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  New IDSA Guideline Provides Vaccine Recommendations
For People with HIV Infection, Cancer and Other Conditions


People with compromised immune systems - such as those with cancer, HIV infection and Crohn's disease - are especially vulnerable to illness and most should receive the flu shot and other vaccinations, notes a new guideline released by the Infectious Diseases Society of America (IDSA). Vaccination rates tend to be lower in patients with compromised immune systems in part because their physicians may be concerned about safety and effectiveness.
Written to address a void in comprehensive recommendations for vaccinations of all different types of immunocompromised patients, the "Clinical Practice Guideline for the Vaccination of the Immunocompromised Host" will be published online Dec. 5 inClinical Infectious Diseases. The new guideline is particularly helpful for primary care physicians and specialists who treat immunocompromised patients. It also provides recommendations for vaccination of people who live with immunocompromised patients.
"The guideline provides 'one-stop shopping' for clinicians caring for children and adults with compromised immune systems and includes recommendations and evidence for all vaccinations, from influenza to chicken pox," said Lorry G. Rubin, MD, director of the Division of Pediatric Infectious Diseases at the Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park, professor of pediatrics at Hofstra North Shore-LIJ School of Medicine and lead author of the guideline. "Previously, the recommendations were difficult to retrieve because in most cases information had to be accessed individually by vaccine rather than by the category of patient disease."
The guideline includes recommendations for most available vaccinations, ranging from hepatitis A, measles, mumps and rubella (MMR) and other childhood vaccinations to those for influenza, pneumococcus and herpes zoster. The guideline notes most immunocompromised patients six months or older should receive the annual influenza shot, but should not receive the live attenuated influenza vaccine that comes in the form of a nasal spray. Patients receiving intensive chemotherapy or who have received anti-B-cell antibodies in the previous six months are unlikley to benefit from a flu shot.
The guideline covers patients with:
· congenital immune deficiencies
· cancer
· solid organ transplant (such as kidney and liver)
· stem cell transplant
· chronic inflammatory conditions (such as rheumatoid arthritis and Crohn's disease)
· sickle cell disease and asplenia
· cochlear implants and
· cerebrospinal fluid (CSF) leaks.
The guideline panel includes adult and pediatric specialists in gastroenterology, immunology, infectious diseases, hematology, oncology, rheumatology and stem-cell and solid-organ transplantation. In addition to Dr. Rubin, the panel includes: Myron J. Levin, MD, Per Ljungman, MD, PhD, E. Graham Davies, MD, Robin Avery, MD, Marcie Tomblyn, MD,Athos Bousvaros, MD, Shireesha Dhanireddy, MD, Lillian Sung, MD, PhD, Harry Keyserling, MD, and Insoo Kang, MD.As with other IDSA guidelines, the vaccination of immunocompromised patient guideline will be available in mobile device and pocket-sized quick-reference editions. These and other guideline related products will be made available on the IDSA website at www.idsociety.org.
Note: For an advance copy of the vaccination of immunocompromised patients guideline, to be published in the Feb. 1, 2014 issue of Clinical Infectious Diseases, please contact Jerica Pitts at (312) 558-1770 or jpitts@pcipr.com. The guideline is embargoed until 12:01 a.m. EDT on Dec. 5.
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Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty.
The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, patient care, prevention, and public health. The Society, which has nearly 10,000 members, was founded in 1963 and is based inArlington, Va. For more information, see www.idsociety.org.
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