We know that immunocompromised kids are especially at risk from vaccine preventable diseases, both because they are immunocompromised and because they often can’t get vaccinated or fully vaccinated.

That why herd immunity is important and there are immunization protocols for immunocompromised kids.

About That Johns Hopkins Protocol of Immunocompromised Kids…

One of the most commonly followed protocols, 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host, was recently published by the Infectious Diseases Society of America.

“Healthy immunocompetent individuals who live in a household with immunocompromised patients should receive the following live vaccines based on the CDC annual schedule: combined measles, mumps, and rubella (MMR) vaccines; rotavirus vaccine in infants aged 2–7 months; varicella vaccine (VAR); and zoster vaccine (ZOS). Also, these individuals can safely receive the following vaccines for travel: yellow fever vaccine and oral typhoid vaccine.”

2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host

There are also guidelines from the Medical Advisory Committee of the Immune Deficiency Foundation, the ACIP, and the American Academy of Pediatrics.

All of the protocols support kids getting vaccinated and protected, unless they have a medical exemption, and that their contacts get vaccinated and protected.

That’s why it is surprising to hear what Robert F. Kennedy, Jr had to say about the protocol he reviewed from Johns Hopkins.

“So I went to the Johns Hopkins protocols for immunocompromised children. And I read it. And when I read it, it’s a long, dense document, but there’s no place in that entire document that said immunocompromised children should be kept away from unvaccinated children. Do you know what there is? Ah! It says that the real danger to immunocompromised children is vaccinated children, because, whatever you do, don’t let your immunocompromised child near a child who has recently, meaning six weeks, had a chickenpox vaccine. Don’t let your child anywhere near a child who has had a polio vaccine. Or a pertussis vaccine. And that’s the worst one. Because the child with pertussis has no knowledge that he has pertussis. He is an asymptomatic carrier. But he can pass it to your child. And he is more likely to pass it to your child if he is vaccinated!”

Robert F. Kennedy, Jr

Where is this Johns Hopkins protocol that Kennedy read?

He can’t be referring to the old version of the Johns Hopkins Hospital Patient Information Guide for the Immunocompromised Patient, can he? The revised Johns Hopkins Hospital Patient Information Guide no longer routinely warns about contact with children who were recently vaccinated.

Although anyone with a severe immunodeficiency should avoid those who have recently received the oral polio vaccine, that vaccine hasn’t been used in the United States since 2000. Also, you don’t have to avoid folks who have received the chickenpox vaccine, unless they get a rash and it is uncovered. And you certainly don’t have to avoid anyone who has received the pertussis vaccine, as it is not a live vaccine.

The Johns Hopkins Hospital Patient Information Guide does warn those who are immunocompromised to “Tell friends and family who are sick not to visit.”

Who’s more likely to get sick with things like measles, chickenpox, and pertussis?

Folks who are unvaccinated!

“The threat of pertussis and other childhood communicable diseases to children with immunodeficiency is particularly alarming. The increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children. The immunosuppressed subject is particularly at risk in crowded living conditions because of the spread of these diseases by aerosol droplets or through the oral-fecal route.”

Medical Advisory Committee of the Immune Deficiency Foundation on Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

Has Kennedy read the protocols from the Immune Deficiency Foundation? They do warn of the risk from intentionally unvaccinated kids!

Has he read the Johns Hopkins Hospital Patient Information Guide, which was updated at least two years ago?

Have you, especially if you are thinking about skipping or delaying your child’s vaccines?

More on the Johns Hopkins Protocol of Immunocompromised Kids…

• Are There 6 Reasons to Oppose SB276?
• Why Is Lying About Vaccines Not Criminal?
• Doing the Math on Kennedy, Vaccines and Mercury
• People with Cancer Are at Risk from Unvaccinated Kids
• Does Getting the DTaP Vaccine Make You More Susceptible to Pertussis?
• Can Vaccinated Children Be Asymptomatic Carriers of Pertussis
• Do More Vaccinated or Unvaccinated Kids Get Pertussis?
• More Misinformation on Vaccine Shedding
• Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts
• 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host
• Fearless Defenders of the Immunocompromised Patient
• Vaccinations and Immunocompromised Children
• CDC –  Altered Immunocompetence Guidelines for Immunizations (ACIP)
• AAP – Immunization in Immunocompromised Children (Red Book)