Immunisation in special circumstances
Vaccination Recommendation in HIV infected child
• Live vaccines should be given in asymptomatic HIV infected children except BCG and OPV.
• In symptomatic child all live vaccines are forbidden, but Measles / MMR / Varicella vaccines may be considered if CD4+ count is >15% (Pediatrican will guide you).
• Post-vaccination regular monitoring of seroconversion (protection) should be done for killed vaccines in an HIV infected child.
Vaccination Recommendation in Human Stem Cell Transplant recipient
• 3 doses of DT should be given after 6 months. If the child is more than seven years of age Tdap 1 dose & Td 2 doses can be given.
• 3 doses of Injectable Poilo vaccine (IPV), Hemophilus influenzae b (Hib) and Hepatitis B vaccine should be given after 6-12 months.
• 3 doses of Pneumococcal conjugated vaccine (PCV) should be given after 3-6 months & 1 dose of Pneumococcal polysaccharide vaccine (PPSV) (if no GVHD).
• 1 dose of Influenza vaccine (IIV) should be given after 6 months & then annually.
• 2 doses of Meningococcal vaccine (MCV4) should be given after 6-12 months.
• 3 doses of Human papilloma virus vaccine (HPV) should be given after 6-12 months to girls 11-26 years.
• No Live vaccine should be given in active GVHD & immunosuppression. Your pediatrician will guide you for this.
Vaccination recommendation in children on oral steroids
• No live vaccines given for 4 weeks after stopping steroids.
• Killed vaccines are also less effective if given after steroids treatment.
Vaccination recommendation in children on IVIG
• After IVIG MMR and Varicella vaccines are not given for 8-11 months.
• After Specific IG MMR and Varicella vaccines are not given for 3 months.
Vaccination recommendation in children on Hematological and solid tumour malignancy
• PCV/PPSV and IIV should be given.
• Other Inactivated vaccines given but not counted
Vaccination recommendation in children on Chemotherapy
• No Live Viral vaccine should be given during chemotherapy.
• Inactivated vaccines and MMR-V can be given after 3 months.
Vaccination recommendation in children whose Spleen is removed
Pneumococcal, Hib, Meningococcal & Typhoid vaccines should be given two weeks before or weeks after the surgery.