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People who are immunocompromised have an increased risk of disease. They may need extra doses of some vaccines to optimise protection. Some vaccines are contraindicated in these people. Immunosuppression can be caused by autoimmune conditions, therapy such as corticosteroids or DMARDs, cancer and cancer therapy, HIV, solid organ transplant, haematopoietic stem cell transplant, or functional or anatomical asplenia. Give influenza, pneumococcal and other inactivated vaccines as required to all people who are immunocompromised. People on immunosuppressive therapy and people who have received a transplant may need extra doses of some vaccines either before or after treatment. Do not give live vaccines to people who are severely compromised. People who are less severely compromised may be able to receive live vaccines, depending on their level of immunocompromise. These vaccines may include MMR, MMRV, rotavirus, zoster and yellow fever. Do not give BCG or oral typhoid vaccines to anyone who is immunocompromised. Household contacts should be fully vaccinated to protect the person who is immunocompromised. Household contacts can safely receive live vaccines. If unsure about whether to vaccinate, check with the person’s treating physician or an immunisation specialist. See the Australian Immunisation Handbook for more details.


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bacille Calmette-Guérin