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Clinical Microbiology Reviews, January 1998, p. 1-26, Vol. 11, No. 1
0893-8512/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Use of Licensed Vaccines for Active Immunization of the Immunocompromised Host

Liise-anne Pirofski and Arturo Casadevall*

Division of Infectious Diseases, Department of Medicine, and Department of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, New York 10461

The latter part of the 20th century has witnessed an unprecedented rise in the number of individuals with impaired immunity. This is primarily attributable to the increased development and use of antineoplastic therapy for malignancies, organ and bone marrow transplantation, and the AIDS epidemic. Individuals with impaired immunity are often at increased risk for infections, and they can experience more severe and complicated courses of infection. The lack of therapy for a variety of viruses and the rise in antimicrobial resistance of many pathogens have focused attention on vaccination to prevent infectious diseases. The efficacy of most licensed vaccines has been established in immunocompetent hosts. However, there is also considerable experience with most vaccines in those with impaired immunity. We reviewed the use of licensed live, inactivated, and polysaccharide vaccines in this group, and several themes emerged: (i) most vaccines are less immunogenic in those with impaired immunity than in normal individuals; (ii) live vaccines are generally contraindicated in this group; and (iii) the efficacy of many commonly used vaccines has not been established in people with impaired immunity. This review suggests that for most vaccines there are little or no efficacy data in those with impaired immunity but their use in this patient group is generally safe.

* Corresponding author. Mailing address: Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461. Phone: (718) 430-4260. Fax: (718) 430-8968. E-mail: casadeva{at}aecom.yu.edu.

Clinical Microbiology Reviews, January 1998, p. 1-26, Vol. 11, No. 1
0893-8512/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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Antimicrob. Agents Chemother. Clin. Vaccine Immunol.
J. Clin. Microbiol. ALL ASM JOURNALS

Copyright © 1998 by the American Society for Microbiology. All rights reserved.