By: Foster, Stephan L. ; Short, Christopher T. ; Angelo, Lauren B.
Among individuals with altered immunocompetence (AI), researchers have found that inactivated vaccines are generally safe, but they may be less effective due to an inadequate immune response. Live vaccines, which have to replicate to be effective, should be avoided for patients with AI unless the benefits outweigh the risks. The researchers, writing in the Journal of the American Pharmacists Association, note that the choice of which vaccines are needed and when should be determined on a case-by-case basis with the patient’s primary physician or infectious-disease specialist. Close contacts of all patients with AI also should be fully immunized based on current recommendations, including household contacts and out-of-home care providers. In general, patients who are about to begin therapies that can alter their immunocompetence, such as chemotherapy or corticosteroids, should receive recommended vaccines at least two weeks before beginning the therapy.