Vaccination of the immunocompromised host

Abstract

Vaccinations are safe and effective in immunocompromised patients. Apparently most vaccines in this patient population are underutilized. General vaccination recommendations are expressed for influenza, diphtheria and tetanus. Pneumococcal, meningococcal und Haemophilus influenzae B immunizations are specially indicated for patients with or developing B-cell-deficiency. Live attenuated vaccines are usually contraindicated. The efficacy of the immunization and its indication can be additionally measured by antibody response, which is usually decreased compared to healthy subjects. Immunocompromised hosts with cancer will benefit from consistent immunization practices. Further clinical trials are urgently warranted.

Influence of Vaccination and Surgery on HLA-DR Expression in Patients with Upper Aerodigestive Tract Cancer

“…16 In immunocompromised patients with cancer, there is convincing evidence that vaccination can be used safely. 17,18 Little is known, however, about the effect of vaccination on cell-mediated immune reactivity in cancer patients undergoing surgery. In order to address this issue we have, to the best of our knowledge, undertaken the first study to investigate the effect of vaccination on monocyte HLA-DR expression and lymphokine release in patients with an upper aerodigestive tract tumour undergoing surgery or conservative treatment.…”

Antibody responses to pneumococcal and hemophilus vaccinations in splenectomized patients with hematological malignancies or trauma

“…The 23-valent pneumococcal polysaccharide vaccine was designed to prevent invasive infection but its immunogenicity has not been fully characterized in immunocompromised persons. Two large reviews of pneumococcal vaccine efficacy in the 1990s reported that efficacy for the prevention of infection ranged from 61-75% in immunocompetent persons [3,7]; however, there are few data available on the efficacy of pneumococcal vaccination in immunocompromised patients [9][10][11][12][13].…”