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Because immunocompromised patients have a weakened immune system, they are more susceptible to communicable diseases and sepsis. Therefore, vaccination in these patients is important to prevent infection associated mortality, but vaccination does not come without a possible altered response to the vaccines they are receiving (See, 2022). We will be discussing age group required vaccinations recommended by the Centers for Disease Control (CDC) and how these vaccinations may affect someone who is immunocompromised.

• Immunization recommendations for age group 11-24 (Centers for Disease Control and Prevention, 2023):
  • Tetanus, Diphtheria, Pertussis (Tdap): A booster shot is recommended at age 11–12, followed by a Td (tetanus and diphtheria) booster every 10 years.
  • Human Papillomavirus (HPV): Recommended for both males and females to prevent HPV-related cancers. A series of doses is given at 11–12 years.
  • Meningococcal Conjugate Vaccine: Protects against meningococcal disease. A first dose is recommended at age 11–12, with a booster at 16 years.
  • Influenza: Annual flu vaccination is recommended.
  • COVID-19: Two or Three dose primary series and booster.
• Immunization recommendations for age group 25-64 (Centers for Disease Control and Prevention [CDC], 2023):
  • Tetanus, Diphtheria, Pertussis (Tdap): Booster every 10 years.
  • Human Papillomavirus (HPV): Catch-up vaccination for those who didn’t receive it earlier (up to age 26).
  • Influenza: Annual flu vaccination.
  • Pneumococcal Vaccine: Recommended at age 65 for those who didn’t receive it earlier.
  • Shingles Vaccine: Recommended at age 50 to prevent shingles and its complications.
  • Hepatitis A and B Vaccines: Depending on risk factors and vaccination history.
  • COVID-19: Two or Three dose primary series and booster.
• Immunization Recommendations for age group 65 and older (Centers for Disease Control and Prevention [CDC], 2023):
• Tetanus, Diphtheria, Pertussis (Tdap)/Tetanus, Diphtheria (Td): Booster every 10 years.
• Influenza: Annual flu vaccination.
• Pneumococcal Vaccine: Recommended pneumonia prevention.
• Shingles Vaccine: Recommended if not previously received.
• COVID-19: Two or Three dose primary series and booster.

In general, immunocompromised patients and those on immunosuppressive therapies might require tailored vaccine schedules, additional doses, or specific vaccine types to achieve adequate protection without causing undue risks. They should also be given vaccines when they are least immunosuppressed.

Based on more than 50 systematic reviews published within the last 5 years, immunocompromised patients expecting a good vaccine response would be someone with chronic kidney disease, HIV (with normal CD4 counts), and solid tumor patients. Further, patients expected a poor vaccine response might be patients with B-cell depleting agents, liver cirrhosis, and organ transplant (See, 2022).

Examples of age specific patients:

Age 17, Female (Immunocompromised) on Immunosuppressive Therapy:

Regular Guidelines: Tdap, HPV, Meningococcal, Influenza.

Impact: Her immune system might not respond as effectively, leading to reduced protection from infections targeted by these vaccines. She may require additional doses or alternative vaccination schedules.

Age 45, Male (Organ Transplant Patient) on Immunosuppressive Therapy:

Regular Guidelines: Tdap, Influenza, Pneumococcal, Shingles (if eligible).

Impact: Immunosuppressive drugs might weaken his ability to generate a strong immune response to vaccines. The vaccine efficacy could be lower, necessitating careful monitoring and potential revaccination.

Age 70, Female (Immunocompetent) with Rheumatoid Arthritis on Immunosuppressive Medication:

Regular Guidelines: Tdap/Td, Influenza, Pneumococcal, Shingles.

Impact: The immunosuppressive medication could somewhat reduce her immune response, but the risk is lower than in severely immunocompromised individuals. She might still benefit from the vaccines, but the healthcare provider might need to time them between doses of her immunosuppressive medication.