title: Immunization in the adult immunocompromised host.
abstract: The number of patients with impaired immune response has been steadily increasing within the last years, not only with the onset of the AIDS epidemic, but also due to increasing numbers of subjects on immunosuppressive therapies. These patients are at an increased risk for infections, many of which are preventable by immunization. Inactivated vaccines are generally safe in subjects with underlying immunosuppression. However, immune response and protection may be hampered, depending on the extent of immunosuppression. In contrast, live vaccines such as yellow fever, measles, rubella, herpes zoster, and cholera may lead to severe reactions in immunocompromised patients and have been shown to deteriorate some immune-mediated diseases such as multiple sclerosis. Data on the efficacy of vaccines in biological therapies is scarce. Where necessary vaccines should be updated before immunosuppressive therapies are started. To improve the vaccination status several guidelines exist for immunosuppressed patients at risk such as those with rheumatic diseases, asplenia or solid organ and hematopoietic stem cell transplantation.
authors.affiliation: Department of Tropical Medicine and Infectious Diseases, University of Rostock, Rostock, Germany. micha.loebermann@uni-rostock.de
authors.forename: Micha
authors.initials: M
authors.lastname: Löbermann
authors.forename: Denise
authors.initials: D
authors.lastname: Boršo
authors.forename: Inken
authors.initials: I
authors.lastname: Hilgendorf
authors.forename: Carlos
authors.initials: C
authors.lastname: Fritzsche
authors.forename: Uwe K
authors.initials: UK
authors.lastname: Zettl
authors.forename: Emil C
authors.initials: EC
authors.lastname: Reisinger
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D001428:Bacterial Vaccines / Q000008:administration & dosage / Q000276:immunology*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007114:Immunization / Q000009:adverse effects; D016867:Immunocompromised Host / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D017053:Infection Control; D007239:Infections / Q000209:etiology; D009103:Multiple Sclerosis / Q000209:etiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D012306:Risk; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000276:immunology; D014765:Viral Vaccines / Q000008:administration & dosage / Q000276:immunology*
chemical_list: D001428:Bacterial Vaccines; D007166:Immunosuppressive Agents; D014613:Vaccines, Attenuated; D014765:Viral Vaccines