40
Management
Table 11. Vaccination Considerations in IEI
Vaccination
approaches
Associated
IEI
Vaccines of
relevance
Strength of
recommendation
Certainty
of
evidence
Contraindicated Severe IEI
— including
SCID,
athymia,
CID, IFN-α
deficiency,
IFN-γ
deficiency,
IL-12 axis
deficiencies,
antibody
deficiencies,
and CGD
All live viral vaccines,
live attenuated
influenza vaccination
(LAIV), dengue.
(Note: CGD
may receive viral
vaccines, if not
immunocompromised)
Strong Low
All live bacterial (BCG,
typhoid)
Active
vaccination
while receiving
IgRT: target
vaccine
preventable-
diseases
Patients with
IEI with
adequate
T-cell
function and
receiving
IgRT
mRNA vaccines, e.g.,
COVID-19 emerging
strains
Conditional Low
HPV vaccines Conditional Very low
Seasonal inactivated
vaccines, e.g., influenza
Conditional Low
Recombinant zoster
vaccine for shingles
Conditional Very low
Section 11. Immunizations in the Management of Inborn
Errors of Immunity
Recommendation 11.1
➤ We recommend the use of vaccine recommendations from public
agencies (e.g., World Health Organization [WHO] and Centers for
Disease Control and Prevention [CDC]) and professional medical
organizations (e.g., the American Academy of Allergy, Asthma and
Immunology [AAAAI], the American College of Allergy, Asthma and
Immunology [ACAAI], and CIS) for patients with IEI. (S-L)
