Safety of live-virus vaccines for children with immune deficiency
Article first published online: 25 SEP 2006
2006 American Academy of Nurse Practitioners
Journal of the American Academy of Nurse Practitioners
Volume 18, Issue 10, pages 494–503, October 2006
How to Cite
Luthy, K. E., Tiedeman, M. E., Beckstrand, R. L. and Mills, D. A. (2006), Safety of live-virus vaccines for children with immune deficiency. Journal of the American Academy of Nurse Practitioners, 18: 494–503. doi: 10.1111/j.1745-7599.2006.00163.x
- Issue published online: 25 SEP 2006
- Article first published online: 25 SEP 2006
- Received: December 2005; accepted: April 2006
- immune suppressed;
- immune compromised;
- live-virus vaccine;
Purpose: 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.
Data sources: 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.
Implications for practice: 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.