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University of Oklahoma Health Sciences Center

Immunization Strategies to Span the Spectrum of Immunocompromised Adults

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Author/s: 
Whitaker, JA
Date Added: 
February 15, 2020
Journal/Publication: 
Mayo Clinic Proceedings
Publisher: 
Elsevier, Inc.
Publication Date: 
February 14, 2020
Type: 
Meta-analyses, Reviews, and Guidelines
DOI (1): 
10.1016/j.mayocp.2019.09.002

RPR Commentary

This is a concise review of the principles involved in the immunization of patients who are immunocompromised.  James W. Mold, MD, MPH

Abstract

The Advisory Committee on Immunization Practices to the US Centers for Disease Control and Prevention provides annual recommendations for routine adult immunizations. Many recommendations consider patient factors such as age, medical conditions, and medications that increase an individual’s risk for infection with a vaccine-preventable disease. These factors, particularly those that lead to immunocompromise, may also alter the risk-benefit ratio for live vaccines, and/or lead to decreased vaccine immunogenicity and effectiveness. The provider may need to consider alternative vaccination strategies, including higher antigen dose vaccines, adjuvanted vaccines, avoidance of live vaccines, and careful timing of vaccination to optimize safety and effectiveness in immunocompromised populations. This thematic review discusses general principles regarding immunization of adults across the spectrum of immunocompromise, examines current guidelines and studies that support them, and outlines future research needs.

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