![]() ![]() ![]() Primary care providers and specialists caring for immunocompromised patients share responsibility for ensuring appropriate vaccination of immunocompromised patients and their households. There is potential for serious illness and death if immunocompromised people are under-immunized and every effort should be made to ensure adequate protection through immunization however, inappropriate use of live vaccines can cause serious adverse events in some immunocompromised people as a result of uncontrolled replication of the vaccine virus or bacterium. Immunodeficiency can also vary over time in many people and the decision to recommend for or against a particular vaccine will depend upon a case-by-case analysis of the risks and benefits. The relative degree of immunodeficiency is variable depending on the underlying condition, the progression of disease and use of immunosuppressive agents. Each immunocompromised person is different and presents unique considerations regarding immunization. The safety and effectiveness of vaccines in immunocompromised persons are determined by the type of immunodeficiency and degree of immunosuppression. In general, immunocompromised persons are more susceptible to vaccine-preventable infections and may have severe infections. Individuals may be immunocompromised as a result of a congenital condition, an illness or medications that suppress immune function. Table 5: Vaccination of HIV-infected persons.Infants exposed to immunosuppressive therapy in the womb.During or after immunosuppressive therapy. ![]() Table 4: Vaccination of solid organ transplant candidates and recipients.Table 3: Post-transplantation vaccination of hematopoietic stem cell transplantation (HSCT) recipients.Hematopoietic stem cell transplantation (HSCT) - autologous or allogeneic.Non-hematologic malignant solid tumours.Table 2: Vaccination of persons with primary immunodeficiencies - live attenuated vaccines.Table 1: Vaccination of persons with primary immunodeficiencies - inactivated vaccines.Combined T and B cell immunodeficiencies (with or without associated /syndromic features) and Immune dysregulation.Predominantly antibody (B cell) deficiencies.Last complete chapter revision: May 2018 On this page March 2023: This chapter was updated to incorporate guidance from the National Advisory Committee on Immunization (NACI) statement: Recommended use of palivizumab to reduce complications of respiratory syncytial virus infection in infants. Last partial content update (see Table of updates): March 2023 For this information, refer to the COVID-19 vaccine chapter. This CIG chapter has not been completely updated to contain all pertinent information regarding COVID-19 vaccines. February 24, 2023: Public health level recommendations on the use of pneumococcal vaccines in adults, including the use of 15-valent and 20-valent conjugate vaccines.This chapter has not yet been updated with the following statement from the National Advisory Committee on Immunization (NACI): ![]()
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