Safety of live-virus vaccines for children with immune deficiency.
OBJECTIVE
Conduct an integrative literature review to evaluate the safety and effectiveness of live-virus vaccines, namely, the measles, mumps, rubella, and varicella vaccines, in children who are immune compromised by exogenous medication either posttransplant or while undergoing maintenance chemotherapy for leukemia.


METHODS
Medline, MedlinePlus, EBSCO, PubMed, MD Consult, CINAHL, Clinical Pharmacology, ERIC, Biomedical Reference Collection-Basic, Health Source-Consumer Edition, Health Source-Nursing/Academic Edition, Ovid, CANCERLIT, and the Cochrane Library Online.


CONCLUSIONS
Because measles infection has a low incidence rate in the United States, it may be advisable not to vaccinate children who are immunocompromised and risk side effects of the vaccine. In contrast to measles infection, varicella has a higher incidence rate and poses a more imminent threat to those who are immunocompromised. Children who are immunosuppressed can receive the varicella vaccination; however, they should have regular titers drawn to confirm adequate protection against the disease and should receive boosters as deemed appropriate.


CONCLUSIONS
The number of solid organ transplant recipients is steadily increasing with more than 600,000 solid organ transplantations worldwide since the first renal transplant in 1954. The steadily increasing numbers of pediatric patients surviving transplantation, coupled with increased life expectancy, accelerate the need for nurse practitioners to understand the management of these delicate patients following release from the transplant unit.
Luthy
Karlen E
KE
College of Nursing, Brigham Young University, Provo, Utah 84602-5432, USA. beth-luthy@byu.edu
Tiedeman
Mary E
ME
Beckstrand
Renea L
RL
Mills
Debra Ann
DA
D002648:Child; D006301:Health Services Needs and Demand; D006801:Humans; D007117:Immunization, Secondary; D016867:Immunocompromised Host / Q000276:immunology*; D007165:Immunosuppression Therapy / Q000009:adverse effects; D022542:Measles-Mumps-Rubella Vaccine / Q000009:adverse effects* / Q000276:immunology; D017410:Practice Guidelines as Topic; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000628:therapy; D012107:Research Design; D012307:Risk Factors; D012449:Safety; D014181:Transplantation Immunology; D014481:United States / Q000453:epidemiology; D014613:Vaccines, Attenuated / Q000009:adverse effects* / Q000276:immunology
D022542:Measles-Mumps-Rubella Vaccine; D014613:Vaccines, Attenuated