[Vaccination and infection protection in patients with acquired or congenital immunodeficiency].
INDICATIONS FOR VACCINATIONS IN IMMUNODEPRESSED PATIENTS: The indication for vaccination depends on the demonstration of their efficacy and tolerance. Few studies have demonstrated a clinical benefit in this heterogeneous population and generally have enrolled splenectomized patients.
Basically, the efficacy of vaccination is assessed from the post-vaccinal immune response which is generally altered in immunodepressed patients. This is specifically demonstrated for polysaccharide anti-pneumococcal vaccine. Thus, classical vaccinations with minimal immunogenic power that do not induce a memory response are not particularly effective for these patients. Indications are very controversial.


CONCLUSIONS
Recently developed conjugated vaccines (anti-haemophilus, anti-pneumococcal vaccines) are more immunogenic and offer interesting perspectives for new vaccination strategies in immunodepressed patients with a major risk of severe infection or infection caused by resistant strains.
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Service d'Immunologie clinique, Hôpital Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, F 94010 Créteil. clinic.immunol@hmn.ap.hp-hop.paris.fr
D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications* / Q000151:congenital; D011008:Pneumococcal Infections / Q000209:etiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines; D014765:Viral Vaccines; D014777:Virus Diseases / Q000209:etiology / Q000517:prevention & control*
D022242:Pneumococcal Vaccines; D014765:Viral Vaccines