Canadian Immunization Guide 2006
Table 8. Vaccination of Individuals with Immunodeficiency
| Vaccine | HIV/AIDS | Severe immuno-deficiency | Solid organ transplantation | Post-BMT | Chronic renal disease/dialysis | Hyposplenism or asplenia |
|---|---|---|---|---|---|---|
| Inactivated/component vaccines | ||||||
| DTaP, Tdap, Td° | Routine use* | Routine use | Routine use | Recommended† | Routine use | Routine use |
| IPV | Routine use | Routine use | Routine use | Recommended | Routine use | Routine use |
| Hib | Routine use | Routine use | Routine use | Recommended | Routine use | Recommended for children < 5 years. Consider for all |
| Influenza | Recommended | Recommended | Recommended | Recommended | Recommended | Recommended |
| Pneumococcal | Recommended | Recommended | Recommended | Recommended | Recommended | Recommended |
| Meningococcal | Routine use | Recommended | Routine use | Routine use | Routine use | Recommended |
| Hepatitis A | Recommended (MSM, IDU) |
Use if indicated** | Use if indicated** | Use if indicated | Use if indicated | Use if indicated |
| Hepatitis B | Recommended (MSM, IDU) |
Routine use | Routine use | Recommended | Recommended (higher dosage) |
Routine use |
| Live vaccines | ||||||
| MMR | Routine use‡ (if no significant compromise) |
Contraindicated | Recommended before transplantation. Contraindicated after*** | Consider at 24 mo (no suppressive Rx, no GVHD) |
Routine use | Routine use |
| Varicella | Consider in asymptomatic and mildly symptomatic disease | Contraindicated | Recommended before transplant. Consider at 24 mo (min suppressive Rx) | Consider at 24 mo (no suppressive Rx, no GVHD) | Recommended | Use if indicated |
| Oral typhoid | Contraindicated (use IM vaccine instead) | Contraindicated (use IM vaccine instead) | Contraindicated (use IM vaccine instead) | Contraindicated (use IM vaccine instead) | If indicated use IM | If indicated use IM |
| BCG | Contraindicated | Contraindicated | Contraindicated | Contraindicated | Use if indicated | Use if indicated |
| Yellow fever | Contraindicated | Contraindicated | Contraindicated | Contraindicated | Use if indicated | Use if indicated |
| Oral cholera | Contraindicated | Contraindicated | Contraindicated | Contraindicated | Use if indicated | Use if indicated |
| BMT: Bone marrow transplantation; MSM: Men who have sex with other men; IDU: intravenous drug users; GVHD: graft-versus-host disease; IM: intramuscular. ° Product used would depend on age. * Routine vaccination schedules should be followed with age-appropriate booster doses. † Vaccination and/or re-vaccination recommended with or without verification of serologic response. ** Recommended for transplant candidates with chronic liver diseases. ‡ Most HIV-positive children can receive the first MMR vaccine without significant risk. Administration of the second MMR dose (particularly in adults) must be evaluated on a case-by-case-basis. *** Consider at 24 mo (no suppressive therapy, no GVHD) in seronegative females before pregnancy. |
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