Table. Vaccination for people with inborn errors of immunity (IEI)
| Category of IEI | Examples of specific immunodeficiency diagnoses | Risk-specific recommended vaccines | Contraindicated vaccines |
|---|---|---|---|
| Antibody (B-cell) immunodeficiencies |
Less severe antibody immunodeficiencies, such as:
|
Some vaccines have altered primary dosing schedule: Additional doses of some vaccines are generally recommended:
|
Live vaccines are generally contraindicated (including LAIV), except MMR and monovalent varicella vaccines, which can be given to people with partial antibody immunodeficiency and known intact T-cell immunity. |
|
Severe antibody immunodeficiencies, such as:
|
Some vaccines have altered primary dosing schedule:
Additional doses of some vaccines are generally recommended:
|
All live vaccines are contraindicated, including LAIV. | |
| T-cell or combined (T- and B-cell) immunodeficiencies |
Less severe or partial immunodeficiencies, such as:
|
Some vaccines have altered primary dosing schedule: Additional doses of some vaccines are generally recommended:
|
Live vaccines are generally contraindicated (including LAIV), except MMR and monovalent varicella vaccines, which can be given to people with partial T-cell or less severe combined immunodeficiencies with a CD4+ count >500 cells/μL and normal mitogen response. |
|
Severe immunodeficiencies, such as:
|
Some vaccines have altered primary dosing schedule:
Additional doses of some vaccines are generally recommended:
|
All live vaccines are contraindicated, including LAIV. | |
| Phagocytic and neutrophil disorders | Congenital neutropenia Cyclic neutropenia Leukocyte adhesion and migration defects Chronic granulomatous disease Myeloperoxidase deficiency Chédiak–Higashi syndrome |
Some vaccines have altered primary dosing schedule: Additional doses of some vaccines are generally recommended:
|
Live bacterial vaccines are contraindicated. Live viral vaccines are generally contraindicated (including LAIV), except for patients with chronic granulomatous disease. All live vaccines are contraindicated in people with leukocyte adhesion defect, myeloperoxidase deficiency and Chédiak–Higashi syndrome, and other defects of cytolytic granule release. |
| Defects of innate immunity | IFNAR defects IFN-gamma/IL-12 axis defects Defects in cytokine generation Toll-like receptor signalling pathway deficiencies (IRAK4 and MyD88 deficiency) |
Some vaccines have altered primary dosing schedule: Additional doses of some vaccines are generally recommended:
|
Live vaccines are contraindicated according to susceptibility to pathogens.
People with defects in the IFN-gamma/IL-12 axis can receive live viral vaccines. |
| Complement deficiency | Primary deficiencies in complement, properdin, factor D or B, and mannan-binding lectin Secondary deficiencies due to complement inhibitor therapies, such as eculizumab, ravulizumab and pegcetacoplan (see Secondary (acquired) immunodeficiency due to medical therapies) |
Additional doses of some vaccines are generally recommended:
|
No vaccines are contraindicated. |
|
Acronyms used:
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