9
Major Antibody Deficiencies in Patients Receiving
Immunoglobulin Therapy
46. Inactivated vaccines other than IIV are NOT routinely administered
to patients with major antibody deficiencies during immunoglobulin
therapy (SR-L).
a. For patients with suspected major antibody deficiencies, all inactivated
vaccines can be administered as part of assessing the immune response prior to
immunoglobulin therapy (SR-L).
47. IIV can be administered to patients with major antibody
deficiencies and some residual antibody production (WR-L).
48. Live OPV should NOT be administered to patients with major
antibody deficiencies (SR-M).
49. Live vaccines (other than OPV) should NOT be administered to
patients with major antibody deficiencies (WR-L).*
Combined Immunodeficiencies
50. For patients with suspected combined immunodeficiencies, all
inactivated vaccines can be administered as part of assessing
the immune response prior to commencement of immunoglobulin
therapy (SR-L).
a. For patients with combined immunodeficiencies who are receiving
immunoglobulin therapy, inactivated vaccines should NOT be routinely
administered (SR-L).
51. For patients with combined immunodeficiencies and residual
antibody production potential, IIV can be administered (WR-VL).
52. Children with partial DiGeorge syndrome (pDGS) should undergo
immune system assessment with evaluation of lymphocyte subsets
and mitogen responsiveness to decide whether they should be given
live viral vaccines. Those with ≥500 CD3 T-cells/mm
3
, ≥200 CD8
T-cells/mm
3
, and normal mitogen response should receive MMR
and VAR (WR-L).*
53. Patients with SCID, DiGeorge syndrome with CD3 T-cell lymphocyte
count of <500 cells/mm
3
, other combined immunodeficiencies with
similar CD3 T-cell lymphocyte counts, Wiskott-Aldrich syndrome,
or X-linked lymphoproliferative disease and familial disorders
predisposing to hemophagocytic lymphohistiocytosis, should avoid
all live vaccines (SR-M).
