTR:c (SR, L)21881
...oses (SR, L)at 3-6 mo posttx21881...
Pneumococcal polysaccharide (PPSV...
...R:c (SR, VL)21881...
...2 mo post-tx if no GVHD (SR, L)21881...
...iovirus, inactiv...
...HSCTU: (SR, VL)2188...
...doses (SR, M)at ≥3 mo post-tx21881...
Rotavirus, li...
...-HSCTX: (WR, VL)21881
...TX: (WR, VL)21881...
...ella, live
...U:a (SR, L)21881
...HSCTX:d (SR, L)21881...
...oster, liv...
Pre-HSC...
...50–59 y* (WR, VL)21881...
...e ≥60 y (SR, L)21...
...ost-HSCT...
...–59 y* (SR, L)2188...
...age ≥60 y (SR, L)2188...
...ed—administer if not previously administe...
...otnotes to Tab...
...vaccines should not be administered...
...ister to adolescents and adults (SR, L)21881...
and to children (SR, M)...
...eviously administered....
...varicella-seronegative, the timing is ≥24...
...e patient is not severely immunosuppr...
...Transplant (See Table 5)...
...nd Patients Before Transplantation...
...8. Living donors should be current with...
...MMRV, VAR, and ZOS administration sh...
...f donors solely for the recipient’s...
...s and children with chronic or end-stage kidney, l...
...following persons should receive PCV13 as...
...lts and children age ≥2 years old who are SOT...
...nd-stage kidney disease should receive...
...ults and children ≥2 years of age w...
...and PPSV23 are indicated, PCV13 should be...
...HBs–negative SOT candidates should receive a He...
...odialysis and age ≥20 years they should rece...
...ccination anti-HBs concentration of ≥10 m...
...dose of HepB after which anti-HBs is tested*)...
...se* for children (WR, L)21881...
...igh dose for adolescents* and adults...
...vaccinated, undervaccinated, or seronegative...
...those ≥2 years. (SR, M)should receive a HepA...
...pA-HepB vaccine can be used for SOT ca...
...ries should be administered to SOT candida...
...andidates 6-11 months of age can rece...
...ion is delayed (and the child is not receiving im...
...R should be administered to SOT cand...
...dministered to varicella-naive SOT candida...
...y, 2 doses should be administered ≥3 month...
...candidates age ≥60 years (SR, M)21881...
...-positive (as defined in recommendation 2...
SOT Recipients
.... Vaccination should be withheld from SOT...
...can be administered ≥1 month after trans...
...9. Standard age-appropriate inactivated vacc...
...ding IIV. (SR, M)(Table 5)21881
...0. PCV13 should be administered starting...
...patients ≥2 years of age, 1 dose of PPSV23 s...
...uld be considered for chronic hepatitis B-i...
...03. MMR and VAR should generally n...
except for VAR in children without evid...
...4. Vaccination should not be withheld because...
...le 5. Vaccinations Prior to or After So...
...influenzae type b conjug...
PretransplantU: (SR, M...
...Months PosttransplantU: (SR, M)21881...
...patitis A...
...etransplant...
U: age 12-23 mo (SR, M)218...
...≥2 y (SR, M)21881...
...2–6 Months PosttransplantR: if not compl...
...atitis B...
...etransplant...
U: age 1-18 y (SR, M)...
...≥18 y (SR, M)218...
...Months PosttransplantR: if not completed p...
...TaP, Tdap
...lantU: (SR, M)21881...
...2–6 Months PosttransplantU: if no...
...PV
...lantU: females age 11-26 y (SR, M)...
Starting 2–6 Months Posttranspl...
...emales age 11-26 y (SR, M)218...
...age 11-26 y (SR, L)21881
...luenza, inactivated...
...etransplantU: (SR, M...
...Months PosttransplantU:b (SR, M)21881...
...nfluenza, live attenuated...
...nsplantX: (WR, L)21881...
Starting 2–6 Months PosttransplantX:...
MMR, liv...
...etransplant
...6-11 mo (WR, VL)21881
...‰¥12 mo (SR, M)21881...
...arting 2–6 Months PosttransplantX: (S...
...V, live...
...lantU:d (SR, M)21881
...rting 2–6 Months PosttransplantX: (SR, L...
Meningococcal conjuga...
PretransplantU: (SR, M)21881
...onths PosttransplantU: (SR, M)21881...
...mococcal conjugate (PCV13)
...etransplan...
...age
R: age ≥6 ye (SR, VL)21881
...ing 2–6 Months Posttransplant...
...age 2-5 y (SR, M)...
...if not administered pretransplante (...
...umococcal polysaccharide (PPSV2...
