William Gardiner
November 14th, 2007, 05:51 PM
During today's immunization updates conference call, a question was asked pertaining to vaccine administration in immunocompromised patients. The following information is provided by Dr. Palevsky.
This is the link to all of the ACIP statements – http://www.cdc.gov/vaccines/pubs/ACIP-list.htm (http://www.cdc.gov/vaccines/pubs/ACIP-list.htm)
In the General Recommendations on Immunization (Recommendations of the Advisory Committee on Immunization Practices) published in the December 2006 MMWR, (http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf (http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf)), there is a section that deals with use of immunizations when a person is receiving antimicrobial agents which states: “Antimicrobial agents have no effect on the response to inactivated, recombinant or polysaccharide vaccines or toxoids” (page 26)
There is also a section on “ Altered Immunocompetence” that begins on age 24. This section also includes a table that can be helpful.
The ACIP statement about use of vaccines in persons with altered immunocompetence is old (published in 1993) http://www.cdc.gov/mmwr/PDF/rr/rr4204.pdf (http://www.cdc.gov/mmwr/PDF/rr/rr4204.pdf). There have been updates made for each vaccine in the vaccine-specific ACIP statements. (http://www.cdc.gov/vaccines/recs/acip/ (http://www.cdc.gov/vaccines/recs/acip/))
The MMWR published October 20, 2000, "Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients" includes information about the use of vaccines: http://www.cdc.gov/mmwr/PDF/rr/rr4910.pdf (http://www.cdc.gov/mmwr/PDF/rr/rr4910.pdf)
In the AAP Red Book 2006 (Report of the Committee on Infectious Diseases) in the chapter titled “Immunization in Special Clinical Circumstances” , there is discussion on the use of vaccines in primary and secondary immune deficiencies. (See pages 71-85)
Regarding the question pertaining to fever and immunization:
See the AAP Red Book 2006 (Report of the Committee on Infectious Diseases) in the chapter on immunization – page 45 – heading “ Minor Illness with or without fever does not contraindicate immunization” and on to page 46 with the heading “Fever, per se, is not a contraindication to immunization”
Sheila L Palevsky, MD MPH
Provider Liaison
Chief, Professional Education Unit
Bureau of Immunization
New York City Department of Health and Mental Hygiene
2 Lafayette Street - 19th floor - CN21
New York, NY 10007
212.676.2264 phone
212.442.8091 fax
spalevsk@health.nyc.gov (spalevsk@health.nyc.gov)
This is the link to all of the ACIP statements – http://www.cdc.gov/vaccines/pubs/ACIP-list.htm (http://www.cdc.gov/vaccines/pubs/ACIP-list.htm)
In the General Recommendations on Immunization (Recommendations of the Advisory Committee on Immunization Practices) published in the December 2006 MMWR, (http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf (http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf)), there is a section that deals with use of immunizations when a person is receiving antimicrobial agents which states: “Antimicrobial agents have no effect on the response to inactivated, recombinant or polysaccharide vaccines or toxoids” (page 26)
There is also a section on “ Altered Immunocompetence” that begins on age 24. This section also includes a table that can be helpful.
The ACIP statement about use of vaccines in persons with altered immunocompetence is old (published in 1993) http://www.cdc.gov/mmwr/PDF/rr/rr4204.pdf (http://www.cdc.gov/mmwr/PDF/rr/rr4204.pdf). There have been updates made for each vaccine in the vaccine-specific ACIP statements. (http://www.cdc.gov/vaccines/recs/acip/ (http://www.cdc.gov/vaccines/recs/acip/))
The MMWR published October 20, 2000, "Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients" includes information about the use of vaccines: http://www.cdc.gov/mmwr/PDF/rr/rr4910.pdf (http://www.cdc.gov/mmwr/PDF/rr/rr4910.pdf)
In the AAP Red Book 2006 (Report of the Committee on Infectious Diseases) in the chapter titled “Immunization in Special Clinical Circumstances” , there is discussion on the use of vaccines in primary and secondary immune deficiencies. (See pages 71-85)
Regarding the question pertaining to fever and immunization:
See the AAP Red Book 2006 (Report of the Committee on Infectious Diseases) in the chapter on immunization – page 45 – heading “ Minor Illness with or without fever does not contraindicate immunization” and on to page 46 with the heading “Fever, per se, is not a contraindication to immunization”
Sheila L Palevsky, MD MPH
Provider Liaison
Chief, Professional Education Unit
Bureau of Immunization
New York City Department of Health and Mental Hygiene
2 Lafayette Street - 19th floor - CN21
New York, NY 10007
212.676.2264 phone
212.442.8091 fax
spalevsk@health.nyc.gov (spalevsk@health.nyc.gov)