IMMUNIZATION AND SYSTEMIC-DISEASES - IMMUNIZATION AND IMMUNE-DEFICIENCY

The hypothesis of systemic disease flare up or onset triggered by vacc ination cannot be confirmed by the analysis of data from the literatur e, In immune deficiency of any cause, immunization is of great interes t to avoid preventable infectious diseases but the risk of adverse eve nts and suboptimal immunologic responses has to be considered. For liv e, attenuated vaccines the main risks are postimmunization complicatio ns, specially in persons severely immunocompromised. For killed or ina ctivated vaccines there are no contraindications, but the immune respo nse is reduced leading to consider higher vaccine doses or more freque nt boosters. However the response to such modifications of vaccine sch edules has not been systematically evaluated and firm recommendations cannot be made at this time. In addition, in HIV infection, the effect of vaccination on viral replication has to be considered. In developi ng countries some live vaccines are still recommended in HIV+ children because of the prevalence of the target-diseases (measles, poliomyeli tis, tuberculosis...) and the rarity of complications.