...splantR: age ≥2 y (SR, M)21881...
...g 2–6 Months PosttransplantR: age ≥2 y...
...virus, inactivated...
...lantU: (SR, M)21881...
...onths PosttransplantU: (SR, M)21881...
Rotavirus,...
PretransplantU:c (SR, M)...
...Months PosttransplantX: (SR, L)21881...
...ella, live
...etransplant
...e 6-11 mo (WR, VL)21881...
...(SR, L)218...
...6 Months PosttransplantX:g (SR, L)21881...
Zoster,...
Pretransplant
...age 50-59 y (WR, L)21881...
...i age ≥60 y (SR, M)21881...
...2–6 Months PosttransplantX: (SR, L)21881...
...recommended—administer if not previously admi...
...hepatitis B vaccine for hepatitis...
...be administered to SOT recipients despite...
...ly if patient is not immunosuppressed and the t...
...atients ≥19 years who have previously received...
...only if patient is not immunosuppressed...
...mmatory Disease Patients Taking Immunosup...
...05. Inactivated vaccines, including I...
or about to be treated with immunosuppressiv...
...PCV13 should be administered to adults and childr...
...uld be administered to patients ≥2 years of a...
...l immunosuppression, (SR, L)21881...
...l immunosuppression. (SR, VL)21881...
...ts should receive PPSV23 ≥8 weeks af...
...should be administered to patients with chronic...
...or to initiation of immunosuppression, (SR, L...
...should be considered for patients without evide...
...d be administered to patients with a chronic...
...r while being treated with low-dose immu...
...o are 50-59 years of age and varicella-positiv...
...ng treated with low-dose immunosuppr...
...11. Other live vaccines should NOT be admini...
...receiving low-level (WR, VL)21881...
...gh-level immunosuppression, (WR, VL)21881...
...V in patients receiving low-level (WR, VL)21881...
...level immunosuppression. (SR, VL)...
...rwise recommended vaccines, including IIV and Hep...
.... Vaccination of Persons With Chronic Infla...
...influenzae type b conjugate...
...unosuppressionU: (SR, M)21881
...mmunosuppressionaU: (SR, L)21881...
...munosuppressionaU: (SR, L)21881...
...epatitis...
...ImmunosuppressionU: (SR, M)21881
...evel ImmunosuppressionaU: (SR, L...
...Level ImmunosuppressionaU: (SR, L)218...
...atitis B...
Planned ImmunosuppressionU: (SR...
...unosuppressionaU: (SR, L)21881
...vel ImmunosuppressionaU: (SR, L)21881...
...TaP, Td, Tdap
...ImmunosuppressionU: (SR, M)21881...
...nosuppressionaU: (SR, L)21881...
...mmunosuppressionaU: (SR, L)21881...
...PV
...unosuppressionU: age 11-26 y (SR, M)21881...
...Level ImmunosuppressionaU: age 11-26 y (SR, L...
...l ImmunosuppressionaU: age 11-26 y (SR, VL)21881...
...uenza, inactivated...
...nosuppressionU: (SR, M)21881...
...vel ImmunosuppressionaU: (SR, M)21881...
...unosuppressionaU: (SR, M)21881...
...nfluenza, live attenua...
...d ImmunosuppressionX: (WR, VL)218...
...l ImmunosuppressionaX: (WR, VL)...
...vel ImmunosuppressionaX: (WR, VL)21881...
...R, live...
...lanned ImmunosuppressionU:b (SR, M)218...
...ImmunosuppressionaX: (WR, VL)21881...
...gh-Level ImmunosuppressionaX: (W...
...V, live...
...mmunosuppressionU:b (SR, L)218...
Low-Level ImmunosuppressionaX: (W...
High-Level ImmunosuppressionaX...
...ngococcal conjugate
...d ImmunosuppressionU: (SR, M)2188...
...mmunosuppressionaU: (SR, M)2188...
...h-Level ImmunosuppressionaU: (SR, L)21881...
...ococcal conjugate (PCV13)...
...nned ImmunosuppressionR:c (SR...
...w-Level Immunosuppressi...
U: age...
R: age ≥6 yc (SR, VL)2...
...el Immunosuppressiona...
U: ag...
...‰¥6 yc (SR, VL)2188...
...ococcal polysaccharide (...
...ppressionR: age ≥2 y (SR, L)21881...
...w-Level ImmunosuppressionaR: age ≥2 y (S...
...ImmunosuppressionaR: age ≥2 y (SR, VL)2188...
Poliovirus, inactiv...
...ImmunosuppressionU: (SR, M)21881
...w-Level ImmunosuppressionaU: (SR, M)218...
