7
29. Patients with primary complement deficiencies should receive
conjugate meningococcal vaccine.
• For children age 6 weeks through 18 months, administer a 4-dose series of
bivalent meningococcal conjugate vaccine and H influenzae type b conjugate
vaccine (Hib-MenCY; MenHibrix
®
) at 2, 4, 6, and 12-15 months (SR-L)
▶ or a 2-dose primary series of quadrivalent meningococcal conjugate vaccine
(MCV4) to patients with primary complement component deficiency age
9 months through 55 years (MCV4-D [Menactra
®
] for those 9-23 months;
MCV4-D or MCV4-CRM [Menveo
®
] for those 2-54 years of age) (SR-L).
• For persons >55 years of age, administer MPSV4 if they have not previously
received MCV4 and MCV4 if they have previously received it (SR-L).
• For patients 9-23 months of age, administer the doses 3 months apart, and
for patients 2 years and older, administer the doses 2 months apart. MCV4-D
should be administered ≥4 weeks after a dose of PCV13 because of a reduced
antibody response to some pneumococcal serotypes when MCV4-D and PCV7
are administered simultaneously (SR-L).
30. Patients with a primary complement component deficiency should
be revaccinated with MCV4 (or MPSV4 for those >55 years of age
who have not previously received MCV4) every 5 years (SR-L).
Phagocytic Cell Deficiencies
Phagocytic cell deficiencies include CGD (chronic granulomatous
disease), leukocyte adhesion deficiency, and Chediak-Higashi
syndrome.
31. Patients with phagocytic cell deficiencies should receive all
inactivated vaccines based on the CDC annual schedule (SR-L).
Children 2-5 years of age should receive PCV13 as in
recommendation 27a (WR-VL).
32. Patients ≥6 years of age with phagocytic cell deficiencies other
than CGD (unless patient with CGD is receiving immunosuppressive
medication) should receive PCV13 as in recommendations 27b-c
(WR-VL).
33. Patients ≥2 years of age with phagocytic cell deficiencies other
than CGD (unless patient with CGD is receiving immunosuppressive
medication) should receive PPSV23 ≥8 weeks after PCV13 and a
second dose of PPSV23 5 years later (WR-L).
34. Live bacterial vaccines, such as bacillus Calmette-Guérin (BCG) or
oral typhoid vaccine, should not be administered to patients with a
phagocytic cell defect (SR-M).
35. Live viral vaccines should be administered to patients with CGD and
to those with congenital or cyclical neutropenia (WR-L).
Special Populations
