title: Immunization of children with secondary immunodeficiency.
abstract: The main causes of secondary immunodeficiency at a pediatric age include infectious diseases (mainly HIV infection), malignancies, haematopoietic stem cell or solid organ transplantation and autoimmune diseases. Children with secondary immunodeficiency have an increased risk of severe infectious diseases that could be prevented by adequate vaccination coverage, but vaccines administration can be associated with reduced immune response and an increased risk of adverse reactions. The immunogenicity of inactivated and recombinant vaccines is comparable to that of healthy children at the moment of vaccination, but it undergoes a progressive decline over time, and in the absence of a booster, the patients remain at risk of developing vaccine-preventable infections. However, the administration of live attenuated viral vaccines is controversial because of the risk of the activation of vaccine viruses. A specific immunization program should be administered according to the clinical and immunological status of each of these conditions to ensure a sustained immune response without any risks to the patients' health.
authors.affiliation: a Pediatric Highly Intensive Care Unit; Department of Pathophysiology and Transplantation ; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico ; Milan , Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.affiliation: a Pediatric Highly Intensive Care Unit; Department of Pathophysiology and Transplantation ; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico ; Milan , Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Prada
authors.affiliation: a Pediatric Highly Intensive Care Unit; Department of Pathophysiology and Transplantation ; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico ; Milan , Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Lelii
authors.affiliation: a Pediatric Highly Intensive Care Unit; Department of Pathophysiology and Transplantation ; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico ; Milan , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Castellazzi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017589:Immunization Programs; D007153:Immunologic Deficiency Syndromes; D007223:Infant; D007231:Infant, Newborn; D014612:Vaccines / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*
chemical_list: D014612:Vaccines
keywords: HIV; autoimmune disease; cancer; immunosuppressive drugs; prevention; secondary immunodeficiency; transplantation; vaccination; vaccine