Vaccination in immunocompromised host: Recommendations of Italian Primary Immunodeficiency Network Centers (IPINET)

Abstract

Infectious complications are a major cause of morbidity and mortality in patients with primary or secondary immunodeficiency. Prevention of infectious diseases by vaccines is among the most effective healthcare measures mainly for these subjects. However immunocompromised people vary in their degree of immunosuppression and susceptibility to infection and, therefore, represent a heterogeneous population with regard to immunization. To date there is no well- established evidence for use of vaccines in immunodeficient patients, and indications are not clearly defined even in high-quality reviews and in most of the guidelines prepared to provide recommendations for the active vaccination of immunocompromised hosts. The aim of this document is to issue recommendations based on published literature and the collective experience of the Italian primary immunodeficiency centers, about how and when vaccines can be used in immunocompromised patients, in order to facilitate physician decisions and to ensure the best immune protection with the lowest risk to the health of the patient.

Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic

“…Vaccine-preventable diseases could reemerge if vaccinations are not routinely administered due to the COVID-19 pandemic, with a dramatic impact on the Health System [49,50]. Therefore, routine immunization activities, both for primary cycles and boosters, as per national vaccine schedule recommendations, have to be maintained, unless specific contraindications for the child with allergy and/or immunodeficiency exist [51].…”

“…When routine immunization activities are not ensured because of the burden of COVID-19 on the health care system, the immunization service providers should create cohorts of children who have missed their vaccine doses and activate plans of recalling for catch-up immunization [49,50].…”

“…Reduce the burden of immunization services, the coadministration of vaccines during the same visit is strongly recommended [49,50].…”

“…Nevertheless, some primary immunodeficiency (PID) patients, especially those with chronic lung disease, might have a more severe clinical course [54]. During the COVID-19 pandemic, reinforcement of influenza immunization programs has also been suggested for 2020-2021 by the Italian Pediatric Society, with particular consideration for children under 6 years of age and patients with chronic underlying conditions [50]. The use of airborne precautions in the office for both children and healthcare operators is recommended during immunization procedures.…”

Szczepienia ochronne u dzieci w trakcie i po leczeniu onkologicznym oraz w wybranych chorobach hematologicznych: rekomendacje Polskiego Towarzystwa Onkologii i Hematologii Dziecięcej

“…Dysfunkcja układu odporności związana z chorobą i leczeniem powoduje, że szczepienia ochronne w tej populacji pacjentów są ważnym elementem opieki medycznej. Zalecenia odnośnie do szczepień u dzieci z guzami litymi oparte są na doświadczeniach polskich ośrodków [3] i są zgodne z zasadami stosowanymi w innych krajach [20].…”