...h-Level ImmunosuppressionaU: (SR,...
...otavirus,...
...unosuppressionU: (SR, M)21881...
...Level ImmunosuppressionaX: (WR, VL)...
...ImmunosuppressionaX: (WR, VL)...
...icella, live
...unosuppressionU:d (SR, M)21881...
...ImmunosuppressionaX:d (WR, VL)21881...
...ImmunosuppressionaX: (SR, M)218...
...ter, live...
...lanned Immunosupp...
...: age 50-59 y* (WR, L)21881
...: age ≥60 y (SR, L)21881...
...w-Level Immunosuppressi...
...-59 y* (WR, VL)21881...
...age ≥60 y (SR, VL)21881...
...igh-Level ImmunosuppressionaX: (WR,...
...mmended—administer if not previously...
c For patients ≥19 years who have previously...
...ion of VAR can be considered for nonâ...
...commendations deviate from CDC ACIP recommendati...
...ia or Sickle Cell Diseases (See Table 7)...
...patients or those with sickle cell diseases shoul...
...LAIV in patients with sickle cell disease. (WR, V...
.... PCV13 should be administered to asple...
...15. PPSV23 should be administered to asplenic p...
...rval of ≥8 weeks after PCV13, and a...
...aive patients ≥2 years of age for w...
...ks following surgery.* (WR, L)21881...
...of Hib should be administered to unvaccinated...
118. Meningococcal vaccine should b...
...mmendation 29 except that MCV4--D shou...
...with MCV4 (or MPSV4 for those >55 years o...
...Barrier Defects (See Table 7)...
...ts and children with profound deaf...
...tients with a cochlear implant, with p...
...ts ≥24 months of age with a cochlear implant,...
...nd PPSV23 should be administered ≥2 weeks p...
...Vaccination of Persons With Asplenia o...
...nfluenzae type b conjugate...
...a or a Sickle Cell Diseas...
...age...
...age ≥5 y (WR, L)21...
Cochlear Implantsa or CSF LeakU: (SR, M)2...
Hepatiti...
...ckle Cell DiseaseU: (SR, M)21881...
...mplantsa or CSF LeakU: (SR, M)2...
...atitis B...
...Sickle Cell DiseaseU: (SR, M)21881...
...tsa or CSF LeakU: (SR, M)21881...
...TaP, Td, Td...
...a Sickle Cell DiseaseU: (SR, M)21881...
...antsa or CSF LeakU: (SR, M)21881...
...PV...
...enia or a Sickle Cell DiseaseU: (SR, M...
...plantsa or CSF LeakU: (SR, M)218...
...za, inactivated...
Asplenia or a Sickle Cell DiseaseU: (SR...
...ochlear Implantsa or CSF LeakU: (SR, M)21...
...a, live attenuated...
...a Sickle Cell DiseaseX: (WR, VL)21...
...antsa or CSF LeakU: (SR, M)21881...
MMR, live
...Sickle Cell DiseaseU: (SR, M)21881...
...mplantsa or CSF LeakU: (SR, M)21881...
...V, live
...ckle Cell DiseaseU: (SR, M)21881...
...lantsa or CSF LeakU: (SR, M)218...
...ococcal conjugat...
...ia or a Sickle Cell DiseaseR: age 2-55 yb...
...tsa or CSF LeakU: (SR, M)21881...
...coccal polysaccharide...
...a Sickle Cell DiseaseR: age >55 yb (SR, L)2188...
...plantsa or CSF LeakU: (SR, M)21881
...neumococcal conjugate (P...
...lenia or a Sickle Cell Di...
...: age...
R: age ≥6 yd (SR, VL)...
...hlear Implantsa or CSF...
...: age
...age ≥6 yd (SR,...
...occal polysaccharide (PPSV23...
...a or a Sickle Cell DiseaseR: age ≥2 ye (SR, L)2...
...lantsa or CSF LeakR: age ≥2 ye (SR, M)...
...oliovirus, inact...
...r a Sickle Cell DiseaseU: (SR, M)21881...
...Implantsa or CSF LeakU: (SR, M...
...tavirus, l...
...a or a Sickle Cell DiseaseU: (SR, M)2188...
...ntsa or CSF LeakU: (SR, M)21881...
...cella, live...
...splenia or a Sickle Cell Disease...
...plantsa or CSF LeakU: (SR, M)21881
...oster, live
...Sickle Cell DiseaseU: (SR, M)21881...
...plantsa or CSF LeakU: (SR, M)2188...
R, recommended—administer if not previo...
...13 has not previously been administered....
...8 or more weeks after indicated dose(s) of PCV13 a...