Have you ever wondered why a “family history of altered immunocompetence” is listed as a contraindication to getting varicella and MMR vaccines?
It’s probably not why you think…
Is a Family History of Altered Immunocompetence a Contraindication to Getting Vaccinated?
Which vaccines are contraindicated if you have a family history of altered immunocompetence?
Typically MMR and Varivax, the chicken pox vaccine.
Is this about side effects?
Kind of.
As they are live vaccines, you don’t usually want to give them to anyone who might be immunocompromised. And since some conditions that cause immune system problems can run in families, if there is a family history of these conditions, you want to make sure your child doesn’t have one before they are vaccinated.
(g) family history of congenital or hereditary immunodeficiency in first-degree relatives (e.g., parents and siblings), unless the immune competence of the potential vaccine recipient has been substantiated clinically or verified by a laboratory.
General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP)
Fortunately, these types of severe immune problems are rare.
They might include:
- Severe antibody deficiencies (e.g., X-linked agammaglobulinemia and common variable immunodeficiency)
- Complete defects (e.g., SCID disease, complete DiGeorge syndrome)
- Partial defects (e.g., most patients with DiGeorge syndrome, Wiskott-Aldrich syndrome, ataxia- telangiectasia)
- Phagocytic deficiencies that are undefined or accompanied by defects in T-cell and NK cell dysfunction (such as a Chediak-Higashi syndrome, Leukocyte Adhesion Deficiency [LAD], and myeloperoxidase deficiency)
Talk to your pediatrician if your child has a first degree relative with one of these conditions, before they get their MMR or chicken pox vaccines.
Still, by twelve months, infants with a severe congenital or hereditary immunodeficiency or any other severe immunodeficiency will almost certainly have symptoms already.
Most children, for example, had been diagnosed with severe combined immunodeficiency (SCID), in early infancy when they have severe and life-threatening infections and failure to thrive.
And most newborns in the United States are now screened for SCID as a part of their routine newborn screening test, and can be diagnosed and treated before they have symptoms! That’s also long before they might be due for their MMR or chicken pox vaccines.
So, if your child has a family history of congenital or hereditary immunodeficiency, and it is in a first-degree relative, but has no symptoms themselves, then they can get safely vaccinated on schedule.
Not surprisingly, anti-vaccine folks try to abuse their family history of altered immunocompetence as an vaccine exemption, even when their own child isn’t immunosuppressed!
More on Vaccine Contraindications
- 10 Warning Signs of Primary Immunodeficiency
- CDC – General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP)
- CDC – Altered Immunocompetence
- Severe Combined Immune Deficiency and Combined Immune Deficiency
- 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
- About Primary Immunodeficiencies
- Fearless Defenders of the Immunocompromised Patient
- Vaccinations and Immunocompromised Children
- WHO – Contraindications – WHO Vaccine Safety Basics