6
Specific Vaccinations
Influenza
24. Annual influenza vaccination with IIV is recommended for
immunocompromised patients ≥6 months of age (SR-M) except for
patients who are very unlikely to respond (although unlikely to be
harmed by IIV), such as those receiving intensive chemotherapy*
(SR-L) or those who have received anti-B cell antibodies within 6
months* (SR-M).
25. LAIV should NOT be administered to immunocompromised persons
(WR-VL).
Primary (Congenital) Immunodeficiency Disorders
Primary Complement Deficiencies
26. Patients with primary complement deficiencies should receive
all routine vaccines based on the CDC annual schedule. None is
contraindicated (SR-L).
27. Patients with primary complement deficiencies and who are:
a. 2-5 years old should receive 1 dose of 13-valent pneumococcal conjugate
vaccine (PCV13) if they have received 3 doses of pneumococcal conjugate
vaccine (PCV) (either 7-valent pneumococcal conjugate vaccine [PCV7] or
PCV13) before 24 months of age, and 2 doses of PCV13 (8 weeks apart) if
they have received an incomplete schedule of ≤2 doses of PCV (PCV7 or
PCV13) before 24 months of age (SR-L).
b. 6-18 years old with a classical pathway (C1, C2, C3, C4), alternate pathway,
or severe mannan-binding lectin (MBL) deficiency who have not received
PCV13 should receive a single dose of PCV13 (SR-VL).
c. ≥19 years old with a classical pathway (C1, C2, C3, C4), alternate pathway,
or severe MBL deficiency who are PCV13-naive should receive a single
dose of PCV13 (SR-VL). For those who have previously received 23-valent
pneumococcal polysaccharide vaccine (PPSV23), PCV13 should be
administered ≥1 year after the last PPSV23 dose (WR-L).
28. Patients ≥2 years of age with an early classical pathway, alternate
pathway, or severe MBL deficiency should receive PPSV23 ≥8 weeks
after PCV13 and a second dose of PPSV23 5 years later (SR-L).
Special Populations
