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January 2014
Top Story
Updated Guideline for Vaccination of Immunocompromised Host Now Available
IDSA has updated its Guideline for the Vaccination of the Immunocompromised Host in an effort to make it easier for clinicians to rapidly find vaccine recommendations for this patient population. The ultimate goal is to decrease morbidity and mortality from vaccine-preventable infections in immunocompromised patients.  
The guideline recommends that primary care clinicians and subspecialty providers share responsibility for ensuring appropriate vaccination of these patients. Vaccination of children and adults with primary immunodeficiencies are discussed, as are patients with a secondary deficiency including HIV infection, cancer treatment, stem cell or solid organ transplant, asplenia, cochlear implant, CSF leak, and patients with chronic inflammatory diseases treated with immunosuppressive therapies. Vaccinations of immunocompetent contacts of patients who have defense abnormalities and travel-related vaccination are also addressed. 
“The guideline provides ‘one-stop shopping’ for clinicians caring for children and adults with compromised immune systems and includes recommendations and evidence for most vaccinations, from influenza to chicken pox,” said Lorry G. Rubin, MD, FIDSA, 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.” Dr. Rubin is 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 and professor of pediatrics at Hofstra North Shore-LIJ School of Medicine.
The vast majority of the recommendations contained in the guideline conform to recommendations of the Advisory Committee on Immunization Practices and the American Academy of Pediatrics. The guideline provides recommendations for most vaccines, including the appropriate use of varicella and zoster vaccines, in easy-reference tables.
Areas where future research is warranted are outlined, such as establishment of a registry of immunocompromised vaccine recipients and research regarding the efficacy and safety of zoster vaccine in these patient populations.
The evidence-based guideline was prepared by an international panel of pediatric and adult experts in infectious diseases, immunology, oncology, stem cell and solid organ transplant, gastroenterology, and rheumatology.
The full guideline is available online and will also appear in the February 1 issue of Clinical Infectious Diseases. Visit the practice guidelines section of the IDSA website for additional guidelines and related resources.

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