While vaccination is the best tool for prevention of the flu, should patients with immune deficiency be given the vaccine?
Immune deficient patients have a decreased resistance to infections, often have repeated infections, or cope with infections that are more severe and cause unexpected complications.
In general, there are two different types of vaccines. One is a live vaccine, the other is a killed vaccine. Live vaccines contain live bacteria or viruses that have been modified or "attenuated". This means they’ve lost their disease-causing ability or are administered by a route that prevents them from causing clinical disease. Killed vaccines are just what the name says—the bacteria or virus in the vaccine is dead.
The difference between the live and killed vaccines is important for those with immune disorders. The live vaccines should not be given to patients with immune deficiencies. This includes FluMist® live attenuated influenza vaccine (LAIV) which is given as a nasal spray rather than a shot. (For the 2017-18 influenza season, LAIV is actually not recommended for anyone due to being less effective than the flu shot.) Also, family members or household contacts should not receive live vaccines, as they may transmit the live virus to the immune deficient family member.
It is important to emphasize that all patients with immune deficiencies and all members of their families or other household contacts should get the killed vaccine for influenza. Although there is the chance that some patients with immune deficiencies may not have a good immune response, the killed vaccine does not pose any danger. In addition, having family members and other household contacts receive the vaccine reduces their risk of developing influenza and transmitting it to the patient with immune deficiency.
Aside from making sure the immune deficient patient and his or her household members receive vaccinations with the killed influenza virus, preventative measures such as hand washing should be practiced. If you, a family member or household contact begins to have flu symptoms, see a physician. A physician can prescribe anti-viral influenza drugs, which should be taken at the first sign of the symptoms.
Find out more about primary immunodeficiency disease (PIDD).
This article has been reviewed by Thanai Pongdee, MD, FAAAAI